Uncategorized – Centre for Family Health Initiative

The Cost of Gender Inequality

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Gender inequality is more than a social issue; it is a barrier to justice, development, and human progress. Across the world, millions of women and girls continue to face discrimination that limits their access to education, healthcare, employment, leadership opportunities, and basic human rights. For many, especially those without a voice or platform to speak out, inequality remains a daily reality that shapes every aspect of their lives. ¹
One of the greatest costs of gender inequality is the loss of opportunity. Despite progress in recent decades, more than 122 million girls remain out of school globally. ³ Many are forced into child marriage, domestic labor, or other circumstances that prevent them from reaching their full potential. Yet research consistently shows that educating girls improves health outcomes, reduces poverty, and strengthens economies. ⁴
Gender inequality also places women and girls at greater risk of poor health outcomes. In many communities, women have limited control over decisions affecting their health and wellbeing. This contributes to preventable maternal deaths, inadequate access to healthcare services, and poor reproductive health outcomes. In 2020 alone, approximately 287,000 women died from preventable pregnancy and childbirth-related causes worldwide. ⁵
Violence against women remains another painful consequence of inequality. Nearly one in three women globally experiences physical or sexual violence during her lifetime. ⁶ Many victims remain silent due to fear, stigma, and lack of support, while countless others never receive justice.
The economic impact is equally significant. Women continue to earn less than men and face greater barriers to employment, financial resources, and leadership positions. According to the International Labour Organization, women earn about 20% less than men globally. ⁷ The World Bank further estimates that gender inequality costs countries trillions of dollars in lost human capital and productivity. ⁹
Gender inequality does not only harm women and girls it weakens families, communities, and nations. When women are denied equal opportunities, societies lose talent, innovation, and economic growth. ¹⁰ Conversely, countries that invest in gender equality experience stronger development outcomes, healthier populations, and more inclusive economies. ¹¹
Achieving gender equality requires more than policies and promises. It demands deliberate action to protect the rights of women and girls, expand access to education and healthcare, eliminate harmful practices, and create spaces where their voices are heard and respected.
The cost of gender inequality is simply too high. Every girl denied an education, every woman denied an opportunity, and every victim denied justice represents a loss not only to individuals but to society. Building a fairer world begins with ensuring that women and girls have the same rights, opportunities, and freedoms as everyone else.

References
1. https://www.unwomen.org/en/what-we-do/facts-and-figures
2. https://www.unesco.org/gem-report
3. https://www.unicef.org/education/girls-education
4. https://www.who.int/news-room/fact-sheets/detail/maternal-mortality
5. https://www.who.int/news-room/fact-sheets/detail/violence-against-women
6. https://www.ilo.org/global/topics/equality-and-discrimination/gender-equality
7. https://www.worldbank.org/en/topic/gender/publication/unrealized-potential-the-high-cost-of-gender-inequality-in-earnings
8. https://www.mckinsey.com/featured-insights/diversity-and-inclusion/the-power-of-parity-advancing-womens-equality-in-africa
9. https://sdgs.un.org/goals/goal5

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Why Primary Healthcare Matters

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For millions of Nigerians, the Primary Healthcare Centre (PHC) is the closest and sometimes the only place where they can receive medical care. Yet, despite serving as the foundation of Nigeria’s healthcare system, many Primary Healthcare Centres remain underfunded, understaffed, poorly equipped, or inaccessible, leaving millions of people without the quality healthcare they deserve.

Primary healthcare is the first level of contact between individuals and the health system. According to the World Health Organization (WHO), it provides comprehensive healthcare services that meet between 80 and 90 percent of an individual’s essential health needs throughout their lifetime (1). These services include health promotion, disease prevention, diagnosis, treatment, rehabilitation, palliative care, maternal and child healthcare, immunization, nutrition services, family planning, HIV and tuberculosis services, mental healthcare, and health education. By bringing these essential services closer to where people live, primary healthcare ensures that healthcare is accessible, affordable, and equitable.

Nigeria has over 30,000 Primary Healthcare Centres distributed across its 774 Local Government Areas (5,7). However, reports from the Federal Ministry of Health indicate that only a fraction of these facilities consistently provide comprehensive, quality services because many lack adequate infrastructure, electricity, clean water, medical equipment, essential medicines, and sufficient healthcare personnel (5). In some rural communities, residents travel several kilometres to reach the nearest functional health facility, often delaying treatment until illnesses become severe.

One of the greatest strengths of primary healthcare is its focus on prevention. Early diagnosis and timely treatment improve health outcomes while reducing the financial burden on families and the healthcare system. Preventive healthcare has consistently been shown to be far more cost-effective than managing advanced diseases that require hospitalization and specialized care (1,6).

