Community Development

Silent Reproductive Health Struggles

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Women’s reproductive health is fundamental to their overall well-being, yet millions of women globally and in Nigeria face persistent, often silent challenges that compromise their health, autonomy, and quality of life [1]. Despite progress in some areas, vast inequities remain in access to services, information, and rights leaving many women vulnerable to preventable health problems [2].

One of the major silent struggles is limited access to essential reproductive health services, including family planning, maternal care, and safe delivery support. In sub-Saharan Africa, one in four women who wish to delay or stop childbearing do not use any contraceptive method, reflecting gaps in availability, choice, and quality of reproductive care [1][5]. These shortfalls contribute to high rates of unintended pregnancies, unsafe abortions, and increased maternal morbidity and mortality. Globally, about 800 women die each day from pregnancy-related causes, many of which are preventable with proper services and support [1].

In Nigeria, reproductive health disparities are stark. A survey of reproductive health concerns found that sexual health, contraception, infections, fertility issues, and reproductive cancers were among the most pressing worries for women, indicating broad unmet needs across the reproductive spectrum [3]. Despite various policies, only a few Nigerian states meet benchmarks for women’s participation in decisions about their sexual and reproductive health, reflecting systemic barriers rooted in socio-cultural norms and limited autonomy [4]. Economic challenges also contribute, with millions of women lacking access to modern contraceptives and comprehensive family planning services due to cost, misinformation, fear of side effects, cultural opposition, and weak health systems [5][6].

Another under-recognized struggle is infertility, which affects a significant portion of women yet remains stigmatized and poorly supported. Recent WHO guidance highlights infertility as a major public health concern, with more than one in six people of reproductive age affected [7]. Access to affordable fertility evaluation and treatment is limited in many countries, forcing women to choose between financial hardship and their desire for children [7].

Maternal health remains a critical issue. Globally, approximately 287,000 women die yearly from complications in pregnancy and childbirth, with nearly all these deaths occurring in low- and middle-income settings where health systems are weak and resources scarce [1]. In areas affected by conflict or economic strain, such as parts of northern Nigeria, women face even greater risks due to disrupted services, insecurity, and collapsed care infrastructure [8].

The impact of these struggles extends beyond physical health. When women cannot access respectful, quality reproductive care, the consequences ripple into social and economic domains limiting educational opportunities, reducing workforce participation, and perpetuating cycles of poverty and inequality [2].

Improving women’s reproductive health requires a holistic approach that ensures affordable and accessible services such as contraception, antenatal care, skilled delivery, and emergency support reach even the most underserved communities [1][5], while also equipping women with accurate, culturally sensitive information to make informed choices about their bodies and health [2]. At the same time, policies must actively protect women’s autonomy and reproductive rights by challenging harmful norms and discrimination [2][4], supported by strong, well-funded health systems with trained personnel to guarantee continuity of care, especially in fragile settings [1][8]. Integrating affordable infertility care and psychosocial support into routine reproductive health services is also essential to address the often hidden emotional and social burdens many women silently endure [7].

Speak Wednesday is an initiative of CFHI to address issues around gender-base violence and gender-bias.

References

  1. WHO Regional Office for Africa. Women’s Health. Available from: https://www.afro.who.int/health-topics/womens-health
  2. United Nations Population Fund (UNFPA). New UNFPA report finds 30 years of progress in sexual and reproductive health has mostly ignored the most marginalized communities. Available from: https://www.unfpa.org/press/new-unfpa-report-finds-30-years-progress-sexual-and-reproductive-health-has-mostly-ignored
  3. Sa’adatu TS, Dieng B, Danmadami AM. Reproductive health issues of concern among Nigerians: an online survey. Int J Community Med Public Health. Available from: https://doi.org/10.18203/2394-6040.ijcmph20234114
  4. Premium Times Nigeria. Only eight Nigerian states meet women’s health benchmark – Report. Available from: https://www.premiumtimesng.com/news/top-news/830200-only-eight-nigerian-states-meet-womens-health-benchmark-report.html
  5. World Health Organization. Sexual and Reproductive Health and Research (SRH): Family planning and contraception. Available from: https://www.who.int/teams/sexual-and-reproductive-health-and-research-%28srh%29
  6. Ballard Brief. Barriers to Family Planning for Women in West Africa. Available from: https://ballardbrief.byu.edu/issue-briefs/barriers-to-family-planning-for-women-in-west-africa
  7. WHO releases first global guideline on infertility care. Reddit; 2025. Available from: https://www.reddit.com/r/EmbryologyIVFSupport/comments/1pcjrzh/who_releases_first_global_guideline_on/
  8. AP News. Pregnancy has become a nightmare for many women in Nigeria’s conflict-hit north. Available from: https://apnews.com/article/c5846961ed87cddd8a24d1c2b04564a0

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Cervical Cancer: What Every Woman Should Know

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Cervical cancer remains a significant public health concern for women both globally and in Nigeria, yet it is largely preventable and treatable when detected early. Understanding its causes, risk factors, prevention strategies, and interventions is critical for improving women’s health outcomes. Cervical cancer develops in the cervix, the lower part of the uterus that connects to the vagina and is one of the most common cancers affecting women worldwide. In 2022, an estimated 660,000 new cervical cancer cases were reported globally, with about 350,000 deaths attributed to the disease, largely in low- and middle-income countries due to disparities in prevention and care access [1].

