Background 

Sexual and reproductive health (SRH) is a state of complete physical, mental, and social well-being regarding the reproductive system, not merely the absence of disease [1]. The death of a woman while pregnant or within 42 days of termination of pregnancy is maternal mortality.  

Globally, as of 2023, approximately 700 to over 800 women die every day from preventable causes related to childbirth and pregnancy [2]. The global mortality rate is estimated at 454 per 100,000 live births [2]. The maternal mortality ratio (MMR) in Africa is the highest in the world, with Sub-Saharan Africa accounting for roughly two-thirds of global maternal deaths, estimates indicate an average of 545 per 100,000 live births (2023) [3].  

Nigeria accounts for roughly 20-29% of global maternal deaths, with an estimated maternal mortality ratio estimated at 993 per 100,000 live births (2023) often driven by low uptake of modern contraception [4]. Sexual and reproductive health (SRH) issues, including complications from pregnancy, childbirth, and unsafe abortion, cause nearly all maternal deaths in Nigeria, with haemorrhage (23%), sepsis (17%), and unsafe abortions (11–13%) being the primary drivers [5]. The SDG [3.1] targets to have fewer than 70 maternal deaths per 100,000 live births by 2030. Achieving a global MMR below 70 by the year 2030 will require an annual rate of reduction of almost 15%, a rate that has rarely been achieved at the national level.  

Improving access to sexual and reproductive health services is essential to overcoming the barriers that limit its uptake. Expanding access to modern contraceptives and safe abortion care can reduce maternal deaths by as much as twothirds, empowering women and girls of reproductive age (14–49 years) to make informed decisions about their reproductive health. This helps prevent unintended pregnancies, supports healthier pregnancies, and enhances both maternal and child health. To make informed SRH choices, women and girls must be aware of the services available and able to obtain them promptly whenever they need care. 

Sexual and Reproductive Health (SRH) Services 

Sexual and reproductive health (SRH) services are comprehensive healthcare, information, and education programs including contraception, STI/HIV prevention, maternal and newborn care, cancer screening (HPV/Cervical), gender-based violence (GBV) support and fertility treatment.  

These services are essential to public health, enabling individuals to make informed decisions about their sexual and reproductive lives, reducing maternal and newborn mortality, and promoting equality. They are often provided in Primary health care centres, clinics, hospitals, and through community outreach which caters to adolescents, adults, and vulnerable populations.  In many settings, these services are available but with low uptake of available sexual and reproductive health services [6].  

What is currently being done? 

The Nigerian government, working alongside key partners such as UNFPA, WHO, Society for Family Health (SFH), and Pathfinder International, adopts a comprehensive strategy to boost the use of sexual and reproductive health (SRH) services. These efforts prioritize expanding access to contraception, strengthening the quality of care, and reducing sociocultural barriers through targeted, youthcentred programs. Despite the extensive efforts of the Nigerian government and its partners, modern contraceptive uptake remains far below national targets [7]. Although awareness of contraceptive options is high, utilization continues to be undermined by deepseated, persistent barriers that have yet to be effectively addressed. 

Modern Contraceptives 

Modern contraceptives are safe, scientifically proven methods for preventing pregnancy. They fall into several categories, including longacting reversible contraceptives (LARCs), hormonal options, barrier methods, and permanent sterilization. Common choices such as implants, intrauterine devices (IUDs), injectables, oral contraceptive pills, and condoms differ in their level of effectiveness and the degree of user involvement required. In some settings, limited or unclear counselling on oral contraceptives has contributed to the frequent use of Emergency Contraceptive Pills (ECPs) as a routine method, despite ECPs being intended for occasional use within 5 days of unprotected sexual intercourse [8]. This highlights the need for strengthened provider training to ensure accurate contraceptive counselling and support informed decisionmaking among clients. 

Barriers to SRH service uptake 

Barriers to sexual and reproductive health (SRH) are those obstacles that prevent individuals from accessing, utilizing and receiving quality care. These barriers often stem from deep-rooted cultural, religious, and socioeconomic factors that restrict access to information, services, and maternal care. Even when people are aware of these services, factors such as cultural stigma, biased attitudes from healthcare providers, concerns about privacy, and misinformation prevent many from using them. Although access to information on sexual and reproductive health services still plays a role in underutilization, tackling these deep-rooted barriers will be mutually beneficial in opening more opportunities that will enable optimization and uptake of SRH services. 

Improving Sexual and Reproductive Health 

Improving sexual and reproductive health requires efforts in addressing barriers to access sexual and reproductive health services. The several ways through which access can be improved include: 

• Advocacy and Community Engagement: Engaging cultural and religious leaders to address community norms that restrict young people’s access to sexual and reproductive health (SRH) services, particularly norms that frame such services as taboo or morally inappropriate for unmarried youth. When influential leaders publicly support discussions on SRH, it shifts community norms in a positive way to accepting SRH services as essential while building trust and an enabling environment for policy implementation. It also encourages parents and guardians support service uptake. 

