Cultural practices in Africa

Families as Frontline Defenders Against Harmful Practices.

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Across the world, harmful practices such as female genital mutilation (FGM) and child marriage continue to violate the rights, health, and futures of millions of girls and young women, often entrenched in patriarchal norms and social pressures. UNICEF estimates that at least 230 million girls and women alive today have undergone FGM, and over 12 million girls are married before age 18 every year, both of which are rooted in gender inequality and harmful social norms upheld at the family and community level. These practices not only harm physical and psychological wellbeing but also constrain girls’ access to education, livelihoods, and basic human rights. (UNICEF)

Families are not merely passive bystanders in this landscape they can be frontline defenders against harmful practices. Research shows that families influence health behavior, decision-making, and wellbeing from early life through adolescence and adulthood, making them invaluable actors in preventing and countering abuse and discrimination. Family-oriented health promotion strategies have been found to be effective in reducing child maltreatment and strengthening protective factors by enhancing parenting practices, social support, and overall family wellbeing. (PubMed)

In many communities where harmful practices like FGM and child marriage persist, decision making often occurs within the household, with parents, extended family members, and elders shaping whether girls are subjected to such rites. In parts of sub-Saharan Africa, families fear social ostracism and harm to a girl’s “marriage prospects” if she is not cut or married early beliefs that are enforced by elders and community expectations. This social pressure persists even where awareness of harm is increasing, illustrating how deeply family influence and social norms are intertwined. (acrl-rfp.org) In Mali, for example, prevalence rates of FGM remain high only dropping from 91% to 89% over two decades underscoring that legal change alone is insufficient without deep shifts in family and community norms. (ODI: Think change)

However, when families act as agents of change rather than enforcers of harmful norms, progress is possible. In Sudan in 2025, community committees that included family members mobilized against an FGM practitioner’s arrival, stopping the practice in its tracks, and demonstrating the power of collective family and community action to protect children. This local action, grounded in awareness about health risks and legal protections, helped shift attitudes and strengthen community resistance against harmful practices. (UNICEF)

Education is another critical lever. Families that value girls’ schooling and future potential are more likely to delay or abandon harmful practices, recognizing the long-term benefits of learning and opportunity. Research from UNICEF indicates that education can shift attitudes and reduce the transmission of harmful practices across generations, as families who understand the risks and benefits are better positioned to protect their daughters. (UNICEF DATA)

Promoting family engagement as a public health strategy also aligns with broader efforts to prevent violence and abuse. Evidence shows that family-based interventions reduce harmful behaviors such as bullying among children and adolescents by improving parenting, communication, and protective supervision. These family systems create environments where children feel supported, informed, and safer, reducing the likelihood of various forms of harm. (SpringerLink)

Yet meaningful change requires more than individual awareness it requires collective, sustained action that equips families with knowledge, resources, and support to challenge harmful norms. Governments, civil society, health systems, and community leaders must invest in education, legal protections, economic opportunities, and culturally appropriate outreach that reinforces families as protectors rather than perpetuators of harmful practices. As one advocate puts it, “Families who understand the suffering these practices cause is increasingly willing to resist, one conversation at a time.” (UNICEF)

Call to Action: Ending harmful practices such as FGM and child marriage depends on empowering families with evidence, support, and tools to reject harmful norms and champion girls’ rights. Invest in family-focused education and prevention, strengthen community support networks, involve elders and parents in advocacy, and ensure every girl’s health, education, and dignity are protected.

References

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Economic Exclusion as Gender-Based Violence

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Gender-based violence (GBV) is most often associated with physical or sexual abuse. However, economic exclusion – the systematic denial of women’s access to jobs, income, assets, and economic decision-making is itself a form of violence that harms individuals, families, and societies. When women are excluded from economic opportunities, the impact goes far beyond loss of income; it restricts freedom, autonomy, safety, and long-term development (1).

