Hygiene

The Invisible Dangers of Tobacco

Tobacco use remains one of the greatest yet preventable public health threats globally. While many people associate tobacco only with smoking, its harmful effects extend beyond the smoker, affecting families, workplaces, schools, and entire communities through second-hand smoke exposure. As the world marks World, No Tobacco Day 31st May, it is important to raise awareness about the hidden dangers of tobacco and why communities must take collective action to protect health.

According to the World Health Organization (WHO), tobacco kills more than seven million people annually, including approximately 1.6 million non-smokers who die from exposure to second-hand smoke [1]. Research further shows that tobacco kills up to half of its users who do not quit, making it one of the leading causes of preventable disease and death globally. Around 80% of the world’s 1.3 billion tobacco users live in low- and middle-income countries, where healthcare systems often struggle to manage the growing burden of tobacco-related diseases.

Tobacco contains thousands of harmful chemicals that damage nearly every organ in the body. Evidence from the Centers for Disease Control and Prevention (CDC) shows that tobacco smoke contains more than 7,000 chemicals, hundreds of which are toxic and about 70 are known to cause cancer [2]. This means smoking is not only harmful to the lungs; it also damages the heart, brain, blood vessels, reproductive system, and immune system.

One of the invisible dangers of tobacco is second-hand smoke, the smoke inhaled by people who do not smoke but are exposed to smoke from cigarettes, cigars, or other tobacco products. Many people believe smoking only harms the person holding the cigarette, but science shows otherwise. There is no safe level of exposure to second-hand smoke, and even brief exposure can cause immediate harm [3]. Children, pregnant women, older adults, and people with underlying illnesses are especially vulnerable. Exposure in homes, vehicles, markets, and workplaces can lead to serious health consequences.

Health hazards linked to tobacco use are severe and life-threatening. Tobacco significantly increases the risk of lung cancer, throat and mouth cancer, chronic respiratory illnesses, heart disease, stroke, and high blood pressure. Studies indicate that smoking contributes to approximately 85% of lung cancer deaths globally [4]. Smokers are also more likely to experience weakened immunity, fertility problems, pregnancy complications, and delayed wound healing. Tobacco exposure increases risks for chronic illnesses that place enormous pressure on families and healthcare systems.

The impact of second-hand smoke on non-smokers is equally alarming. Research from the CDC shows that people who do not smoke but regularly breathe second-hand smoke at home or work have a 25–30% higher risk of developing heart disease and a 20–30% increased risk of stroke [5]. Among children, second-hand smoke exposure is linked to respiratory infections, ear infections, worsening asthma, poor lung development, and increased illness frequency [6]. Since 1964, an estimated 2.5 million people who did not smoke have died due to health conditions caused by second-hand smoke exposure.

Beyond health, tobacco has social and economic consequences. In many households, money spent on tobacco products competes with essential needs such as food, school fees, medicines, and shelter. WHO reports that tobacco addiction can contribute to poverty by diverting limited family resources away from necessities [1]. Communities also suffer productivity losses due to illness, disability, and premature deaths caused by tobacco-related diseases.

Public health experts recommend stronger tobacco control measures to reduce these risks. WHO promotes strategies such as smoke-free public spaces, stronger public education, restrictions on tobacco advertising, support for quitting tobacco, and increased taxation on tobacco products [7]. Evidence suggests that increasing tobacco prices reduces tobacco use, especially among young people and low-income populations. Health education and early prevention are equally important in discouraging tobacco initiation among adolescents and young adults.

Communities and families also have a role to play. Parents and caregivers should avoid smoking around children, establish smoke-free homes, and openly discuss the dangers of tobacco use. Schools, faith-based organizations, youth groups, and community leaders can support awareness campaigns that encourage healthier lifestyles and reduce stigma around seeking help to quit tobacco.

Tobacco-related diseases are largely preventable. Protecting ourselves and others begins with informed choices. Saying no to tobacco, supporting smoke-free environments, and encouraging those struggling with tobacco dependence to seek help can save lives. As we reflect on the dangers of tobacco this May, let us remember that healthy communities begin with healthy habits, informed decisions, and collective responsibility.

References

  1. https://www.who.int/news-room/fact-sheets/detail/tobacco
  2. https://www.cdc.gov/tobacco/secondhand-smoke/index.html
  3. https://www.cdc.gov/tobacco/secondhand-smoke/health.html
  4. https://www.cdc.gov/tobacco/secondhand-smoke/home.html
  5. https://www.cdc.gov/niosh/reproductive-health/prevention/secondhand-smoke.html
  6. https://www.who.int/health-topics/tobacco

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Building Strong Homes for Better Well-being

Good health does not begin in the hospital it begins at home. While healthcare facilities remain essential for treatment, the home is the first and most effective line of defense against illness. A well-informed family that practices prevention, safety, and early detection creates a protective environment where diseases are less likely to thrive. Research shows that many common illnesses can be prevented through simple household practices, making the home a critical space for safeguarding health and well-being [1].