Almost all cervical cancers, over 99%, are caused by persistent infection with high-risk types of Human Papillomavirus (HPV), a sexually transmitted virus. While most HPV infections are naturally cleared by the immune system, persistent infection with oncogenic HPV types, particularly HPV 16 and 18, can lead to abnormal cell changes and eventual cancer over many years if not identified and treated [2]. Beyond HPV infection, several factors increase the risk of cervical cancer in women. HIV infection and weakened immunity accelerate cancer progression [1]. Smoking impairs immune response and promotes cellular changes [3]. Early onset of sexual activity, multiple sexual partners, and long-term use of certain hormonal contraceptives also contribute to heightened risk [4].

Cervical cancer is highly preventable and much more treatable when detected early. HPV vaccination, administered to girls typically aged 9 to 14, is highly effective at preventing infections that cause most cervical cancers [1]. Regular screening through Pap smears or HPV tests allows for the detection of precancerous changes before they progress to cancer, significantly improving treatment outcomes [2]. Despite these preventive measures, in Nigeria, cervical cancer remains the second most frequent cancer among women and a leading cause of cancer-related death [5]. Awareness and screening uptake are low, particularly in rural areas, due to financial barriers, limited access to screening facilities, and insufficient information about prevention [6].

To further reduce the burden of cervical cancer, it is essential to scale up HPV vaccination campaigns targeting adolescent girls before exposure to the virus, expand the availability and affordability of cervical cancer screening at primary healthcare levels, and strengthen health education to promote understanding of cervical health through sustained community engagement. Addressing gender and social barriers that limit women’s access to preventive care is also critical. Cervical cancer should not be a life sentence. With knowledge, preventive action, and supportive community health services, every woman can protect her health and future.

References

  1. World Health Organization. Human papillomavirus (HPV) and cervical cancer fact sheet. Dec 2025. Available from: https://www.who.int/news-room/fact-sheets/detail/human-papillomavirus-%28hpv%29-and-cervical-cancer
  2. World Health Organization. Cervical cancer prevention, diagnosis, and screening overview. Available from: https://www.who.int/cancer/prevention/diagnosis-screening/cervical-cancer/en/
  3. Centers for Disease Control and Prevention. Cervical Cancer Risk Factors. Available from: https://www.cdc.gov/cervical-cancer/risk-factors/index.html
  4. National Cancer Institute. Cervical Cancer Causes, Risk Factors, and Prevention. Available from: https://www.cancer.gov/types/cervical/causes-risk-prevention
  5. World Health Organization Regional Office for Africa. Cervical cancer early detection saves lives (Nigeria). Available from: https://www.afro.who.int/countries/nigeria/news/cervical-cancer-early-detection-saves-lives
  6. The Guardian (Nigeria). Screening, awareness gaps slow cervical cancer elimination. Available from: https://guardian.ng/features/health/screening-awareness-gaps-slow-cervical-cancer-elimination/

 

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Ensuring Health Services Reach Everyone

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Ensuring that health services reach everyone remains one of the world’s most urgent development challenges, especially as global progress toward Universal Health Coverage (UHC) continues to slow. Worldwide, more than 4.6 billion people still lack access to essential health services, leaving millions at risk of preventable illness and financial hardship [1]. Although the global service coverage index has risen from the mid-50s in 2000 to around 71 in 2023, the gains remain uneven and fragile [2]. In Nigeria, persistent gaps in primary healthcare, maternal and newborn services, limited staffing, shortages of essential supplies and unreliable electricity continue to restrict access for many communities, particularly in rural and underserved areas [3,4].

Electricity is one of the most basic requirements for safe and functional health care. In many low-resource settings, including parts of Nigeria, frequent power interruptions limit the ability of facilities to conduct safe night-time deliveries, sterilize equipment, store vaccines, or run lifesaving laboratory tests. Evidence shows that roughly one-third to two-fifths of Nigeria’s primary health care centres still lack stable electricity, forcing some to rely on kerosene lamps, phone flashlights or fuel-powered generators that often fail when needed most [5,6]. Without reliable light and power, both mothers and newborns face heightened risks, and health workers struggle to provide the standard of care for which they are trained.