Primary healthcare is also essential for improving maternal and child health. Nigeria accounts for one of the highest burdens of maternal and child mortality globally. According to the United Nations Maternal Mortality Estimation Inter-Agency Group, Nigeria recorded approximately 1,047 maternal deaths per 100,000 live births in 2020, one of the highest maternal mortality ratios in the world (3). In addition, UNICEF reports that millions of Nigerian children still miss essential vaccines each year, making the country one of the largest contributors to the global number of “zero-dose” children – those who have not received even a single routine vaccine (4).

Primary healthcare also plays a central role in controlling infectious diseases. According to the World Malaria Report 2024, Nigeria accounts for approximately 27 percent of all global malaria cases and about 31 percent of malaria-related deaths worldwide (2). The diagnosis, treatment, prevention, and distribution of insecticide-treated mosquito nets are largely coordinated through primary healthcare facilities. Strengthening these facilities directly contributes to reducing malaria-related illness and deaths.
Beyond routine healthcare, Primary healthcare Centres serve as the country’s first line of defence during disease outbreaks and public health emergencies. Whether responding to cholera outbreaks, Lassa fever, meningitis, COVID-19, or emerging infectious diseases, Primary Healthcare Centres play a central role in disease surveillance, case detection, public awareness, vaccination campaigns, contact tracing, and referrals (1,5). Community health workers are often the first professionals to identify unusual disease patterns and alert public health authorities before outbreaks escalate.

Investing in primary healthcare also makes economic sense. The World Bank estimates that investments in primary healthcare generate substantial economic returns because preventing illness costs significantly less than treating advanced disease (6). When affordable healthcare is available within communities, families are less likely to experience catastrophic health expenditures that push them deeper into poverty when affordable healthcare is available within their communities.

Unfortunately, many Nigerian communities continue to experience the consequences of weak primary healthcare systems (5,7). Health centres without skilled personnel, essential medicines, functional laboratories, ambulances, reliable electricity, clean water, or adequate medical equipment cannot provide quality services. Patients are often referred unnecessarily to already overcrowded secondary and tertiary hospitals, increasing waiting times, treatment costs, and avoidable deaths. Pregnant women may be forced to deliver at home or travel long distances while in labour. Children may miss life-saving immunizations because vaccines are unavailable or cold-chain equipment is non-functional.

The consequences extend beyond health. Weak primary healthcare reduces workforce productivity, increases school absenteeism, places greater financial pressure on households, and perpetuates poverty. Ultimately, no nation can achieve sustainable development without a strong and accessible primary healthcare system, because the health of its people is fundamental to its social and economic progress (6).

Governments at all levels must prioritize sustained investment in Primary Healthcare Centres. Strengthening primary healthcare is not merely a health sector priority, it is an investment in Nigeria’s future. It is the foundation upon which healthier families, stronger communities, and prosperous nations are built.

Every Nigerian, regardless of where they live or their socio-economic status, deserves access to a well-equipped Primary Healthcare Centre capable of delivering safe, timely, and quality healthcare.

References
1. World Health Organization (WHO). Primary Health Care. Geneva: WHO; 2024. Available from: https://www.who.int/health-topics/primary-health-care
2. World Health Organization. World Malaria Report 2024. Geneva: WHO; 2024.
3. United Nations Maternal Mortality Estimation Inter-Agency Group. Trends in Maternal Mortality: 2000–2020. New York: United Nations; 2023.
4. UNICEF Nigeria. Immunization and Zero-Dose Children in Nigeria. Abuja: UNICEF Nigeria.
5. Federal Ministry of Health and Social Welfare. Nigeria Health Sector Renewal Investment Initiative. Abuja: Federal Government of Nigeria.
6. World Bank. Primary Health Care and Universal Health Coverage. Washington, DC: World Bank.
7. National Primary Health Care Development Agency (NPHCDA). Primary Health Care Under One Roof (PHCUOR) Policy. Abuja: NPHCDA.

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The WASH Crisis Affecting African Children

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Access to clean water, safe sanitation, and proper hygiene collectively known as Water, Sanitation, and Hygiene (WASH) is not a luxury but a fundamental human right. Yet, for millions of children across Africa, this right remains unfulfilled. Every day, children are exposed to contaminated water, poor sanitation facilities, and inadequate hygiene conditions that threaten their health, education, dignity, and future. The WASH crisis is one of Africa’s most pressing public health challenges, silently contributing to preventable diseases, malnutrition, school absenteeism, and child mortality.

