Gender

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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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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Beyond Stigma: Community-Led Support for Women and Girls Living with HIV

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Stigma remains one of the greatest obstacles to ending HIV: globally, according to the latest UNAIDS estimates, about 40.8 million people were living with HIV as of the end of 2024, with women and girls accounting for approximately 53% of all infections [1]. Despite progress in expanding treatment access bringing lifesaving antiretroviral therapy to over 31 million people worldwide millions still face stigma, discrimination, and social exclusion, which continue to limit their ability to seek testing, care, and long-term support [1].

Evidence shows that stigma discourages people from testing, delays linkage to treatment, and undermines adherence; pooled analyses across African surveys and facility studies find that people who experience stigma are significantly less likely to know their status or remain engaged in care, which in turn reduces chances of viral suppression and worsens health outcomes [2,3]. The scientific consensus that “U=U” (Undetectable = Untransmittable) underscores why ending stigma is also a prevention strategy: people on effective antiretroviral therapy (ART) who achieve and maintain an undetectable viral load do not sexually transmit HIV [4]. Despite these advances, gaps remain UNAIDS reports that while millions are on treatment, about 31.6 million people were accessing ART in 2024, leaving a substantial number still unreached by life-saving services [1].

Community-led support is central to bridging those gaps for women and girls. Practical, evidence-based community interventions peer support groups, community health worker follow-up, safe disclosure spaces, integrated mental-health services, and targeted outreach to adolescents have been shown to increase testing uptake, improve retention on ART, and reduce internalized stigma [5,6]. In Nigeria and other countries, facility-level and community studies link stigma with lower adherence and higher loss to follow up, highlighting the need for local, culturally sensitive responses that engage families, faith leaders, youth networks, and women’s groups [3,7]. Gender-sensitive programming is particularly important: women and girls face intersectional stigma driven by gender norms, economic dependence, and the risk of gender-based violence barriers that require combined social protection, livelihood support, and confidential clinical services to overcome [5].

At the Centre for Family Health Initiative (CFHI), community-led support is operationalized through sustained activities that go beyond one-day events. CFHI provides community HIV testing and counselling, adolescent-friendly education, psychosocial support, and peer navigation to link women and girls to care and keep them on treatment [8]. The organization integrates stigma-reduction messaging into gender-norms dialogues, trains community health volunteers in respectful care, and runs livelihood and empowerment sessions that reduce economic vulnerability an important factor that often forces women to remain in situations where disclosure is dangerous. CFHI’s community outreach also emphasizes U=U messaging to demystify treatment and encourage adherence and last year’s community testing and sensitization activities in Imo State reached hundreds with counselling and referrals, reinforcing the role of sustained local engagement in improving outcomes [8].

Ending HIV stigma requires action across sectors. Health facilities must adopt anti-discrimination policies and provide confidential, quality services; community leaders and faith institutions must publicly reject harmful narratives; schools and youth groups must deliver age-appropriate HIV education; and social protection programmes should prioritize women and girls so economic dependence does not block access to care. Donors and governments must sustain funding for community-led responses, which evidence shows are cost-effective and essential for reaching the UN targets to end AIDS as a public health threat [5,6].

Now is the time for communities to move from awareness to durable action. Support people living with HIV by learning and sharing accurate facts, joining, or starting peer support groups, encouraging friends and family to test, demanding respectful care at clinics, and supporting empowerment programmes that reduce vulnerability. CFHI and partners stand ready to work with communities, faith groups, schools, and health services to build safe, supportive environments where women and girls living with HIV can thrive. Together we can make stigma a thing of the past because when communities lead, lives change.

 

References

  1. Global HIV & AIDS statistics — Fact sheet. Geneva: Joint United Nations Programme on HIV/AIDS; 2025.
    Available from: https://www.unaids.org/en/resources/fact-sheet
  2. Doyle CM, Kuchukhidze S, Stannah J, Flores Anato JL, Xia Y, Logie CH, et al. The impact of HIV stigma and discrimination on HIV testing, antiretroviral treatment, and viral suppression in Africa: a pooled analysis of population-based surveys.
    Available from: https://www.researchgate.net/publication/391079137_The_Impact_of_HIV_Stigma_and_Discrimination_on_HIV_Testing_Antiretroviral_Treatment_and_Viral_Suppression_in_Africa_A_Pooled_Analysis_of_Population-Based_Surveys
  3. Mahlalela NB, et al. The association between HIV-related stigma and health-seeking behaviour, testing and adherence: a systematic review. J Public Health. 2024.
    Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10896802/
  4. UNAIDS / IAS / Prevention Access Campaign. Undetectable = Untransmittable (U=U) consensus and evidence. Geneva: UNAIDS; 2018–2024.
    Available from: https://www.unaids.org/en/resources/presscentre/featurestories/2018/july/undetectable-untransmittable
  5. World Health Organization. Eliminating stigma and discrimination in HIV responses: evidence and interventions. Geneva: WHO; 2022.
    Available from: https://www.who.int/teams/global-hiv-hepatitis-and-stis-programmes/hiv/strategic-information/hiv-data-and-statistics
  6. Community-led monitoring / Community-led responses — evidence and good practice. Geneva: UNAIDS; 2023.
    Available from: https://www.unaids.org/en/resources/documents/2023/community-led-monitoring-in-action
  7. Okunola A, et al. The impact of stigma on ART adherence in Ondo State clinics: cross-sectional evidence. Int J Res Innov Social Sci. 2025.
    Available from: https://rsisinternational.org/journals/ijriss/articles/the-impact-of-stigma-and-discrimination-on-adherence-levels-in-hiv-positive-patients-evidence-from-ondo-state-clinics/
  8. Centre for Family Health Initiative (CFHI). Community HIV services, stigma reduction and outreach report. Owerri: CFHI; 2024–2025.
    Available from: https://www.cfhinitiative.org