Creating a healthy home starts with basic hygiene and sanitation practices. Proper handwashing, safe disposal of waste, access to clean water, and maintaining a clean environment significantly reduce the spread of infections. According to global health evidence, about 88% of diarrhoeal diseases are linked to unsafe water, sanitation, and hygiene practices [1]. These simple but consistent practices help families prevent diseases before they begin and create a healthier living environment for everyone.

Early prevention and detection are equally important in building strong homes. Families that are attentive to early symptoms, seek timely medical care, and participate in routine health checks are more likely to prevent complications. Evidence from community health interventions in Nigeria shows that poor health-seeking behaviour and lack of early detection contribute significantly to disease burden, while community engagement improves outcomes [2]. This reinforces the importance of making prevention a daily habit within households.

The Centre for Family Health Initiative (CFHI) has, over the years, played a critical role in strengthening vulnerable families and communities through prevention-focused interventions with support from our funders and community stakeholders. [3].

Ultimately, building strong homes is essential for creating healthier communities. When families take responsibility for prevention through hygiene, proper nutrition, safety practices, and early healthcare seeking they reduce the spread of disease and improve overall well-being. The impact goes beyond individual households, contributing to stronger, healthier, and more resilient communities.

The call to action is clear let every home become a center of prevention, protection, and care. By adopting simple health practices and supporting community-based interventions, we can collectively build a future where illness is reduced, and well-being thrives.

References

  1. World Health Organization – Hygiene and health
    https://www.emro.who.int/child-health/community-family/key-family-practices-on-child-health-care/Hygiene.html
  2. Community health systems in Nigeria – Read study on community health systems
  3. CFHI Malaria & Community Health Intervention – Read CFHI malaria outreach report
  4. CFHI Programs Overview – https://www.cfhinitiative.org/health-is-more-than-treating-illness/

 

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VACCINES SAVE LIVES

Vaccination is one of the greatest achievements in public health, and the statement “vaccines save lives” is far more than a slogan it is a reality backed by decades of scientific evidence, global data, and measurable impact across countries and generations. Vaccines protect individuals and communities by preventing illness, disability, and death from infectious diseases such as measles, polio, tetanus, and influenza. According to the World Health Organization, immunization prevents between 3.5 and 5 million deaths every year worldwide [1], while the Centers for Disease Control and Prevention estimates that about 4 million deaths are prevented annually through childhood vaccination alone [2]. These are not projections they are outcomes already achieved through consistent global efforts.

Looking over a longer period, the scale of impact becomes even more striking. In the past 50 years, vaccination programmes have saved approximately 154 million lives globally [3], which translates to about six lives saved every minute [4]. Most of these lives around 95 percent are children under the age of five [5], highlighting the critical role vaccines play in child survival. Measles vaccination alone accounts for nearly 94 million lives saved [3], demonstrating how a single vaccine can transform global health outcomes. These figures are supported by extensive research, including studies published in The Lancet, which consistently confirm the enormous contribution of immunization to reducing mortality and improving life expectancy worldwide [6].

Vaccines work by training the body’s immune system to recognize and fight harmful pathogens before they cause disease, providing protection that is both effective and long-lasting. Their benefits extend beyond individual protection to entire populations. By reducing disease transmission, vaccines create herd immunity, protecting even those who cannot be vaccinated. They prevent outbreaks of deadly diseases, reduce the burden on healthcare systems, and generate significant economic returns saving up to $52 for every $1 invested in immunization programmes in low- and middle-income countries [2]. Over time, vaccines have contributed to a 40 percent reduction in global infant mortality [5], a remarkable achievement that underscores their importance in improving survival rates.

Diseases that once caused widespread fear and death have been brought under control or eliminated entirely due to vaccination. Smallpox, for example, has been eradicated globally, while polio is now on the verge of elimination after decades of sustained immunization efforts. These successes demonstrate what is possible when science, policy, and community engagement work together.

Despite these achievements, significant gaps in immunization coverage remain. An estimated 14.3 million children worldwide have never received a single dose of any vaccine, often referred to as “zero-dose” children [7]. Nigeria is among the countries with the highest number of unvaccinated children, highlighting a critical public health challenge that requires urgent attention [7]. In addition, measles vaccination coverage remains below optimal levels in many regions, leaving millions of children vulnerable to preventable disease outbreaks [7]. These gaps not only endanger lives but also risk reversing decades of progress.