At its core, GBV includes economic abuse, where financial control is used as a tool of power and coercion. Economic violence may involve denying women access to money, preventing them from working, confiscating earnings, or restricting access to education and financial resources, forcing dependency and disempowerment (1). In many contexts, economic abuse is one of the most widespread yet least recognized forms of gender-based violence.

Economic exclusion is sustained by discriminatory laws, weak institutional protections, and unequal social norms. Globally, over 2.7 billion women live in countries where laws restrict the types of jobs they can do, and at least 43 economies still lack legislation addressing workplace sexual harassment, creating unsafe and unequal labor environments (2).

Intimate partner violence which frequently includes economic abuse affects approximately one in three women worldwide, limiting their ability to earn, save, and participate fully in public and economic life (3). In South Africa, studies indicate that one in eight adult women has experienced economic abuse, including being deliberately deprived of money or access to financial resources by a partner (4).

The consequences extend beyond individuals to national economies. Gender-based violence, including its economic dimensions, has measurable effects on productivity and growth. Evidence suggests that GBV can cost countries between 1–2% of Gross Domestic Product (GDP) due to absenteeism, reduced productivity, healthcare costs, and forced withdrawal from the workforce (5).

In Nigeria, the economic cost of gender-based violence is estimated at approximately USD 3 billion annually, equivalent to about 1% of the nation’s GDP, underscoring the scale of economic loss linked to women’s exclusion and abuse (6).

Economic exclusion intersects with social norms that treat women as inferior, dependent, or secondary earners. When women lack control over income, are denied access to employment, or are discouraged from education and financial decision-making, the result is structural violence a normalized and persistent denial of rights and well-being.

This exclusion is not accidental; it is deeply rooted in patriarchal systems and discriminatory practices that limit women’s autonomy and participation. The World Bank has emphasized that violence against women undermines economic growth and damages communities and future generations by restricting women’s productive potential (7).

Experts have consistently highlighted both the human and economic costs of this form of violence. According to the World Bank:

“Violence against women and girls is a global epidemic that endangers lives and carries wide-ranging consequences for individuals, families, and communities.” (7)

Research further shows that economic abuse and exclusion lead to long-term psychological harm, loss of independence, and restricted life opportunities for women and girls. Conversely, policies that promote women’s economic empowerment are associated with reduced exposure to GBV and increased participation in education, employment, and leadership (8).

Ending economic exclusion as a form of gender-based violence requires deliberate and sustained action, including:

  • Strong legal protections guaranteeing equal work rights, pay equity, and safeguards against economic abuse.
  • Transformation of harmful social norms that portray women as dependents rather than economic actors.
  • Targeted economic empowerment initiatives that expand women’s access to education, finance, and entrepreneurship.
  • Inclusive workplace policies that ensure safety, fair remuneration, and career advancement for women

Economic exclusion is not merely an economic challenge it is a human rights violation. Recognizing it as a form of gender-based violence strengthens advocacy, accountability, and policy responses, and is essential to building societies where women can live, work, and thrive free from coercion and inequality.

References

  1. Women’s World Banking. What is economic violence against women and why does it matter? Available from:
    https://www.womensworldbanking.org/insights/what-is-economic-violence-against-women-and-why-does-it-matter/
  2. UN Women. Facts and figures: Women’s economic empowerment. Available from:
    https://knowledge.unwomen.org/en/articles/facts-and-figures/facts-and-figures-economic-empowerment
  3. Asia-Pacific Economic Cooperation (APEC). Violence against women: An overlooked economic barrier. Available from:
    https://www.apec.org/press/blogs/2025/violence-against-women–an-overlooked-economic-barrier
  4. Independent Online (IOL). Economic abuse: The most common yet overlooked form of GBV in South Africa. Available from:
    https://iol.co.za/mercury/2025-07-02-economic-abuse-the-most-common-yet-overlooked-form-of-gender-based-violence-in-south-africa/
  5. International Monetary Fund. How domestic violence is a threat to economic development. Available from:
    https://www.imf.org/en/blogs/articles/2021/11/24/how-domestic-violence-is-a-threat-to-economic-development
  6. The Whistler Newspaper. Nigeria loses estimated $3bn annually to gender-based violence. Available from:
    https://thewhistler.ng/nigeria-loses-estimated-3-0bn-annually-to-gender-based-violence/
  7. World Bank. More than 1 billion women lack legal protection against domestic and sexual violence. Available from:
    https://www.worldbank.org/en/news/press-release/2018/02/01/more-than-1-billion-women-lack-legal-protection-against-domestic-sexual-violence-finds-world-bank-study
  8. MDPI. The quest for female economic empowerment in Sub-Saharan Africa and implications for GBV. Available from:
    https://www.mdpi.com/1911-8074/17/2/51