According to the WHO/UNICEF Joint Monitoring Programme (JMP), an estimated 2.1 billion people worldwide still lack access to safely managed drinking water, while 3.4 billion people do not have safely managed sanitation services. Furthermore, 1.7 billion people are unable to wash their hands with soap and water at home because they lack basic handwashing facilities ⁽¹⁾^. The burden of this crisis falls disproportionately on low- and middle-income countries, with sub-Saharan Africa recording some of the lowest levels of access to safe WASH services.

For African children, the consequences are severe. UNICEF estimates that 190 million children in ten African countries face a dangerous combination of water scarcity, unsafe drinking water, poor sanitation, climate-related shocks, and recurring disease outbreaks ⁽²⁾^.

One of the most devastating consequences of poor WASH is the high prevalence of diarrhoeal diseases. According to the World Health Organization, diarrhoea remains one of the leading causes of death among children under five years of age, claiming approximately 443,000 young lives every year worldwide. More importantly, WHO estimates that 58% of diarrhoeal diseases are directly linked to unsafe water, poor sanitation, and inadequate hygiene ⁽³⁾^. These are illnesses that can largely be prevented through access to clean water, improved sanitation, and proper hygiene practices.

The health effects extend far beyond diarrhoea. Poor WASH conditions increase the spread of cholera, typhoid fever, dysentery, hepatitis A, intestinal worm infections, trachoma, and several neglected tropical diseases. Children suffering from repeated infections often experience dehydration, nutrient loss, weakened immunity, and chronic undernutrition. Studies have shown that repeated episodes of diarrhoea significantly contribute to stunting, a condition that affects both physical growth and brain development, reducing children’s cognitive abilities and limiting their educational achievement and future productivity ⁽⁴⁾^.

The recent cholera outbreaks across Africa further illustrate the urgency of the situation. Between January 2024 and March 2025, countries in Eastern and Southern Africa reported more than 178,000 cholera cases and nearly 2,900 deaths, with children among the most vulnerable groups ⁽⁵⁾^. Cholera spreads rapidly in communities where access to clean water and sanitation is limited, highlighting the direct relationship between inadequate WASH infrastructure and disease outbreaks.

The WASH crisis also affects children’s education. Millions of African children miss school because they are sick from waterborne diseases or because they spend hours each day fetching water for their families. UNICEF reports that girls are particularly affected. Many adolescent girls skip classes or drop out of school due to the absence of private, clean, and functional toilets and inadequate menstrual hygiene facilities. This not only affects academic performance but also perpetuates gender inequality and limits future opportunities ⁽⁶⁾^.

Fortunately, investing in WASH produces remarkable health and economic returns. According to WHO, every US$1 invested in water and sanitation generates an estimated US$4.30 in economic returns through reduced healthcare costs, improved productivity, and fewer lost school and workdays ⁽⁷⁾^. Communities with improved WASH services experience fewer disease outbreaks, lower child mortality, better nutrition, higher school attendance, improved maternal health, and stronger resilience during public health emergencies.

Ensuring every child has access to safe water, sanitation, and hygiene requires coordinated efforts from governments, development partners, communities, schools, parents, and civil society. Governments should prioritize investments in safe water supply systems, sanitation infrastructure, and hygiene promotion, particularly in rural and underserved communities. Development partners and civil society organizations should continue supporting innovative WASH programmes that expand access to safe water and sanitation services for vulnerable populations.

Schools should provide safe drinking water, gender-friendly toilets, handwashing stations with soap, and age-appropriate hygiene education. Government and Communities have a vital responsibility to protect local water sources by discouraging open defecation, promoting proper waste disposal, and preventing environmental contamination. Parents also play an important role by teaching children healthy hygiene practices from an early age and ensuring safe water storage and handling at home.

Access to safe water and sanitation should never depend on where a child is born or the income of their family. Ensuring universal access to WASH is not only essential for improving health but also for reducing poverty, promoting education, advancing gender equality, and achieving sustainable development across Africa.

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

WHO & UNICEF Joint Monitoring Programme (JMP): https://washdata.org
UNICEF – Water Security and Climate Crisis in Africa: https://www.unicef.org
WHO – Drinking Water Fact Sheet: https://www.who.int/news-room/fact-sheets/detail/drinking-water
UNICEF – Water, Sanitation and Hygiene Programme: https://www.unicef.org/wash
UNICEF Eastern and Southern Africa – Cholera Situation Updates: https://www.unicef.org/esa
UNESCO – Water, Sanitation, Hygiene and Education: https://www.unesco.org
WHO – Global Analysis and Assessment of Sanitation and Drinking Water (GLAAS): https://www.who.int/teams/environment-climate-change-and-health/water-sanitation-and-health

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The Hidden Harm of Gender Bias in Parenting

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Parenting is one of the most influential responsibilities in shaping a child’s future. Yet, many parents unknowingly raise their children through the lens of gender bias, assigning different expectations, opportunities, emotions, and responsibilities to boys and girls based solely on societal stereotypes. While these practices may seem harmless or culturally acceptable, their long-term consequences can be damaging to children’s mental health, self-esteem, educational outcomes, and overall well-being.