Efforts to close these gaps are strengthened by global initiatives such as World Immunization Week, celebrated annually in the last week of April. Led by the World Health Organization, this campaign raises awareness about the importance of vaccines, promotes equitable access, and encourages governments and communities to prioritize immunization [8]. Themes such as “Immunization for All is Humanly Possible” emphasize the need to reach every child, everywhere, regardless of location or socioeconomic status.

At the national level, governments play a central role in ensuring vaccine access and uptake. In Nigeria, interventions such as the National Programme on Immunization (NPI), the integration of vaccines into primary healthcare services, and partnerships with global organizations have significantly improved immunization coverage. Campaigns targeting polio eradication and routine immunization have contributed to notable progress, but challenges remain. Reaching underserved communities, strengthening healthcare infrastructure, and addressing vaccine hesitancy require sustained investment and commitment.

Recent global disruptions, including the COVID-19 pandemic, have led to missed vaccinations and declining coverage in some areas, increasing the risk of disease outbreaks. Public health experts warn that without renewed efforts, diseases that were once under control could resurface, threatening lives and straining already burdened health systems. This makes it more important than ever to prioritize immunization as a cornerstone of public health.[9]

At the Centre for Family Health Initiative (CFHI), these gaps have been actively addressed through sustained, community-driven interventions aimed at improving immunization uptake over time. CFHI has implemented targeted vaccine awareness campaigns, strengthened community mobilization, and integrated immunization education into maternal, child health, and HIV service delivery platforms. Through consistent engagement with caregivers, community leaders, and health facilities, CFHI has contributed to reducing vaccine hesitancy, improving demand for routine immunization, and supporting last-mile access to life-saving vaccines in underserved communities. These efforts form part of CFHI’s broader commitment to strengthening primary healthcare systems and safeguarding children and vulnerable populations from vaccine-preventable diseases.[10]

Vaccines remain one of the most cost-effective, impactful, and scalable health interventions available today. However, their life-saving potential can only be realized when they reach the people who need them. Vaccines save lives but only when they are accessible, accepted, and administered on time. Individuals and families must ensure that children receive all routine immunizations according to schedule, while communities must promote accurate information and counter misinformation. Governments must increase funding for immunization programmes and strengthen healthcare systems, while organizations and partners must support outreach to underserved populations. Health workers, as trusted voices, must continue to advocate for vaccination and engage communities effectively.

No one should die from a disease that vaccines can prevent. The science is clear, the evidence is overwhelming, and the solution is within reach. Vaccines save lives and with collective action, they can save millions more.

References

  1. WHO – Vaccines and Immunization: https://www.who.int/health-topics/vaccines-and-immunization
  2. CDC – Global Immunization Fast Facts: https://www.cdc.gov/global-immunization/fast-facts
  3. WHO – 154 million lives saved: https://www.who.int/news/item/24-04-2024-global-immunization-efforts-have-saved-at-least-154-million-lives-over-the-past-50-years
  4. London School of Hygiene & Tropical Medicine – EPI impact
  5. UNICEF – Why vaccines matter: https://www.unicef.org/stories/why-vaccines-matter-children
  6. The Lancet Study on Immunization Impact
  7. WHO – Immunization Coverage Factsheet: https://www.who.int/news-room/fact-sheets/detail/immunization-coverage
  8. World Immunization Week Overview
  9. https://www.who.int/news/item/15-07-2022-covid-19-pandemic-fuels-largest-continued-backslide-in-vaccinations-in-three-decades?utm_source=chatgpt.com
  10. https://www.cfhinitiative.org/ending-hiv-stigma-community-support-beyond-world-aids-day/ 

 

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Handwashing Prevents Disease

Handwashing with soap remains one of the most effective and affordable ways to prevent diseases and protect public health. According to the World Health Organization and global health partners, proper hand hygiene significantly reduces the spread of infectious diseases such as diarrhea, respiratory infections, and even emerging outbreaks [1]. Despite its simplicity, handwashing is often overlooked, contributing to millions of preventable illnesses and deaths worldwide.

Scientific evidence shows that unclean hands are a major pathway for disease transmission. Germs from faecal matter, contaminated surfaces, and respiratory droplets easily spread through touch, food handling, and person-to-person contact. Research indicates that a single gram of human faeces can contain up to one trillion germs, making proper hand hygiene critical in breaking the chain of infection [2]. Handwashing with soap has been shown to reduce diarrheal diseases by 23–40% and respiratory infections by up to 21% [3].

Globally, the burden of poor hand hygiene remains alarming. An estimated 2.3 billion people lack access to basic handwashing facilities with soap and water, while 1.7 billion still do not have basic hygiene services at home [4]. Additionally, nearly half of healthcare facilities worldwide lack proper hand hygiene services, putting patients at risk of infections [5]. Among children, poor hygiene contributes significantly to disease, with approximately 1.8 million children under five dying annually from preventable illnesses such as diarrhea and pneumonia conditions that proper handwashing could help reduce [6].