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Breaking Myths, Ending Stigma, and Acting Against Cervical Cancer

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Cervical cancer is a major global health issue yet one of the most preventable forms of cancer. Almost all cervical cancer cases (about 99%) are linked to infection with high-risk human papillomaviruses (HPV), which are extremely common and transmitted through sexual contact. Persistent HPV infection can cause cervical cancer if left untreated, but early detection and prevention make this disease largely preventable. ¹

Despite this, myths and misinformation persist and contribute to stigma around cervical cancer screening and HPV. Studies show that many women feel shame, anxiety, and embarrassment when diagnosed with HPV or advised to get screened, often because HPV is incorrectly perceived as a sign of promiscuity or extreme risk. ² This stigma can deter women from seeking preventive care and early diagnosis, undermining efforts to reduce disease burden. ³

Globally, cervical cancer remains a leading cause of cancer deaths among women. In 2022, an estimated 660,000 new cases were diagnosed worldwide, with about 350,000 deaths many of which could be prevented through vaccination, regular screening, and early treatment. ¹ In Nigeria, cervical cancer is the second most common cancer among women and carries significant risk in the reproductive age group. ⁴

Despite proven benefits, uptake of cervical cancer screening and HPV vaccination remains low. Studies in Nigeria (2021–2023) show that fewer than 15% of adolescent girls have received the HPV vaccine and only about 10% of women have ever been screened, indicating slow progress compared to global targets.⁵ This low uptake is driven by limited awareness, misconceptions, stigma, and weak family or partner support, while reviews from 2022–2024 highlight persistent beliefs that screening is only for certain women or may cause harm, further discouraging participation.⁶

Myths about cervical cancer include beliefs that HPV always leads to cancer, that only women with symptoms should screen, or that screening itself causes harm. Evidence shows these are false HPV does not always cause cancer, early stages of disease often have no symptoms, and regular screening (Pap tests or HPV testing) is safe and effective in detecting abnormalities before they progress. ⁷

Stigma further compounds the problem. Surveys indicate that significant numbers of women experience emotional distress or feel ashamed after receiving abnormal screening results, which can delay follow-up care and discourage others from attending future screenings. ² Overcoming this stigma requires not just medical interventions but community education and open conversations about HPV and cervical health.

Acting against cervical cancer involves three key strategies: vaccination, screening, and treatment. The World Health Organization’s global strategy targets HPV vaccination of 90% of girls by age 15, screening 70% of eligible women twice in their lifetimes, and ensuring 90% of women with pre-cancer or invasive cancer receive appropriate care. ⁴ Countries such as Pakistan have demonstrated wide vaccination coverage, with campaigns reaching millions of girls despite resistance fueled by misinformation.

Breaking myths and ending stigma is essential to increase screening uptake and vaccine acceptance. Community education campaigns, trusted health messaging, and culturally sensitive outreach can help shift perceptions, build trust, and empower women to take preventive action. We urge communities, health workers, and families to actively support women in accessing screenings and vaccinations, speak openly about cervical health, and challenge harmful myths whenever they arise. When women understand the facts and feel supported rather than judged, lives can be saved, and the stigma that hinders progress can be dismantled.