Gender bias in parenting occurs when children are treated differently because of their sex. It often begins early in life. Boys may be encouraged to be strong, assertive, and emotionally reserved, while girls may be expected to be gentle, obedient, and nurturing. These expectations influence how children view themselves and their place in society ^(1).

Research shows that children begin developing gender awareness between the ages of two and five. During this period, parents play a critical role in shaping beliefs about what boys and girls can or cannot do. When children are repeatedly exposed to restrictive gender messages, they may limit their own aspirations and abilities based on those expectations rather than their true interests and potential ^(1,2).

One of the most significant hidden harms of gender-biased parenting is its impact on mental health. Boys who are constantly told to “man up,” “be tough,” or “stop crying” may learn to suppress emotions rather than express them in healthy ways. Over time, emotional suppression can contribute to anxiety, depression, anger-related problems, and difficulties in seeking help when needed. Mental health experts have long emphasized that emotional expression is essential for psychological well-being regardless of gender ^(3).

Girls, on the other hand, often face pressure to prioritize appearance, compliance, and caregiving roles. Constant messages about being “good,” “quiet,” or “beautiful” can create unrealistic standards that undermine self-confidence and self-worth. Research has linked gender stereotypes and restrictive expectations to increased risks of low self-esteem, anxiety, body image concerns, and reduced leadership aspirations among girls ^(2,4).

Gender bias can also affect educational and career development. For example, boys may be discouraged from pursuing interests perceived as feminine, such as nursing, caregiving, or the arts, while girls may receive less encouragement in science, technology, engineering, and mathematics (STEM) fields. These biases limit children’s opportunities and reinforce inequality across generations ^(1,5).

Another overlooked consequence is the effect on family relationships. When boys are given greater freedom while girls face stricter controls, or when household responsibilities are distributed unequally based on gender, feelings of resentment and unfairness may develop. Such experiences can affect sibling relationships and shape attitudes toward equality in adulthood ^(5).

Studies have also found that parental gender attitudes are associated with children’s emotional and behavioral outcomes. Children raised in environments with rigid gender expectations may experience higher levels of emotional distress and difficulties adjusting socially, highlighting the importance of equitable parenting practices ^(6).

Addressing this issue requires intentional action from parents, caregivers, educators, and communities. Parents can start by encouraging children to explore their interests freely, regardless of gender stereotypes. Household chores should be shared fairly among boys and girls. Children should be taught that emotions are normal and healthy for everyone to express. Parents should also challenge harmful statements such as “boys don’t cry” or “girls can’t do that” whenever they arise.

Furthermore, schools, religious institutions, community organizations, and policymakers must support efforts that promote gender equality and positive parenting practices. Parenting programs that encourage gender-transformative approaches have shown promise in reducing harmful norms and creating healthier environments for children ^(7).

Every child deserves the freedom to grow, learn, dream, and thrive without the limitations imposed by gender stereotypes. When parents nurture children based on their unique strengths rather than societal expectations, they help raise a generation that is healthier, more confident, emotionally resilient, and better prepared to contribute positively to society.

The hidden harm of gender bias in parenting is not always visible, but its effects are profound. By recognizing and addressing these biases today, we can create a future where every child has an equal opportunity to reach their full potential.

As parents, caregivers, educators, and community leaders, let us examine our own beliefs and practices. Let us create homes where boys and girls are equally valued, equally heard, and equally supported. By challenging gender stereotypes and embracing inclusive parenting, we can protect children’s mental health, promote equality, and build a more just and compassionate society for future generations.

References

UNICEF. Equal Treatment from Day One: Gender-Responsive Parenting.
https://www.unicef.org/parenting/child-development/what-gender-responsive-parenting
American Psychological Association (APA). Gender Stereotypes.
https://dictionary.apa.org/gender-stereotype
BMJ Mental Health. Universal, Selective and Indicated Parenting Interventions to Prevent Adverse Mental Health Outcomes in Youth.
https://mentalhealth.bmj.com/content/28/1/e301613
UNICEF. Tackling Gender Inequality From the Early Years.
https://www.unicef.org/reports/tackling-gender-inequality-early-years
UNICEF. Resource Package and Training Modules for Promoting Gender-Transformative Parenting.
https://www.unicef.org/reports/resource-gender-transformative-parenting
Aguirre E., Benzeval M., Murray A. (2024). Parental Gender Attitudes and Children’s Mental Health: Evidence from the UK Household Longitudinal Study.
https://www.sciencedirect.com/science/article/pii/S0277953624000765
BMJ Mental Health. Early Parenting Interventions to Prevent Internalising Problems in Children and Adolescents.
https://mentalhealth.bmj.com/content/26/1/e300811