Various interventions have been implemented globally to promote hand hygiene. Organizations such as UNICEF and WHO continue to support handwashing campaigns, improve access to water and sanitation, and integrate hygiene education into schools and communities [1]. Community awareness programs, provision of handwashing facilities, and behavior change communication have proven effective in improving hygiene practices. Studies show that even a small investment less than $1 per person annually can significantly expand access to handwashing facilities and save hundreds of thousands of lives [7].

Our commitment to ‘Standing with Science’ was most evident during the height of the COVID-19 pandemic. Recognizing that awareness is only effective when paired with resources, CFHI conducted extensive sensitization and distribution drives across the FCT. This included critical interventions at the Kuje Prison in Abuja and various schools throughout the FCT, where we provided essential hygiene tools such as professional-grade hand sanitizers, liquid soaps, and specialized buckets and bowls with attached taps to facilitate contactless handwashing. This proactive approach ensured that the most vulnerable populations had the physical means to break the chain of infection.

In conclusion, handwashing is a simple yet powerful tool that everyone can practice daily. Individuals are encouraged to wash their hands regularly especially before eating, after using the toilet, and after contact with potentially contaminated surfaces. Governments and institutions must also invest in accessible hygiene facilities and promote behaviour change. By making handwashing a habit, we can prevent diseases, save lives, and build healthier communities. Clean hands are not just a personal responsibility they are a public health necessity.

References

  1. https://www.who.int/news-room/fact-sheets/detail/hand-hygiene
  2. https://www.cdc.gov/hygiene/about/index.html
  3. https://www.cdc.gov/hygiene/personal-hygiene/hands.html
  4. https://www.unicef.org/reports/state-worlds-handwashing-2021
  5. https://www.who.int/publications/i/item/9789240055445
  6. https://www.who.int/news-room/fact-sheets/detail/diarrhoeal-disease
  7. https://www.worldbank.org/en/news/feature/2020/04/22/handwashing-for-all-the-value-of-hand-hygiene-to-save-lives-and-economies

 

 

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Unsafe Water and Poor Sanitation: Hidden Threats to Community Health

By Chiadika Emmanuel Chidera 

Unsafe water and poor sanitation remain major but often overlooked threats to community health. Access to clean drinking water and safe sanitation is a fundamental human right and a critical pillar of disease prevention. Yet millions of people around the world still lack these essential services. According to global health data, about 2 billion people do not have access to safely managed drinking water, while nearly 3.6 billion people lack safely managed sanitation services¹. These gaps create conditions where preventable diseases easily spread, particularly among vulnerable populations such as children and women.

Contaminated water often carries harmful bacteria, viruses, parasites, and toxic substances that can lead to serious illnesses. Diseases such as cholera, typhoid fever, dysentery, hepatitis A, and diarrhoea are commonly transmitted through unsafe water. Health estimates show that approximately 1.4 million deaths each year are linked to inadequate water, sanitation, and hygiene (WASH) services². Diarrhoeal diseases alone cause over 1 million deaths annually, with nearly 395,000 of these deaths occurring among children under the age of five². In Nigeria, the situation remains concerning, as reports indicate that over 100 children die daily from diarrhoeal diseases, many of which are connected to unsafe water sources and poor sanitation practices⁴.

The health hazards associated with unsafe water and poor sanitation are wide-ranging. These include (1) the rapid spread of waterborne diseases such as cholera and typhoid, (2) severe diarrhoeal infections that cause dehydration and malnutrition, (3) parasitic infections like intestinal worms that affect about 1.5 billion people globally³, (4) long-term malnutrition and stunted growth among children due to repeated infections, and (5) exposure to chemical contaminants that can lead to organ damage and developmental problems. Poor sanitation practices such as open defecation further worsen these risks by contaminating water sources and the surrounding environment.

Beyond the health effects, unsafe water and poor sanitation also create social and economic challenges. Families often spend limited resources on treating preventable diseases, children miss school due to illness, and communities experience reduced productivity. Research shows that improving water, sanitation, and hygiene services can reduce diarrhoeal diseases by 30–40 percent³, making WASH one of the most cost-effective public health interventions.

Addressing this hidden crisis requires coordinated action from governments, communities, and development partners. Expanding access to safe water infrastructure, improving sanitation facilities, and promoting hygiene education are critical steps toward protecting public health. Individuals and communities can also contribute by (1) using safe or treated drinking water, (2) practicing proper sanitation and avoiding open defecation, (3) washing hands regularly with soap, and (4) protecting local water sources from contamination.