These structural challenges contribute to persistent health inequalities. Nigeria retains one of the highest maternal mortality ratios globally, despite substantial global declines since the early 2000s [2,7]. Skilled birth attendance an essential determinant of maternal and newborn survival has improved in some regions but still varies widely across northern states, where many young women remain unable to access skilled care at birth [4]. Preventive services such as immunisation have also fluctuated, with pandemic-related disruptions causing setbacks. Although recovery efforts are ongoing, routine immunisation coverage remains below global and regional benchmarks, leaving children in remote communities at disproportionate risk [3,8].

Nonetheless, evidence from recent interventions demonstrates that targeted, practical investments can quickly strengthen essential health services. Solar electrification of primary health care facilities, particularly through durable systems designed for maternal and emergency care, has been shown to improve night-time service delivery, stabilize cold-chain systems and increase overall service availability [6,9]. When paired with training and continuous supervision, such interventions support proper equipment use, routine maintenance and long-term sustainability an approach consistently endorsed by global health experts and backed by facility-level assessments [7]. Furthermore, integrating community engagement, leadership participation and strong referral mechanisms encourages service uptake and strengthens public trust.

To accelerate progress, policymakers, donors, and community leaders must prioritize primary healthcare revitalization, commit to electrifying facilities, invest in continuous staff training, and support service delivery models proven to work. Ensuring that health services reach everyone is both achievable and urgent. With collective action, equitable investment and strengthened partnerships, Nigeria can move closer to a future where every individual regardless of geography or socioeconomic status receives the essential care needed to live a healthy and dignified life.

 

References

  1. World Health Organization. Universal health coverage (UHC) fact sheet. 2024 [cited 2025 Dec 12]. Available from: https://www.who.int/news-room/fact-sheets/detail/universal-health-coverage-%28uhc%29
  2. World Bank. Tracking Universal Health Coverage — 2025 Global Monitoring Report. 2025 [cited 2025 Dec 12]. Available from: https://www.worldbank.org/en/topic/universalhealthcoverage/publication/2025-global-monitoring-report-gmr
  3. WHO. Nigeria Country Health Profile — Health System Performance, Immunisation & Primary Care Indicators. 2024 [cited 2025 Dec 12]. Available from: https://www.who.int/countries/nga
  4. Afape AO, et al. Prevalence and determinants of skilled birth attendance among young women in Northern Nigeria. 2024 [cited 2025 Dec 12]. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11389318/
  5. World Health Organization. Electricity in health-care facilities. 2023 [cited 2025 Dec 12]. Available from: https://www.who.int/news-room/fact-sheets/detail/electricity-in-health-care-facilities
  6. Sustainable Energy for All. Powering primary healthcare in Nigeria. 2024 [cited 2025 Dec 12]. Available from: https://www.seforall.org
  7. World Bank. Maternal mortality ratio — Nigeria. 2024 [cited 2025 Dec 12]. Available from: https://data.worldbank.org/indicator/SH.STA.MMRT?locations=NG
  8. UNICEF. Immunisation data and analysis. 2024 [cited 2025 Dec 12]. Available from: https://data.unicef.org/topic/child-health/immunization/
  9. Nigeria Health Watch. Solar power solutions for primary healthcare centres. 2024 [cited 2025 Dec 12]. Available from: https://articles.nigeriahealthwatch.com/a-solar-power-project-is-keeping-primary-healthcare-centres-running-in-abuja/

 

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UHC Day 2025: Unaffordable health costs? We’re sick of it!

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Universal Health Coverage (UHC) Day is a global reminder that access to quality health care is a fundamental right, not a privilege reserved for the wealthy. This year’s theme, “Unaffordable health costs? We’re sick of it!”, speaks directly to one of the biggest barriers facing millions of Nigerians: skyrocketing healthcare costs and the widening gap between health needs and the ability to pay.

While achieving UHC requires multisectoral commitment, one of the most critical systems needed to bridge this gap is health insurance, an essential mechanism designed to protect individuals from financial hardship, ensure continuity of care, and promote equitable access to essential services. Yet, despite the existence of the National Health Insurance Authority (NHIA) and state-level schemes, enrolment remains abysmally low. Out-of-pocket payments still account for over 76% of total health spending in Nigeria, pushing millions deeper into poverty every year.

Health insurance providers cannot succeed alone; they face chronic underfunding, limited subsidies, weak enforcement, and low public awareness. Sustainable progress requires stronger government leadership, increased premium subsidies for the poor, upgraded health facilities, and digital systems that make enrolment seamless.

Yet progress is possible, and CFHI is proving it every day.

Through relentless community mobilization and strategic partnerships with philanthropists like Satoshi Koiso and development partners such as the Institute of Human Virology Nigeria (IHVN), CFHI has successfully enrolled 224 vulnerable individuals into NHIA-supported health coverage this year alone.

These are not just numbers.

They are mothers who no longer skip medication.

They are children who can see a doctor without their parents selling assets.

They are families now protected from choosing between medicine and food.

Health insurance must be affordable, accessible, and functional for every Nigerian. It is not just a policy tool; it is a lifeline that protects households from falling into poverty and guarantees timely care, especially for vulnerable groups.