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The Hidden Impact of Substance Abuse on Children

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As the world commemorates the International Day Against Drug Abuse and Illicit Trafficking, attention often focuses on individuals who use drugs, alcohol, and tobacco. Yet, another group silently bears the consequences of substance abuse vulnerable children who are homeless, in informal settlements, and in Internally Displaced Persons (IDP) camps. These children may not be using substances themselves, but they are frequently exposed to smoking, alcohol abuse, and drug use by adults and older youths around them. The effects of such exposure extend far beyond physical health and can have profound psychological and emotional consequences ^(1).

For many vulnerable children, exposure to substance abuse is a daily reality. They witness intoxicated adults, observe risky behaviours, and often live in environments where smoking and drinking are normalized. Research has shown that children learn behaviours by observing those around them, especially adults and older peers. When substance use becomes part of their everyday environment, children may begin to perceive it as an acceptable way to cope with stress, hardship, or emotional pain ^(2).

Street-connected children are particularly vulnerable. A systematic review involving 50 studies from 22 countries found that substance use is highly prevalent among street children, with an estimated lifetime prevalence of 60%. The review also identified tobacco, alcohol, and inhalants as commonly used substances among this population ^(2). While these findings focus on substance use among street children, they also highlight the environments in which many vulnerable children’s live environments where exposure to substance abuse is widespread and often unavoidable.

Children who regularly encounter drunken behaviour, substance-related conflicts, neglect, or aggression may experience persistent fear, anxiety, stress, and emotional insecurity. Such experiences can undermine a child’s sense of safety and stability, both of which are essential for healthy emotional development ^(3).

Children living in IDP camps face additional challenges. Many have already experienced displacement, loss of family members, violence, disruption of education, and uncertainty about the future. Exposure to substance abuse in these settings can compound existing trauma and increase the risk of psychological distress. Mental health experts have consistently noted that repeated exposure to stressful and unsafe environments during childhood can affect emotional regulation, concentration, learning ability, and social relationships later in life ^(3).

Research among street-living children has also shown that lack of family attachment, exposure to adult substance users, and psychosocial stress are strongly associated with substance use and poor mental well-being among children and adolescents ^(4). When children grow up surrounded by substance abuse, they may become more susceptible to depression, low self-esteem, behavioural problems, and future substance use themselves.

The effects are not only psychological. Children exposed to second-hand smoke face increased risks of respiratory infections, asthma, impaired lung development, and other health complications. Emerging research also suggests that exposure to tobacco smoke during childhood may affect cognitive development and contribute to learning and behavioural difficulties ^(5). For vulnerable children already facing multiple hardships, these additional health burdens can further limit their opportunities to thrive.

Perhaps most concerning is that many of these children remain invisible in public health discussions. While humanitarian responses often prioritize food, shelter, and healthcare, the mental and emotional well-being of children exposed to substance abuse frequently receives less attention. Yet mental health is just as important as physical health. A child who lives in constant fear, uncertainty, or emotional distress may carry those experiences into adolescence and adulthood.

Protecting vulnerable children requires a holistic approach. Safe spaces, mental health support services, positive role models, child protection mechanisms, and substance abuse prevention programmes are all critical. Communities must also recognize that substance abuse does not only harm the user; it affects everyone around them, especially children who depend on adults for safety, guidance, and care.

As we observe the International Day Against Drug Abuse and Illicit Trafficking, let us remember the forgotten victims of substance abuse. Street-connected children and children living in IDP camps deserve more than survival. They deserve safe environments that nurture their mental health, protect their well-being, and allow them to reach their full potential.

Protecting children from the hidden effects of substance abuse is not only a public health responsibility it is a moral obligation. Every child deserves the opportunity to grow up free from fear, free from harmful influences, and full of hope for the future.

Governments, humanitarian organizations, community leaders, and families must work together to reduce substance abuse in environments where vulnerable children live. Investments in child protection, mental health services, psychosocial support, and substance abuse prevention programmes can help break cycles of vulnerability and create healthier futures for children. By protecting children today, we strengthen the well-being of future generations.