Improving water, sanitation, and hygiene services is essential for building healthier communities and preventing avoidable diseases. By prioritizing safe water and proper sanitation, societies can protect lives, strengthen public health systems, and ensure a healthier future for all.

Monday Health Burst is an initiative of CFHI to address issues of basic health concern. Join us every Monday on all our social media platforms for more episodes.

References

  1. UNICEF & World Health Organization Joint Monitoring Programme for Water Supply, Sanitation and Hygiene (JMP). https://washdata.org
  2. World Health Organization. Global Burden of Disease Attributable to Water, Sanitation and Hygiene. https://www.who.int/health-topics/water-sanitation-and-hygiene-wash
  3. Centers for Disease Control and Prevention. Global Water, Sanitation, and Hygiene (WASH) Data. https://www.cdc.gov/healthywater/global/index.html
  4. Nigeria WASH and diarrhoeal disease statistics. https://washnigeria.com

 

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Maternal Health – Access to Care

Nigeria’s maternal health landscape continues to reveal stark inequalities that jeopardize the lives of women and newborns, particularly in underserved states like Adamawa and Zamfara. Despite global and national efforts to improve maternal survival, access to essential care remains limited for millions of women across the country. Research shows that utilisation of maternal healthcare services including antenatal care, skilled delivery, and postnatal care is persistently low, with only about 52% of women attending at least four antenatal visits, 38% delivering in health facilities, and about 37% receiving postnatal care. These gaps contribute directly to preventable complications and deaths during pregnancy and childbirth. ¹

According to the 2024 Nigeria Demographic and Health Survey (NDHS), while antenatal care coverage has improved to 63%, only 46% of births are attended by skilled health personnel, leaving more than half of Nigerian mothers vulnerable during their most critical hour.² The stakes are staggering; a woman in Nigeria faces a 1 in 19 lifetime risk of dying during pregnancy or childbirth, compared to 1 in 4,900 in high-income countries.³ Despite these daunting statistics, recent government reports from the 2025 Joint Annual Review indicate a 17% reduction in maternal deaths across high-burden areas, driven largely by initiatives like the Maternal and Neonatal Mortality Reduction Innovation Initiative (MAMII), which facilitated over 4,000 free Cesarean sections and revitalized 435 health facilities within one year.⁴

At the heart of this changing landscape is the work of the Centre for Family Health Initiative (CFHI) through the BIRTH Project (Building Innovative Responses to Transform Healthcare), currently being implemented in Adamawa State and Zamfara State. In these regions, where geographical, financial, and systemic barriers often stand between a mother and survival, CFHI’s interventions are providing practical and life-saving solutions to improve access to skilled maternal care.

In Adamawa State, CFHI strengthened the Rumde Primary Health Care Centre in Yola North by installing a solar-powered birth suitcase, ensuring uninterrupted delivery services even in the absence of stable electricity. The intervention has become the primary source of light during childbirth in the facility, enabling safe deliveries at all hours. Beyond the health facility, the project promotes maternal wellbeing through community-led nutrition demonstrations aimed at preventing maternal anemia, a condition responsible for a significant proportion of pregnancy-related complications worldwide³.

In Zamfara State, where facility-based delivery rates have historically been low, similar solar-powered birth kits were installed at facilities such as Shagari Primary Health Centre, improving nighttime emergency response and increasing community confidence in the health system. However, the BIRTH Project goes beyond the provision of equipment. It directly addresses the five delays identified under the Maternal and Neonatal Mortality Reduction Innovation Initiative (MAMII).

The consequences of poor access are not only clinical but social and economic. Women who cannot reach care in time often resort to unskilled birth attendants or home deliveries, increasing the likelihood of complications and long-term disability. National analyses show that financial constraints, distance to facilities, and perceived poor quality of care are major determinants of home births, even among women who attend antenatal care. ⁶ Beyond these structural issues, cultural norms and limited decision-making autonomy further restrict women’s ability to seek timely and appropriate maternal healthcare.

To transform maternal health outcomes in Nigeria with Adamawa and Zamfara as case studies sustained investment is required in strengthening primary healthcare systems, expanding referral networks, improving emergency transport, and increasing the availability of skilled health workers trained in emergency obstetric and newborn care. Governments, donors, and civil society must work together to remove financial barriers, improve transportation systems, and empower women socially and economically so that no woman is forced to choose between distance and survival.

CFHI’s ongoing MNCH interventions demonstrate that progress is possible when communities are engaged, health systems are supported, and maternal care is prioritized. The task ahead is to scale these efforts with urgency, political commitment, and adequate funding to ensure that every pregnancy is safe, and every mother survives childbirth.

Monday Health Burst is an initiative of CFHI to address issues of basic health concern. Join us every Monday on all our social media platforms for more episodes.