On UHC Day 2025, our message is unequivocal:

No Nigerian should be denied quality care because they cannot afford it.

We call on federal and state governments to:

  • Fully subsidize premiums for low-income and vulnerable households
  • Strengthen primary health care facilities that deliver insured services
  • Enforce mandatory coverage and streamline digital enrolment

It is time to end the era of unaffordable health costs.

Health care is a right for every Nigerian, irrespective of socio-economic status.

Together, we can make “We’re sick of it” a rallying cry that finally delivers results.

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Removing Gender Barriers in Healthcare Access

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Removing gender barriers to healthcare is not only a matter of equity it is a moral and practical necessity if societies are to survive and thrive. Women and girls face layered obstacles to care: constrained mobility, financial dependence, harmful social norms, and health systems that are under-resourced and sometimes discriminatory. The World Health Organization highlights that gender norms and discrimination systematically limit access to services for women and girls, reducing their ability to obtain timely information, preventive care, and lifesaving treatment (1). These barriers are compounded by grim facility gaps: recent WHO/UNICEF data show billions are treated in health settings that lack basic water, sanitation, hygiene, and reliable electricity conditions that make safe maternal care and emergency treatment precarious (2). At the same time, progress toward universal health coverage (UHC) has slowed, leaving significant groups especially women in rural and low-income communities exposed to out-of-pocket costs and unmet needs (3).

The consequences are measurable and stark. Nigeria, for example, continues to bear a disproportionate share of global maternal deaths, a reality linked to regional inequalities in access, weak infrastructure, and funding shortfalls (4). Globally, analyses of health inclusivity reveal that refugees, displaced women, women with disabilities and other marginalized groups are far more likely to be denied or excluded from care in some cases by more than twenty percentage points compared with non-marginalized groups (5). These are not abstract injustices: they translate into delayed antenatal visits, unattended deliveries, untreated complications, and endless cycles of preventable suffering. Removing gender barriers means addressing the social drivers that prevent women from seeking care as urgently as fixing the physical gaps in facilities.

Civil society organisations and local actors are essential partners in closing these gaps. The Centre for Family Health Initiative (CFHI) works at the community level to confront both practical and cultural barriers to care: we run health education and rights-awareness campaigns that equip women and families with knowledge about available services and how to claim them; we strengthen linkages between households and primary health centres through referrals and case management; we support WASH and menstrual hygiene programmes so women can access services with dignity; and we provide capacity building for community health workers and facility staff so that care is both accessible and respectful (6). Where infrastructure is missing, CFHI has partnered with donors and initiatives to deliver pragmatic solutions for example installing solar birth kits in underserved PHCs to ensure safe night-time deliveries while simultaneously training Healthcare Professionals and Community Health Extension Workers (CHEWs) to enhance their competencies in clinical care, documentation, counselling, and emergency response, ensuring that PHCs can deliver reliable and respectful services across all essential health areas

To remove gender barriers at scale, governments, donors, and health systems must act on several fronts. First, finance primary health care adequately and ensure that essential services are free or financially protected at the point of use, so women are not forced to choose between care and survival. Second, invest in facility infrastructure WASH, electricity, cold chain and privacy provisions because dignity and safety are prerequisites for access. Third, embed gender-responsive policies across health programming: mandate respectful maternity care, train providers on implicit bias and discrimination, involve women and adolescent girls in service design, and expand targeted outreach for marginalized groups. Fourth, strengthen data systems to capture gender-disaggregated indicators and unmet needs so resource allocation can follow the evidence. Finally, create accountability mechanisms community scorecards, patient charters and independent oversight so promises become measurable action.

Change requires more than policy papers; it requires citizens, health workers, NGOs and governments to demand it and to act. We call on policymakers to prioritise gender responsive UHC financing and facility upgrades, on donors to fund long-term health system strengthening rather than short-term projects, on facility managers to adopt respectful care protocols today, and on community leaders to champion women’s right to health. If we truly value half our population, we will remove the gender barriers that deny women the healthcare they are owed.

References

  1. World Health Organization. Gender and health. Available from: https://www.who.int/health-topics/gender.
  2. World Health Organization; UNICEF. Countries making unprecedented efforts but billions still lack basic services in health-care facilities — WHO-UNICEF report warns. WHO website. 24 Sep 2025. Available from: https://www.who.int/news/item/24-09-2025-countries-making-unprecedented-efforts-but-billions-still-lack-basic-services-in-health-care-facilities—who-unicef-new-report-warns.
  3. World Health Organization. Universal health coverage (UHC) fact sheet. Available from: https://www.who.int/news-room/fact-sheets/detail/universal-health-coverage-(uhc).
  4. The Guardian. ‘Difficult choices’: aid cuts threaten effort to reduce maternal deaths in Nigeria. 21 May 2025. Available from: https://www.theguardian.com/world/2025/may/21/aid-cuts-threaten-effort-reduce-maternal-deaths-nigeria.
  5. Economist Impact. Understanding health inclusivity for women. Available from: https://impact.economist.com/projects/health-inclusivity-index/inclusivity-topics/articles/understanding-health-inclusivity-for-women.
  6. Centre for Family Health Initiative (CFHI). Who we are / What we do. Available from: https://www.cfhinitiative.org.