 

 

Beyond Stigma: Community-Led Support for Women and Girls Living with HIV Read More »

World AIDS Day

16DaysOfActivism, Gender, Health, Health Communication, HIV/AIDS, Hygiene, Monday Health Burst /

Today, December 1st, the world once again marks World AIDS Day, a global reminder of our shared responsibility to end HIV and support people living with it. This year’s theme, “Overcoming Disruption, Transforming the AIDS Response,” highlights the urgent need to rebuild stronger, more resilient, and equitable systems that ensure no one is left behind in HIV prevention and care [1]. Despite decades of progress, HIV continues to thrive where misinformation, stigma, poverty, and limited access to health services persist, especially among vulnerable groups such as adolescents, young women, and key populations [2].

Understanding how HIV spreads remains essential. The virus is transmitted through unprotected sexual intercourse, sharing contaminated needles, mother-to-child transmission during pregnancy, birth, or breastfeeding, and rarely through unscreened blood transfusion [3]. It is important to emphasize that HIV cannot be transmitted through casual contact, which means stigma rooted in misinformation must continue to be challenged [4]. Prevention remains powerful when individuals consistently use condoms, access regular HIV testing, utilize PrEP when at risk, avoid sharing needles, and ensure pregnant women living with HIV receive PMTCT services [5]. Effective treatment such as antiretroviral therapy suppresses viral load, making HIV untransmittable when undetectable (U=U), a breakthrough in global HIV care [6].

The Centre for Family Health Initiative (CFHI) remains committed to strengthening the HIV response through coordinated community engagements that include HIV testing, counselling, prevention education, PMTCT support, stigma reduction activities, and linkage to care for individuals and families. Over the years, CFHI has collaborated with partners such as Excellence and Friends Management Care Centre (EFMC), the Catholic Caritas Foundation of Nigeria (CCFN), and the Institute of Human Virology Nigeria (IHVN). These partnerships have supported CFHI in reaching over 14,000 children and caregivers with essential HIV-related services. Currently, CFHI continues to work actively with IHVN alongside support from the FCT Social Development Secretariat (SDS) to provide ongoing care, and treatment adherence services to about 6,000 children and their caregivers. Through its OVC programming, CFHI remains committed to improving long-term health, resilience, and stability for vulnerable families affected by HIV.

As Nigeria joins the global community in commemorating World AIDS Day 2025, it is essential for the government to strengthen its leadership in the national HIV response. This includes increasing investment in public health systems, ensuring consistent availability of testing kits and antiretroviral medications, expanding prevention programs such as PrEP and PMTCT, and improving data management for timely decision-making. Government action is also needed to address stigma through nationwide awareness campaigns, to support state-level implementation of HIV programs, and to create enabling environments where community organizations, healthcare workers, and development partners can scale interventions effectively. HIV is preventable and treatable, and with informed choices, prioritizing equitable access to services, sustaining political commitment, and collective action, Nigeria can accelerate progress toward ending AIDS as a public health threat.

Everyone is encouraged to take responsibility by getting tested, reducing risk, supporting those living with HIV, and rejecting stigma in every form.

 

References

  1. World Health Organization. World AIDS Day 2025 Theme: Overcoming Disruption, Transforming the AIDS Response. Geneva: WHO; 2025. https://www.who.int
  2. UNAIDS. Global HIV & AIDS Statistics — Fact Sheet 2025. Joint United Nations Programme on HIV/AIDS; 2025. https://www.unaids.org/en/resources/fact-sheet
  3. Centers for Disease Control and Prevention. HIV Transmission Overview. Atlanta: CDC; 2024. https://www.cdc.gov/hiv/basics/transmission.html
  4. UNAIDS. Confronting HIV Stigma and Discrimination. Joint United Nations Programme on HIV/AIDS; 2024. https://www.unaids.org/en/key-programmes/stigma-discrimination
  5. World Health Organization. HIV Prevention Guidelines. Geneva: WHO; 2024. https://www.who.int/health-topics/hiv
  6. UNAIDS. Undetectable = Untransmittable (U=U) Scientific Update. Geneva: UNAIDS; 2024. https://www.unaids.org/en/resources/presscentre/featurestories/2024/u-u
  7. Centre for Family Health Initiative. Community HIV Services and OVC Support Report. Abuja: CFHI; 2024. https://www.cfhinitiative.org