References

  1. World Health Organization (WHO). Cervical cancer prevention, diagnosis, screening.
    https://www.who.int/cancer/prevention/diagnosis-screening/cervical-cancer/en/
  2. Sheena Meredith. HPV stigma leads to shame for women with diagnosis. Medscape.
    https://www.medscape.com/viewarticle/HPV-Stigma-Leads-Shame-Women-Diagnosis-2022a10004lc
  3. BMC Public Health. Barriers to cervical cancer screening in Africa.
    https://bmcpublichealth.biomedcentral.com/articles/10.1186/s12889-024-17842-1
  4. WHO Africa. Cervical cancer early detection saves lives (Nigeria context).
    https://www.afro.who.int/countries/nigeria/news/cervical-cancer-early-detection-saves-lives
  5. BMC Women’s Health. Cervical cancer screening and HPV vaccination knowledge in Nigeria.
    https://bmcwomenshealth.biomedcentral.com/articles/10.1186/s12905-023-02345-9
  6. PubMed Central. Cervical cancer stigma—a silent barrier to elimination.
    https://pmc.ncbi.nlm.nih.gov/articles/PMC11869935/
  7. Thomson Medical. 9 common myths about cervical cancer debunked.
    https://www.thomsonmedical.com/blog/myths-about-cervical-cancer

 

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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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When Healthcare Costs Become a Form of Bias

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When healthcare costs rise beyond the reach of ordinary people, they silently become a form of bias one that decides who lives, who suffers, and who is forced to endure preventable pain. In Nigeria today, access to quality healthcare is increasingly determined not by need, but by ability to pay. For millions of women and girls, especially in low-income and underserved communities, the cost of care has become a cruel barrier that denies them their most basic right: the right to health. This hidden injustice affects lives, futures, and communities.

The impact of this bias is devastating. Pregnant women delay antenatal care because consultation fees are unaffordable, adolescent girls are denied reproductive health services, and survivors of gender-based violence cannot access timely medical attention due to cost. These barriers fuel inequality, worsen health outcomes, and perpetuate cycles of suffering. When healthcare becomes a privilege instead of a right, women and girls bear the heaviest burden, trapped in a system that marginalizes them and ignores their dignity.

The financial strain of out-of-pocket spending is crushing. Families are forced to choose between food, education, and medical care, often at the expense of women and girls. This reality exposes a health system that has failed to protect those most vulnerable, leaving them at risk of illness, neglect, and further gender-based harm. A functional, responsive healthcare system should uplift women and girls, not push them into vulnerability. Every woman and girl deserve care, respect, and protection regardless of income.

The Nigerian government must act decisively. Investing in maternal, reproductive, and gender-sensitive health services, strengthening primary healthcare, implementing effective insurance schemes, and ensuring accountability at every level are not optional, they are urgent obligations. Health must be treated as a national priority, because no society can prosper while its women and girls remain unwell, unprotected, and underserved. A fair and just society is one where access to healthcare is based on need, not income. Ending cost-driven bias in healthcare requires collective action from policymakers prioritizing women’s health financing, to institutions delivering quality care, to communities demanding equitable systems.

The call to action is clear: the government, stakeholders, and citizens must commit to ensuring healthcare is affordable, accessible, and equitable for all. Healthcare should heal, protect, and empower women and girls, and not discriminate against them. Until costs no longer determine who can access care, gender-based bias will continue to persist quietly, unfairly, and at an unacceptable human cost.

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

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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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Removing Gender Barriers in Healthcare Access

16DaysOfActivism, Anxiety Disorder, Child Labour, ChildNotBride, Community Development, Cultural practices in Africa, Drugs, Gender, Gender Based Violence, Gender Equality, Health, Health Communication, Men, Mental Health, Speak Wednesday, Women, Women's Rights /

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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Limited Awareness and Education

16DaysOfActivism, Community Development, Cultural practices in Africa, Gender, Gender Based Violence, Gender Equality, Health, Health Communication /

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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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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