 

References

  1. National Library of Medicine (PMC). Determinants of maternal healthcare service utilization in Nigeria.
    https://www.ncbi.nlm.nih.gov/pmc/articles/PMC
  2. National Population Commission (NPC) Nigeria and ICF. Nigeria Demographic and Health Survey 2024 (Key Indicators Report).
    https://dhsprogram.com
  3. World Health Organization (WHO). Trends in Maternal Mortality 2000–2023.
    https://www.who.int/publications
  4. Federal Ministry of Health Nigeria. 2025 Joint Annual Review Report & MAMII Initiative Update.
    https://health.gov.ng
  5. National Library of Medicine (PubMed). Barriers to facility-based delivery after antenatal care attendance in Nigeria.
    https://pubmed.ncbi.nlm.nih.gov

 

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Health Is More Than Treating Illness

Health is often misunderstood as the absence of illness, yet evidence shows that health is far more than treating disease after it occurs. The World Health Organization defines health as a state of complete physical, mental, and social well-being, not merely the absence of disease or infirmity (1). This means that healthcare systems and communities must move beyond reactive treatment and prioritize prevention, education, and supportive environments that enable people to live healthy lives long before they become patients.

Globally, nearly 60% of deaths are linked to preventable causes, including infections, maternal complications, malnutrition, and non-communicable diseases that could be reduced through early awareness, healthy behaviors, and timely care (1). Treating illness alone addresses only the final stage of a much longer health journey. When communities lack access to accurate information, clean water, nutrition, and preventive services, diseases spread faster and outcomes worsen, even when treatment is available.

In Nigeria, the limits of treatment-focused health systems are clearly visible. The country bears a disproportionate burden of preventable conditions, accounting for about 20% of global maternal deaths, many of which are linked to delays in care-seeking, poor nutrition, and lack of antenatal education rather than lack of hospitals alone (2). Similarly, malaria remains endemic, with over 1.9 million reported cases annually, despite the disease being largely preventable through awareness, environmental control, and early testing (3). These figures demonstrate that treatment without prevention is insufficient.

Recent public health emergencies further reinforce this reality. Between 2023 and 2024, Nigeria recorded over 19,000 suspected cholera cases, driven by unsafe water, poor sanitation, and limited hygiene awareness (4). Cholera is not primarily a failure of medicine but a failure of systems that support healthy living. Likewise, outbreaks of measles and other vaccine-preventable diseases continue to occur, largely due to misinformation and low community awareness rather than lack of vaccines (5).

Health also includes mental and social well-being, areas often overlooked in treatment-centered approaches. Studies show that people living in environments marked by poverty, stress, gender inequality, or violence experience poorer health outcomes even when medical care is available (6). Women and girls exposed to harmful practices or denied health information often suffer long-term physical and psychological consequences that treatment alone cannot undo.

Research consistently shows that preventive and promotive health interventions can reduce disease burden by up to 40%, improve service uptake, and lower healthcare costs (1). Community education, early screening, nutrition support, immunization, clean water access, and supportive social structures are as essential to health as hospitals and medicines. Healthy communities are built through informed choices, safe environments, and systems that support well-being at every stage of life.

Call to Action: If health is truly more than treating illness, then governments, health institutions, civil society organizations, and communities must invest in prevention, awareness, and social support systems. Strengthening health education, promoting early screening, improving water and sanitation, addressing gender and social inequalities, and empowering communities with knowledge are critical steps toward sustainable health outcomes. Treating illness saves lives but preventing illness and promoting well-being transforms societies.

References

  1. World Health Organization – Constitution & Health Promotion
    https://www.who.int/about/governance/constitution
    https://www.who.int/teams/health-promotion
  2. WHO Nigeria – Maternal Health Facts
    https://www.who.int/nigeria/health-topics/maternal-health
  3. World Health Organization – Malaria Factsheet
    https://www.who.int/news-room/fact-sheets/detail/malaria
  4. Nigeria Centre for Disease Control – Cholera Updates
    https://ncdc.gov.ng/diseases/cholera
  5. UNICEF Nigeria – Immunization and Disease Prevention
    https://www.unicef.org/nigeria/health
  6. World Health Organization – Social Determinants of Health
    https://www.who.int/health-topics/social-determinants-of-health
  7. PAHO Calls for Increased Surveillance Amid Rising Measles Cases https://www.reuters.com/business/healthcare-pharmaceuticals/paho-calls-increased-surveillance-amid-rising-measles-cases-americas-2026-02-04/ (turn0news26)

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Female Genital Mutilation as Gender-Based Violence: A Violation of Girls’ Rights

Female Genital Mutilation (FGM) is a harmful traditional practice and a clear form of gender-based violence that fundamentally violates the human rights of girls and women. The World Health Organization defines FGM as all procedures involving the partial or total removal of the external female genitalia or other injury to female genital organs for non-medical reasons (1). The practice has no health benefits and causes lifelong harm, violating girls’ rights to health, bodily integrity, security, and freedom from cruel, inhuman, or degrading treatment (1).