 

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Human Rights and Access to Quality Healthcare for All

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Access to quality healthcare is recognized globally as a fundamental human right. Yet, billions of people still cannot exercise this right. Recent WHO and UNICEF estimates, about 1.1 billion people received healthcare in facilities without basic water services, while 3.0 billion lacked access to sanitation services, creating unsafe environments for patients and health workers alike (1). Additionally, 1.7 billion individuals were cared for in facilities without proper hygiene standards, and about 2.8 billion lacked access to safe health-care waste management, exposing communities to preventable infections (1). Another WHO report highlights that nearly one billion people depend on facilities with unreliable or no electricity, making safe childbirth, emergency care, vaccine storage, and laboratory services extremely difficult (2). To address such challenges, CFHI, with support from Grand Challenges Nigeria, recently installed solar birth kits at Rumde PHCC in Adamawa and Gusau PHCC in Zamfara States. These kits provide reliable solar-powered lighting, enabling skilled birth attendants to conduct deliveries safely at night or during power outages, support emergency care, and ensure essential medical equipment can function consistently.

Such deficits represent clear violations of the right to health. Quality healthcare must be safe, clean, affordable, and accessible. Studies further show that poor healthcare access contributes to increased maternal mortality, preventable illnesses among children, late health-seeking behaviour, and financial hardship. Globally, millions face catastrophic out-of-pocket spending on healthcare, pushing vulnerable families into poverty each year (3). Universal Health Coverage frameworks emphasize equity; however, implementation remains slow in many developing countries, especially in rural and underserved communities where health investment is still low.

In Nigeria, although relevant health policies exist, many communities still lack the enabling environment to exercise their health rights, the government has the primary responsibility to provide healthcare services and maintain facilities, the reality is that many health centres remain dilapidated and under-resourced. This situation underscores the urgent need for authorities to prioritize investment in health infrastructure, provide functional equipment, and ensure every facility meets minimum standards to protect the lives of mothers, newborns, and communities. This is where organizations such as Centre for Family Health Initiative (CFHI) contribute meaningfully to bridging the gap. CFHI works to expand equitable healthcare access by implementing interventions that support orphans and vulnerable children, adolescents, caregivers, and low-income households. The organization improves community knowledge on health rights, offers psychosocial support, conducts HIV counselling, testing, and referrals, and assists vulnerable families in navigating access to healthcare facilities (4).

Through capacity building for healthcare workers, stronger health facility linkage, and participatory learning sessions, CFHI promotes informed decision-making and encourages service utilization which are critical elements of health rights implementation. Ultimately, improved health outcomes must go beyond policy frameworks; communities must receive accessible services delivered in dignity, and families must be able to seek care without financial ruin.

Achieving true universal access requires investment in basic facility infrastructure, elimination of discriminatory practices, improved health financing, and strengthened accountability mechanisms. When communities are assured of safety, fairness, and affordability, healthcare becomes a right in practice not merely in principle.

References

  1. World Health Organization and UNICEF. Countries making unprecedented efforts but billions still lack basic services in health-care facilities. WHO website. Available at: https://www.who.int/news/item/24-09-2025-countries-making-unprecedented-efforts-but-billions-still-lack-basic-services-in-health-care-facilities—who-unicef-new-report-warns
  2. World Health Organization. Global progress report on universal access to WASH services in healthcare facilities. WHO website. Available at: https://www.who.int/news/item/24-09-2025-countries-making-unprecedented-efforts-but-billions-still-lack-basic-services-in-health-care-facilities—who-unicef-new-report-warns
  3. World Bank Group. Billions left behind on the path to universal health coverage. World Bank website. Available at: https://www.worldbank.org/en/news/press-release/2023/09/18/billions-left-behind-on-the-path-to-universal-health-coverage
  4. Centre for Family Health Initiative (CFHI). Programme information and reports. CFHI website. Available at: https://www.cfhinitiative.org

 

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Limited Awareness and Education

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Limited awareness and inadequate education remain one of the most persistent barriers to ending gender-based violence (GBV) in our communities. While conversations around rights, dignity, and safety have expanded globally, many people within local communities still lack basic knowledge of what constitutes GBV, how to recognize it, and how to seek help. GBV is often normalized through culture, silence, and misinformation, making harmful actions seem acceptable simply because “that is how it has always been done.” When people do not understand that verbal abuse, economic deprivation, physical harm, intimidation, and forced sexual relations are forms of violence, it becomes difficult to report, prevent, or advocate against them. Limited awareness means many survivors suffer silently, believing their experience is personal failure rather than an injustice.