World AIDS Day Read More »

Economic Dependence and Poverty

16DaysOfActivism, Gender, Gender Based Violence, Gender Equality, Health, Health Communication, Men's Health /

Economic dependence and poverty are not just financial issues they are powerful forces that shape power dynamics, influence decision-making, and, far too often, trap women and girls in cycles of gender-based violence (GBV). As the world marks the UN 16 Days of Activism Against Gender-Based Violence, it is essential to spotlight how economic injustice fuels abuse and limits survivors’ ability to break free.

Globally, 1 in 3 women experience physical or sexual violence in their lifetime [1]. But this statistic tells only part of the story. Economic vulnerability magnifies the risk. According to UN Women, women who lack income or financial independence are more than twice as likely to experience intimate partner violence (IPV) compared to women with stable earnings [2]. Poverty does not cause violence, but it creates the conditions that allow it to thrive.

Women and girls in low-income settings often face restricted access to education, limited job opportunities, lower wages, and discriminatory cultural norms that position men as sole decision-makers. In many African countries, including Nigeria, the gender wage gap persists, and only 47% of women participate in the labor force compared to 74% of men [3]. Economic dependence becomes both a weapon and a barrier abusers use financial control to dominate, and survivors stay because they have nowhere else to go.

Research also shows that economic abuse such as preventing a woman from working, taking her earnings, or denying access to financial resources is present in 94% of abusive relationships [4]. This form of violence is silent but devastating. It keeps survivors trapped in relationships where they fear not only physical harm, but homelessness, hunger, and inability to care for their children.

During the 16 Days of Activism, the global community emphasizes prevention, protection, and justice. Yet these efforts are incomplete without addressing the economic realities that shape women’s lives. Economic empowerment is not a luxury it is a protective factor. Studies show that when women have financial independence, the likelihood of experiencing intimate partner violence drops significantly, sometimes by up to 35% [5].

To meaningfully address GBV, we must:

  • Expand women’s access to education, digital literacy, and vocational training.
  • Promote equal employment opportunities and enforce equal pay legislation.
  • Support women-owned businesses and access to credit.
  • Integrate economic empowerment programs into GBV prevention strategies.
  • Provide social protection, cash transfers, and safety nets that reduce vulnerability.

 

Over the years, the Centre for Family Health Initiative (CFHI) has consistently advanced economic and gender justice through practical empowerment programmes that strengthen the financial independence of women and adolescent girls. Across various communities, CFHI has trained over 500 women and girls in income-generating skills such as tailoring, pastry production, craft design, and household product manufacturing interventions that have enabled many beneficiaries to start small-scale businesses and reduce their economic dependence.

Under its OVC and community health programs, CFHI has also supported female caregivers from over 1000 vulnerable households with start-up kits, access to savings groups, and linkages to livelihood opportunities. Additionally, CFHI’s gender norms and leadership development activities have reached thousands of adolescents and young women, strengthening their confidence, shifting harmful cultural perceptions, and enhancing their participation in community leadership. Support for adolescent mothers has remained a core focus. These combined interventions reflect CFHI’s long-standing commitment to empowering women and girls with the skills, resources, and opportunities needed to achieve economic independence and live free from violence.

As we participate in the global campaign, let us remember that ending violence requires ending poverty and dependence. Governments, development actors, communities, and individuals must work together to expand economic opportunities and dismantle systems that keep women financially trapped.

Empowering women economically is one of the most powerful ways to break the silence, stop the violence, and build a future where every woman can live with dignity, safety, and independence. Economic justice is gender justice. A world free from violence must also be a world free from poverty.

 

References

  1. World Health Organization. Violence against women: prevalence estimates 2018. Geneva: WHO; 2021. Available from: https://www.who.int/publications/i/item/9789240022256
  2. UN Women. Facts and figures: Ending violence against women. 2024. Available from: https://www.unwomen.org/en/what-we-do/ending-violence-against-women/facts-and-figures
  3. World Bank. Labor force participation rate, female (% of female population ages 15+). 2023. Available from: https://data.worldbank.org
  4. Adams AE, Sullivan CM, Bybee D, Greeson M. Development of the scale of economic abuse. Violence Against Women. 2008;14(5):563-588.
  5. UNFPA. Economic empowerment and the reduction of gender-based violence: Global evidence. 2023. Available from: https://www.unfpa.org

 

 

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