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

Street Children and Drug Abuse. JAMA.
https://jamanetwork.com/journals/jama/article-abstract/1738906
The Epidemiology of Substance Use Among Street Children in Resource-Constrained Settings: A Systematic Review and Meta-analysis.
https://pmc.ncbi.nlm.nih.gov/articles/PMC3776018/
(PMC)
Protocol for an Observational Study on the Effects of Paternal Alcohol Use Disorder on Children’s Later Life Outcomes.
https://arxiv.org/abs/2412.15535
(arXiv)
Sociodemographic and Psychosocial Correlates of Substance Abuse Among Street Children: A Cross-Sectional Survey in Kolkata, India.
https://pubmed.ncbi.nlm.nih.gov/34322422/
(PubMed)
Research on Childhood Exposure to Second-Hand Smoke and Cognitive/Health Outcomes.
https://www.sciencedirect.com/science/article/pii/S0160412024007918
(Reddit)

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Gender Inequality: A Threat to the Health, Safety, and Rights of Women and Girls in Nigeria

Community Development, End FGM, Female Genital Mutilation, Female Roles in Nation Building, Gender, Gender Based Violence, Gender Equality, Girl Education, Global warming, Health, Health Communication, International Day of Rural Women, Mental Health, Monday Health Burst, Reproductive Health, SDG, Speak Wednesday, Special Events, Stop FGM, Uncategorized, WHO, Women, Women Education, Women in Leadership, Women's Rights / cfhinitiative

Gender inequality remains a deeply entrenched threat to the health, safety, and rights of women and girls in Nigeria, undermining progress toward equitable development and directly shaping outcomes in health, education, economic participation, political representation, and freedom from violence. According to the United Nations Development Programme (UNDP), Nigeria ranks 147 out of 191 countries on the Gender Inequality Index, reflecting large disparities between men and women in reproductive health, empowerment, and labour market participation. ¹ These inequalities manifest in real and measurable ways that compromise the wellbeing and opportunities of women and girls across the country.

One of the most profound impacts of gender inequality in Nigeria is observed in health outcomes. The maternal mortality ratio remains unacceptably high at 512 maternal deaths per 100,000 live births, indicating that women are still at disproportionate risk during pregnancy and childbirth compared to global averages. ² Factors driving this include limited access to quality reproductive health services, lack of autonomy in health decision-making, and economic barriers that delay care-seeking. Research shows that women who lack financial independence or decision-making power are less likely to utilise antenatal care or deliver in health facilities, increasing the likelihood of preventable complications. ³

Education is another field deeply affected by gender inequality. UNESCO reports that girls’ school completion rates in Nigeria lag boys’, particularly at the secondary level, a gap that translates into reduced opportunities for advanced learning, better jobs, and informed health choices later in life. ⁴ Early marriage, still prevalent in many regions, significantly contributes to school dropout rates among girls. UNICEF estimates that 43% of girls in Nigeria are married before their 18th birthday, limiting educational attainment and exposing them to early pregnancy and increased health risks such as obstetric fistula and maternal mortality. ⁵

Gender-based violence (GBV) is another grave consequence of systemic inequality. The Nigeria Demographic and Health Survey (NDHS) reveals that around 30% of ever-married women aged 15–49 have experienced physical violence, with many cases going unreported due to stigma, fear, and weak legal enforcement. ⁶ Violence affects not only physical health but also leads to long-term psychological trauma, increased vulnerability to HIV infection, and reduced participation in economic and community life. ⁷

Political inequality further illustrates the scale of exclusion. In the current 10th National Assembly (2023–2027), women remain severely underrepresented in national decision-making. Out of 109 Senate seats, only 4 are held by women (approximately 3.7%), while 105 seats (96.3%) are held by men. In the House of Representatives, only 17 out of 360 seats are occupied by women (approximately 4.7%), compared to 343 men. Altogether, women hold just 21 out of 469 seats in the National Assembly, representing about 4.2% of federal lawmakers.¹⁰ This means that despite women making up nearly half of Nigeria’s population, their voice in shaping laws and policies that directly affect their health, safety, and rights remains below 5% — one of the lowest representation rates in the region.¹¹ Limited political participation restricts the advancement of gender-responsive policies and slows progress on critical issues such as maternal health funding, protection from violence, and equal economic opportunities.

Economic inequality further compounds these threats. Although women actively participate in Nigeria’s labour force, wage gaps, informal employment, and occupational segregation persist. The World Economic Forum’s Global Gender Gap Report highlights that women often earn less than men for similar work and remain underrepresented in leadership positions. ⁸ Without economic empowerment, many women are unable to afford essential health services, invest in their education, or break cycles of poverty and dependency.