Education goes beyond literacy; it includes exposure to accurate information, safe spaces for dialogue, and empowerment to act. In communities where cultural beliefs are deeply rooted, myths such as “a man owns his wife,” “discipline is love,” or “girls deserve blame for harassment” thrive due to the absence of counter-information. When adolescents do not receive early education about consent, bodily integrity, and respectful relationships, cycles of abuse continue from one generation to the next. Schools, households, and religious institutions hold influence, yet not all incorporate GBV-sensitive learning. Even government policies exist, but without grassroots awareness, they remain distant frameworks unknown to those who need them most.

Limited awareness also weakens community response systems. Many families do not know where to report cases, while some believe law enforcement processes are pointless. Survivors often fear stigma, shame, or retaliation, and without education, communities reinforce these fears. Knowledge is power but silence gives power to abusers. Increasing awareness has proven effective in correcting harmful norms, encouraging reporting, and improving support systems. Community-based education, particularly when delivered in local languages, builds collective accountability. When young boys understand respect and emotional responsibility, and girls recognize their worth, a foundation for prevention is strengthened.

At the Centre for Family Health Initiative (CFHI), sustained advocacy has shown that when the right information reaches people, attitudes change. Over the past year, CFHI has facilitated community dialogues on GBV, implemented school-based sensitization on healthy relationships, and organized youth-led conversations addressing harmful norms both online and offline. During commemorative events including the 16 Days of Activism and International Women’s Day CFHI has raised awareness on digital violence, safe spaces, consent, reporting pathways, and survivor-centered responses. Activities like safe-spaces campaigns, mentorship sessions, and referral support for vulnerable groups have contributed to reducing silence around violence.

As we continue observing the 16 Days of Activism, one truth stands out clearly: ignorance sustains abuse. Every community member has a responsibility to learn, speak, and act. Parents must educate their children early; faith leaders must preach protection and dignity; schools must include GBV topics in their learning process; and local authorities must provide accessible reporting platforms. No change happens when people are uninformed, but transformation begins when knowledge shifts mindsets.

The call to action is simple yet urgent: let us learn, let us teach, and let us speak out. Ending GBV will not be achieved through laws alone; it requires awareness deep enough to shift beliefs and strong enough to build a culture that protects women, girls, and all vulnerable persons. Ending GBV begins with knowledge, and knowledge shared becomes change multiplied.

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Ending HIV Stigma: Community Support Beyond World AIDS Day

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Ending HIV stigma remains one of the most critical steps in achieving an effective HIV response globally. Even though scientific progress has transformed HIV from a life-threatening illness to a manageable condition, stigma continues to undermine prevention, testing, treatment, and quality of life. Studies show that nearly 1 in 4 people living with HIV report experiencing discrimination in healthcare settings, which discourages timely care-seeking and contributes to poor health outcomes (1). Community stigma also remains widespread; in sub-Saharan Africa, where the burden of HIV is highest, research found that over 35% of adults still hold discriminatory attitudes toward people living with HIV (2). These attitudes are deeply rooted in misinformation, fear, cultural norms, and moral judgments that continue to silence individuals and limit their ability to access support.

Stigma does not only affect individuals emotionally; it has direct medical consequences. Evidence shows that people who experience HIV-related stigma are three times more likely to delay or avoid HIV testing and up to 50% less likely to adhere to treatment due to fear of being discovered (3). This delay fuels the cycle of transmission and reduces the chances of achieving viral suppression. Yet, viral suppression keeping HIV levels undetectable is proven to eliminate the risk of sexual transmission entirely, a fact summarized in the principle U=U (Undetectable = Untransmittable) (4). Ending stigma, therefore, is not only a human rights issue but a powerful public health strategy.

Beyond World AIDS Day, communities must unite to promote supportive environments where people living with HIV feel safe to disclose, access services, and receive continuous care. Community-led awareness, inclusive language, youth-friendly education, and culturally sensitive advocacy have proven to reduce stigma by strengthening empathy and understanding (5). Empowering young people with evidence-based information also plays a vital role since adolescents remain vulnerable to societal misconceptions and pressure surrounding HIV.

At the Centre for Family Health Initiative, efforts to end HIV stigma go beyond commemoration events. CFHI continues to create safe spaces within communities through targeted HIV education, gender-sensitive communication, counselling support for adolescents and caregivers, and stigma-reduction sessions integrated into school and community health activities. Through the ASPIRE project and other community interventions, CFHI consistently promotes testing uptake, linkage to care, and treatment adherence especially among vulnerable populations. Last year in Imo State, CFHI carried out a community HIV awareness and testing outreach that reached dozens of individuals with prevention messages, counselling, and referrals, reinforcing the message that HIV is manageable and that stigma must never stand between anyone and access to care. As we move beyond World AIDS Day, CFHI encourages everyone to be intentional about kindness, to challenge myths, to stand against discrimination, and to help build communities where people living with HIV are treated with dignity. Ending stigma begins with each of us, and together we can create a society where support is stronger than silence