Globally, more than 230 million girls and women alive today have undergone FGM, spanning at least 30 countries across Africa, the Middle East, and parts of Asia (1). Each year, an estimated 4 million additional girls remain at risk, most of them under the age of 15, highlighting the urgent need for accelerated action (1). These figures reflect not isolated incidents, but a sustained pattern of violence rooted in gender inequality.

FGM persists primarily because of unequal power relations and entrenched social norms that subordinate girls and women. In many communities, the practice is falsely justified as a cultural rite of passage, a prerequisite for marriage, or a means of controlling female sexuality. These beliefs reinforce the notion that girls’ bodies are subject to communal control rather than individual rights, a hallmark of gender-based violence (2).

FGM remains most prevalent in sub-Saharan Africa, with some of the highest rates recorded in Somalia (approximately 99%), Guinea (94.5%), and Djibouti (93%) among women aged 15–49 (3). In Nigeria, an estimated 19.9 million girls and women have undergone FGM, making it one of the countries with the highest absolute number of survivors globally (4). Prevalence varies significantly across regions, with higher rates reported in the South-East and South-West, including states such as Imo, where prevalence exceeds 60% in some communities (4). These statistics underscore how deeply embedded the practice remains at both national and sub-national levels.

As a form of violence, FGM is typically carried out without informed consent, often during childhood, and results in enduring physical, psychological, and social harm. Survivors frequently report anxiety, emotional distress, reduced self-esteem, and loss of bodily autonomy, which can persist throughout adulthood (5). The trauma associated with the experience often affects girls’ confidence, participation in education, and ability to form healthy relationships later in life.

Beyond psychological harm, FGM has serious implications for sexual and reproductive health. It increases the risk of complications during pregnancy and childbirth, contributes to maternal and neonatal morbidity, and places additional strain on already fragile health systems in low-resource settings (1). These consequences further affirm why FGM is recognized globally as both a public health crisis and a human rights violation.

Recognizing its severity, the international community has committed to eliminating FGM under Sustainable Development Goal (SDG) Target 5.3, with a global target year of 2030 (5). Agencies such as the World Health Organization (WHO) and UNICEF have led coordinated efforts focusing on legal reform, community engagement, survivor-centred health services, and prevention strategies that challenge harmful gender norms (6).

At the national level, progress has been uneven. In countries like Somalia, WHO and partners have supported health system reforms, professional training, and community-based interventions to address both FGM and broader gender-based violence (7). In Nigeria, UNICEF has supported community-led abandonment initiatives in high-prevalence states, mobilizing local leaders, families, and youth to protect girls at risk and shift social norms (4).

The impact of FGM on confidence and well-being cannot be overstated. Many survivors live with lasting psychological effects, including post-traumatic stress, fear, and diminished self-worth, which influence education, employment, and social participation (5). These invisible scars are often overlooked, yet they shape the life chances of millions of women and girls.

Ending FGM requires decisive, multi-level action. Governments must strengthen and enforce laws that criminalize the practice. Communities must be supported to challenge harmful norms through dialogue and education. Health systems must provide survivor-centred care, including mental health services. Men and boys must be engaged as allies in promoting gender equality, while robust data systems are needed to monitor progress and guide policy decisions. Only through sustained, coordinated action can FGM be eliminated, and girls’ rights fully protected.

FGM is not culture it is violence. Ending it is not optional; it is an urgent moral, public health, and human rights imperative.

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

References

  1. World Health Organization (WHO). Female Genital Mutilation.
    https://www.who.int/health-topics/female-genital-mutilation
  2. WHO Regional Office for Africa. Female Genital Mutilation.
    https://www.afro.who.int/health-topics/female-genital-mutilation
  3. UNICEF. New Statistical Report on Female Genital Mutilation.
    https://www.unicef.org/png/press-releases/new-statistical-report-female-genital-mutilation-shows-harmful-practice-global
  4. UNICEF Nigeria. FGM on the Rise Among Young Nigerian Girls.
    https://www.unicef.org/nigeria/press-releases/unicef-warns-fgm-rise-among-young-nigerian-girls
  5. UNICEF DATA. Female Genital Mutilation Statistics.
    https://data.unicef.org/topic/gender/fgm/
  6. World Health Organization. New Recommendations to End Medicalized FGM.
    https://www.who.int/news/item/28-04-2025-who-issues-new-recommendations-to-end-the-rise-in–medicalized–female-genital-mutilation-and-support-survivors
  7. World Health Organization. Addressing FGM and GBV in Somalia.
    https://www.who.int/about/accountability/results/who-results-report-2020-mtr/country-story/2023/improving-maternal-health-outcomes-by-addressing-female-genital-mutilation-and-gender-based-violence-in-somalia