These disparities are not inevitable; they are shaped by social norms, discriminatory practices, and gaps in policy implementation. Research consistently shows that gender-responsive policies including universal access to reproductive healthcare, enforcement of laws against child marriage, protection from gender-based violence, equal educational opportunities, and increased political inclusion significantly improve health, economic, and social outcomes. ⁹

Addressing gender inequality is therefore not only a moral obligation but also a public health, governance, and economic priority. When women and girls have equal access to education, healthcare, leadership opportunities, and economic resources, maternal and infant mortality decline, household incomes rise, communities become safer, and national development accelerates. Nigeria cannot achieve sustainable development while half of its population remains structurally disadvantaged.

We call on the Federal and State Governments to strengthen and fully enforce laws protecting women and girls from discrimination and violence, expand access to quality healthcare services, promote girls’ education, and implement affirmative measures to increase women’s political representation. Development partners, civil society, and community leaders must intensify advocacy, scale up gender-responsive programming, and challenge harmful norms that sustain inequality. Every sector health, education, justice, governance, and economic development must mainstream gender equity as a foundational principle. The health, safety, and rights of Nigeria’s women and girls demand bold, sustained, and collective action.

References

UNDP Gender Inequality Index
https://hdr.undp.org/data-center/thematic-composite-indices/gender-inequality-index
WHO Trends in Maternal Mortality 2000–2023
https://www.who.int/publications/i/item/9789240068759
Journal of Women’s Health – Decision-Making Power & Maternal Service Utilisation
https://www.liebertpub.com/doi/10.1089/jwh.2020.8805
UNESCO Institute for Statistics – Girls’ Education
https://uis.unesco.org/en/topic/girls-education
UNICEF – Child Marriage in Nigeria
https://data.unicef.org/topic/child-protection/child-marriage/
Nigeria Demographic and Health Survey (NDHS)
https://dhsprogram.com/pubs/pdf/FR379/FR379.pdf
WHO – Violence Against Women Prevalence Estimates
https://www.who.int/publications/i/item/9789240022256
World Economic Forum – Global Gender Gap Report 2023
https://www3.weforum.org/docs/WEF_GGGR_2023.pdf
Journal of Gender & Development – Gender-Responsive Policies
https://www.tandfonline.com/doi/full/10.1080/13552074.2021.1952743
The Nation Newspaper – Women in the 10th National Assembly
https://thenationonlineng.net/meet-the-only-four-female-senators-in-10th-nass/
The Guardian Nigeria – Women’s Representation in N’Assembly
https://guardian.ng/news/national/only-4-5-of-nassembly-members-are-women-says-wilan-report/

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MONDAY HEALTH BURST ON BREASTFEEDING AND MATERNAL MENTAL HEALTH: NURTURING BOTH MOTHER AND CHILD

Uncategorized / cfhinitiative

Breastfeeding is often described as the most natural way to feed a baby, providing essential nutrients and antibodies that protect infants from illness. Beyond its physical health benefits, breastfeeding is an emotional process that can significantly influence a mother’s mental well-being. However, while breastfeeding can be a source of comfort and connection, it can also present emotional challenges that affect a mother’s psychological health.

The Emotional Connection

Breastfeeding stimulates the release of hormones like oxytocin and prolactin, which promote relaxation, bonding, and a sense of fulfillment. Many mothers describe feeding time as a period of closeness that strengthens their connection with their babies. This hormonal and emotional bond can contribute to reduced stress levels and enhanced maternal confidence.

Challenges and Emotional Strain

Not every breastfeeding journey is smooth. Difficulties such as poor latching, low milk supply, engorgement, or mastitis can cause physical discomfort and emotional distress. Some mothers may feel guilt, shame, or inadequacy if they cannot breastfeed as planned. These feelings can be amplified by societal expectations, cultural pressures, and conflicting advice from healthcare providers or family members.

For mothers already at risk of postpartum depression or anxiety, breastfeeding difficulties can intensify symptoms. Lack of sleep, hormonal changes, and the overwhelming demands of caring for a newborn can create a perfect storm for mental health struggles.

Postpartum Depression and Breastfeeding

The relationship between breastfeeding and postpartum depression is complex. For some women, successful breastfeeding is linked to a lower risk of depression due to increased oxytocin and emotional satisfaction. For others, persistent breastfeeding challenges can become a source of stress, increasing feelings of hopelessness and isolation. Recognizing these different experiences is essential to providing the right kind of support.

The Role of Support Systems

Maternal mental health during breastfeeding is best protected when mothers have strong support networks. Partners can share responsibilities such as burping, diaper changes, and household tasks, allowing the mother to rest. Family and friends can offer encouragement rather than criticism, while healthcare providers can provide evidence-based guidance tailored to the mother’s unique needs.