 

References

  1. Joint United Nations Programme on HIV/AIDS (UNAIDS). Confronting Discrimination: Overcoming HIV-related Stigma and Discrimination in Health-care Settings. 2020. Available from: https://www.unaids.org
  2. United Nations Children’s Fund (UNICEF). HIV and AIDS Statistical Update. 2023. Available from: https://www.unicef.org
  3. Turan B, et al. The Impact of HIV-related Stigma on Treatment Adherence. AIDS Behav. 2017;21(1):283–291. Available from: https://link.springer.com
  4. Prevention Access Campaign. The U=U Declaration. 2016. Available from: https://preventionaccess.org
  5. World Health Organization (WHO). Global HIV Programme: Eliminating Stigma and Discrimination. 2022. Available from: https://www.who.int

 

 

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Socio-Cultural Norms and Practices A Deep-Rooted Barrier to Ending GBV

16DaysOfActivism, Child Trafficking, Community Development, Cultural practices in Africa, Gender, Gender Based Violence, Gender Equality, Health, Health Communication, Men, Men's Health, Mental Health /

Across communities, the fight against Gender-Based Violence (GBV) is often undermined not by the absence of laws or policies, but by something far more entrenched socio-cultural norms and practices. These norms act as invisible rules that govern how people think, behave, and relate to each other, shaping gender expectations from childhood into adulthood. When these expectations are rooted in inequality, they form a powerful barrier that normalizes violence against women and girls and shields perpetrators from accountability. To truly eliminate GBV, we must confront these beliefs, because they are the soil from which violence grows.

In many parts of Nigeria, men are socialized to be dominant and authoritative, while women are groomed to be submissive, tolerant, and “obedient.” These expectations directly reinforce violence. A study in Northwest Nigeria showed that domestic violence is often justified by community members as a “corrective measure,” particularly when women fail to adhere to traditional roles of respect and submission to their husbands 2. This cultural acceptance makes reporting violence extremely difficult, as survivors fear being blamed, shamed, or even punished by their own families or communities.

Deep-seated practices such as female genital mutilation (FGM), child marriage, widowhood rituals, and the payment of bride price further cement gender inequality. In Northern Nigeria, child marriage is frequently defended as a cultural or religious requirement, yet research shows it exposes girls to sexual violence, health risks, and lifelong disempowerment 3 Similarly, FGM persists in communities where it is considered a rite of passage or a marker of purity, despite its severe physical and psychological consequences. These practices reinforce the idea that a woman’s value is tied to her body and her obedience, not her autonomy or humanity 6.

Gender norms also influence how communities perceive survivors and perpetrators. In the Niger Delta, for instance, over 75% of respondents in one study believed that women provoke violence when they fail to meet cultural expectations of submission and domestic responsibility 7. This belief creates a dangerous cycle where victims are blamed and perpetrators are excused, further emboldening violence. Even in settings considered more progressive, such as universities, harmful beliefs remain widespread. Research among students at the University of Calabar revealed that many still view men as inherently superior and justified in exerting control over women through violence 4.

These norms are not just personal attitudes they have structural consequences. A multivariate analysis across different regions of Nigeria confirmed a strong correlation between cultural beliefs and the prevalence of GBV 10. They influence legal reporting, access to justice, community support systems, and even the willingness of institutions to intervene. So long cultural frameworks continue to excuse or minimize violence, GBV will persist regardless of how many laws or policies exist on paper.

To dismantle these barriers, Nigeria must invest in cultural transformation alongside policy reforms. This requires community dialogues, gender-transformative education, economic empowerment of women, and meaningful engagement with traditional and religious leaders who hold influence over cultural practices. It also means amplifying survivor voices, strengthening community accountability systems, and challenging harmful norms through storytelling, media campaigns, and grassroots activism. Socio-cultural norms are deeply rooted but they are not unchangeable. Change begins when communities recognize that culture should protect, not destroy.

 

 