 

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Sexual Violence Against Women with Disabilities

Sexual violence against women with disabilities is a deeply troubling yet often overlooked dimension of gender-based violence that intersects with ableism, discrimination, and social neglect. Evidence shows that women with disabilities face a significantly higher risk of sexual violence compared to women without disabilities, in part because of societal attitudes that devalue their autonomy and normalize their marginalization. Research indicates that women with any form of disability may experience sexual violence at roughly double the rate of women without disabilities over their lifetimes, with heightened vulnerability among those with multiple or cognitive disabilities [1]. In some settings, women with disabilities are disproportionately likely to be victims of rape and other forms of coerced sexual contact, underscoring the urgent need to recognize their specific risks and experiences as part of broader violence prevention efforts [2].

The vulnerability of women with disabilities to sexual violence is driven by multiple factors including dependency on caregivers or partners for daily needs, limited mobility or communication barriers, and pervasive myths that deny their sexual agency and rights. These conditions not only increase exposure to abuse but also make it harder for survivors to report violence or access support services due to fear, shame, or lack of accessible reporting mechanisms. Global research highlights that women with disabilities are more likely to face not only sexual violence but also emotional and physical abuse, with long-term impacts on physical and mental health, autonomy, and quality of life [3]. The Office of the United Nations High Commissioner for Human Rights has repeatedly called attention to the disproportionate risk of violence faced by women with disabilities and the necessity for better data, inclusive services, and tailored policies to protect their rights [4].

In Nigeria, too, gender-based violence is addressed under laws such as the Violence Against Persons (Prohibition) Act 2015, which aims to eliminate all forms of violence against individuals, including sexual violence. While such legal frameworks exist, enforcement, awareness, and protection for women with disabilities remain inconsistent, with many survivors still falling through gaps in reporting, healthcare, and justice systems [5]. It is therefore critical for policymakers, health systems, community leaders, and service providers to mainstream disability-inclusive approaches that recognize the intersecting vulnerabilities that these women face.

At the Centre for Family Health Initiative (CFHI), addressing violence against women especially among vulnerable populations like women with disabilities is integral to our community health work. CFHI integrates gender-based violence awareness and response into school and community engagements, ensuring that information on rights, reporting pathways, and support services reaches diverse audiences. Through partnerships with health facilities, community leaders, and referral networks, CFHI also supports safe and confidential reporting channels, linking survivors to medical care, psychosocial support, and legal aid where available. By advocating for inclusive prevention strategies and survivor-centred responses, CFHI reinforces that violence against women with disabilities is not inevitable it is preventable and must be confronted collectively.

Ending violence against women with disabilities requires an intersectional approach that dismantles harmful social norms, strengthens legal protections, and ensures that services are accessible and responsive to the unique needs of survivors. Education and awareness campaigns must challenge myths about disability and sexuality, while community-level prevention programmes should promote respect, consent, and equality for all women regardless of ability. Health workers, educators, and law enforcement must be trained to recognise and respond to sexual violence sensitively and without bias. Importantly, women with disabilities themselves should be engaged as leaders in advocating for change, ensuring that policies and interventions are shaped by their lived experiences.

The fight against sexual violence is not only a matter of law or policy it is a moral imperative rooted in human rights, dignity, and justice. As communities, governments, and organisations, we must commit to creating environments where vulnerable women anf girls can live free from the threat of violence, access support without barriers, and assert their rights with confidence and respect.

 

References

  1. Centers for Disease Control and Prevention. Sexual Violence and Intimate Partner Violence Among People with Disabilities. Available from: https://www.cdc.gov/sexual-violence/about/sexual-violence-and-intimate-partner-violence-among-people-with-disabilities.html (CDC)
  2. Z. C. et al. Sexual Violence Against Women With Disabilities: Experiences With Force and Lifetime Risk. American Journal of Preventive Medicine (lifetime risk higher among women with disabilities). (Reddit)
  3. Health and Socioeconomic Determinants of Abuse among Women with Disabilities. International Journal of Environmental Research and Public Health (higher prevalence and lower escape rates). (MDPI)
  4. World Health Organization. WHO calls for greater attention to violence against women with disabilities and older women. WHO. (World Health Organization)
  5. Violence Against Persons (Prohibition) Act 2015 (Nigeria). Available from: https://en.wikipedia.org/wiki/Violence_Against_Persons_%28Prohibition%29_Act_2015 (en.wikipedia.org

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Silent Reproductive Health Struggles

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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