• SRH Sensitization and Youth Engagement: Reducing social stigma and shame associated with seeking care after experiencing sexual violence, and address misconceptions that individuals with disabilities are not sexually active, which often prevents them from accessing essential SRH services. This removes psychological a social barrier to care, promotes inclusivity, and encouraged disclosure and early treatment of sexual violence. 

• Provider Training and Accountability: Retraining health‑care workers to reduce judgmental and harsh attitudes toward adolescents, unmarried individuals, and people experiencing fertility challenges who seek SRH services. This will reduce discrimination and bias in service delivery, enhance quality counselling and information, promotes youth-friendly care and builds accountability which in turn improves uptake of SRH services. 

• SRH Education: Promoting awareness initiatives to improve women’s autonomy over their body including informed contraceptive use, and decision-making during childbirth such as opting for C-Section without labelled weak or stigmatized. This enhances knowledge and improves maternal health decision making towards SRH services. 

• Health System Strengthening: Integrating digital health in SRH service delivery will open a path for young girls and women to interact with the service providers anonymously using a health app can improve their uptake of these available services. Anonymity of patients name and age can also reduce the bias from the health care workers and improve trust in seeking care.  

• Financing and Insurance Coverage: Ensuring that sexual and reproductive health (SRH) services is comprehensively covered under national and private healthinsurance schemes will improve affordability and equitable access. The outcome will lead to reduced financial barrier to SRH, improve access to vulnerable groups, and encourages routine and preventive care. 

Sydani Group remains committed to implementing targeted solutions to reducing preventable deaths by expanding access to skilled birth attendants, improving emergency obstetric care, strengthening primary healthcare systems, increasing access to contraceptive services including providing health talks on family planning and reproductive health at the community level. 

In conclusion, the primary barrier to increased use of sexual and reproductive health (SRH) services is the persistence of community norms often reinforced by cultural and religious interpretations and the bias of healthcare workers that discourage adolescents and unmarried people from seeking care. The most effective immediate intervention is sustained community engagement with cultural and religious leaders and continuous health system strengthening approach to normalize SRH accurate information circulation and serviceseeking among youth. This approach is expected to increase timely uptake of contraception and maternal health services, reduce unintended pregnancies and preventable complications, and contribute to lowering maternal mortality. By improving uptake of SRH services, Nigeria can accelerate progress toward SDG 3.1 (reducing the maternal mortality ratio) through greater prevention, earlier careseeking, and more consistent use of quality maternal and newborn services.  

References 

1. World Health Organization (2006a). Sexual and reproductive health and Research. Accessed on 25/01/2026. Available at https://www.who.int/teams/sexual-and-reproductive-health-and-research/key-areas-of-work/sexual-health/defining-sexual-health  

1. World Health Organization (2025). Maternal Mortality Factsheet. Accessed on 25/01/2026. Available at https://www.who.int/news-room/fact-sheets/detail/maternal-mortality  

1. World Bank Group (2024). Economics. Accessed on 25/01/2026. Available at https://genderdata.worldbank.org/en/economies/nigeria#:~:text=The%20maternal%20mortality%20ratio%20in,200  

1. United Nations Children’s Fund (2025). Maternal Mortality. Accessed on 25/01/2026. Available at https://data.unicef.org/topic/maternal-health/maternal-mortality/#:~:text=Levels%20of%20maternal%20mortality,%2C%20delivery%2C%20and%20postpartum%20care.  

1. Izugbara, C., Wekesah, F., Adedini, S. A. (2016). Maternal Health in Nigeria: A situation update. Research Gate. https://doi.org/10.13140/RG.2.1.1291.9924    

1. Olajubu, A. O., Olowokere, A. E., & Naanyu, V. (2025). Barriers to Utilization of Sexual and Reproductive Health Services among Young People in Nigeria: A Qualitative Exploration Using the Socioecological Model. Global qualitative nursing research, 12, 23333936241310186. https://doi.org/10.1177/23333936241310186 

1. Jegede, A. S., Adewole, I. F., Ejiade, O. O., Abdullahi, A. M., Adebiyi, A., Okara, D., … & Yusuf, O. B. (2022). Uptake of modern and traditional contraceptive methods in Nigeria: Lessons from a nationwide initiative on programming for results (2015-2018). African Journal of Reproductive Health, 26(11), 62-68. 

1. WHO (2021). Emergency Contraception. Available at https://www.who.int/news-room/fact-sheets/detail/emergency-contraception [Accessed on 02/02/2026]