References

  1. Ede V, Arinze-Umobi C. Gender Issues in Islam. Teologia. 2024.
    https://journal.walisongo.ac.id/index.php/teologia/article/view/25466
  2. Argungu AM, Safiyanu S, Abba M. Domestic Violence and Women’s Rights in Northwest Nigeria. ASJP African Journal of Arts, Humanities & Social Sciences.
    https://aspjournals.org/ajahss/index.php/ajahss/article/view/173
  3. Adeyemi S, Engwa GA. Influence of Socio-Cultural Beliefs on Gender-Based Violence in Nigeria.
    Semantics Scholar.
    https://www.semanticscholar.org/paper/Socio-Cultural-Beliefs-and-Gender-Based-Violence-Adeyemi-Engwa/3cd20061f7caa3c54b6b88ff063d5ba2272f2c6b
  4. Ibekwe J. Influence of cultural norms and stereotypes on gender-based violence among students of the University of Calabar. International Journal of Medical Students.
    https://ijms.pitt.edu/IJMS/article/view/2956
  5. Olaseni AO, Akpa OM. Socio-cultural perspectives of GBV in Nigeria. SAGE Journals.
    https://journals.sagepub.com/doi/full/10.1177/2158244020982992
  6. Ojedokun U. Religion, Culture and Violence Against Women in Nigeria. Religions Journal. 2023.
    https://www.mdpi.com/2077-1444/16/3/359
  7. Idumwonyi I, Aigbokhaevbolo O. Community Perceptions of GBV in the Niger Delta Region of Nigeria. DOAJ.
    https://doaj.org/article/670a61e4b2bc4c9fbe669857804551ab
  8. Mulbah J, et al. Cultural beliefs and GBV in Sub-Saharan Africa. BMC Public Health.
    https://bmcpublichealth.biomedcentral.com/articles/10.1186/s12889-020-09138-9
  9. Onyekwere G. Widowhood practices and socio-cultural norms reinforcing GBV in Nigeria. African Journals Online (AJOL).
    https://www.ajol.info/index.php/jsda/article/view/233564
  10. Bala RY, Idris A. Socio-Cultural Drivers of Gender-Based Violence: A Multivariate Analysis in Nigeria.
    IJMRA. https://ijmra.in/v7i5/6.php

 

 

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Supporting Survivors Beyond the Statistics: A Call to Action This 16 Days of Activism

16DaysOfActivism, ChildNotBride, Community Development, Gender, Gender Based Violence, Gender Equality, Girl Education, Health, International Day for the Eradication of Poverty, Men, Mental Health, Speak Wednesday /

Each year, the 16 Days of Activism Against Gender-Based Violence reminds the world that violence against women and girls is not just a crisis it is a daily reality for millions [1]. Reports, data sheets, and global indicators help us understand the magnitude, but behind every statistic is a living, breathing person whose life has been altered by harm. This year, as we observe the campaign, it is crucial that we shift our collective attention from the numbers to the humans behind them. True progress lies in supporting survivors beyond the statistics.

Too often, survivors are reduced to percentages “1 in 3,” “1 in 5,” “35% globally” [2]. While these numbers capture attention, they do not capture the emotional, physical, and economic aftermath that survivors carry. They do not speak to the silence, the stigma, the fear of seeking help, or the systemic barriers that make healing harder than the violence itself. Ending gender-based violence requires more than awareness. It demands empathy, survivor-centered systems, and long-term support [3].

Supporting survivors goes far beyond responding to incidents; it means creating environments where they are believed, protected, and empowered to rebuild. It means ensuring access to justice, psychosocial care, healthcare, safe spaces, and economic opportunities [5]. It also means challenging harmful gender norms, dismantling structures that enable violence, and educating communities to recognize and prevent abuse before it happens.

At the Centre for Family Health Initiative (CFHI), this survivor-centered approach is at the heart of our work. Through our gender norms interventions, community dialogues, capacity-building programs, and youth engagement initiatives, CFHI champions the rights, dignity, and well-being of women, girls, and all survivors. From preventive education to psychosocial support and referral services, we ensure that survivors are not lost in the numbers but seen, heard, and supported through their healing journey.

But CFHI cannot do this alone. Ending violence is a collective responsibility; As we mark this year’s 16 Days of Activism, we call on, communities to break the culture of silence and create safe spaces for survivors, institutions to strengthen reporting systems, legal protections, and survivor-friendly services. Parents and caregivers to model respect and equality within their homes, young people to speak up against online and offline violence and promote positive gender norms. Government and policymakers to invest in prevention, strengthen accountability, and fund survivor services, you, reading this, to challenge harmful behaviours, support survivors around you, and become an advocate for a violence-free world.

Survivors are not statisticsthey are individuals deserving of dignity, justice, and healing. As we stand together during the 16 Days of Activism, let us commit to building a society that supports survivors not just in reports but in real life, every day [4].

CFHI remains steadfast in its mission: promoting health, protection, and empowerment for all. Together, we can end violence one voice, one action, and one survivor supported at a time.

 

References

[1] UN Women. (2024). Ending Violence Against Women: Facts & Figures.
https://www.unwomen.org/en/what-we-do/ending-violence-against-women/facts-and-figures

[2] World Health Organization. (2021). Violence Against Women Prevalence Estimates 2018.
https://www.who.int/publications/i/item/9789240022256

[3] UN Women. 16 Days of Activism Against Gender-Based Violence Campaign.
https://www.unwomen.org/en/what-we-do/ending-violence-against-women/take-action/16-days-of-activism

[4] United Nations. (2024). International Day for the Elimination of Violence Against Women  Background.
https://www.un.org/en/observances/ending-violence-against-women-day

[5] UNFPA. (2023). Gender-Based Violence: Global Overview and Response Strategies.
https://www.unfpa.org/gender-based-violence

 

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