Peer support groups both in-person and online also give mothers a safe space to share experiences, learn practical tips, and feel understood.

Empowering Informed Choices

One of the most important steps in protecting maternal mental health is removing the pressure to breastfeed at all costs. While exclusive breastfeeding is highly recommended for the first six months, mothers who cannot or choose not to breastfeed should be supported without judgment. The ultimate goal is a healthy, thriving mother and baby and that can be achieved through different feeding approaches.

Breastfeeding is a journey that intertwines physical nourishment with emotional well-being. By acknowledging the mental health dimension of breastfeeding, society can move away from guilt-driven narratives and toward a culture of understanding and support. When a mother’s mental health is prioritized, she is better equipped to care for herself and her child fostering a healthier start to life for both.

Monday Health Burst is an initiative of Centre for Family Health Initiative (CFHI) to tackle issues of basic health concerns. Join us every Monday for more health-related articles on all our social media platforms.

References

MONDAY HEALTH BURST ON BREASTFEEDING AND MATERNAL MENTAL HEALTH: NURTURING BOTH MOTHER AND CHILD Read More »

SPEAK WEDNESDAY ON FEEDING THROUGH FEAR: HOW GENDER-BASED VIOLENCE UNDERMINES INFANT HEALTH

Uncategorized / cfhinitiative

“You can’t nourish from an empty cup, and you definitely can’t breastfeed through trauma.”
The right to nourishment is a fundamental human right. Yet, for millions of infants in Nigeria and around the world, that right is compromised from birth, not by poverty alone, but by violence inflicted on the very individuals tasked with nurturing them. As the world marks World Breastfeeding Week, it is imperative to confront a rarely addressed but devastating intersection: the relationship between gender-based violence (GBV) and infant health, particularly breastfeeding outcomes.

Breastfeeding is globally recognized as a cornerstone of infant survival and development. According to the World Health Organization (WHO), optimal breastfeeding could prevent over 823,000 child deaths annually across the globe. However, in households where women face psychological, physical, or sexual violence, the act of breastfeeding becomes compromised, interrupted, or entirely abandoned, placing infants at heightened risk of disease, malnutrition, and death.

Understanding Gender-Based Violence in Nigeria
In Nigeria, gender-based violence is a pervasive issue. According to the National Demographic and Health Survey (NDHS), 30% of Nigerian women aged 15–49 have experienced physical violence since age 15, and 9% experienced sexual violence. The figures are even higher in certain rural communities and internally displaced persons (IDP) camps, where systemic poverty, displacement, and insecurity magnify the risks.

This violence is not limited to isolated acts of cruelty. It is embedded in socio-cultural systems that normalize women’s suffering and silence, even during vulnerable periods such as pregnancy and postpartum. These environments profoundly impact maternal mental health and consequently, infant care practices.
How Gender-Based Violence Impacts Breastfeeding
Numerous peer-reviewed studies affirm that women who experience GBV, especially during or immediately after pregnancy, are significantly less likely to initiate or continue breastfeeding.
1. Physiological Disruption of Lactation
The stress caused by violence increases cortisol levels, which can inhibit the production of oxytocin, a hormone essential for milk let-down. In essence, a mother’s body under chronic threat cannot perform its nurturing functions efficiently.
2. Mental Health Consequences
Women exposed to intimate partner violence (IPV) are at increased risk of postpartum depression, anxiety, and post-traumatic stress disorder (PTSD). These conditions are linked to early cessation of exclusive breastfeeding.
3. Limited Access to Healthcare
GBV survivors are often restricted in their mobility and decision-making, making them less likely to access maternal health services. This further reduces opportunities for lactation counseling or timely postnatal care, which are vital for breastfeeding success.
4. Physical Trauma
Injuries to the breasts or upper body from physical abuse can make breastfeeding painful or physically impossible. Moreover, repeated violence erodes a mother’s sense of bodily autonomy, which may deter her from engaging in breastfeeding altogether.
Impact on Infant Health
When mothers are unable to breastfeed exclusively for the first six months, a practice strongly endorsed by WHO and UNICEF, the consequences for infants are profound:
• Increased risk of diarrhea, respiratory infections, and undernutrition.
• Higher likelihood of stunted growth and developmental delays.
• Elevated infant mortality, particularly in settings with limited access to safe alternatives.

In Nigeria, where 44% of children under five are stunted, the added burden of disrupted breastfeeding due to GBV further deepens a national child health crisis.
Sociocultural and Structural Drivers

In many Nigerian communities, cultural norms that promote male dominance and female submissiveness inhibit women’s ability to seek help or resist abuse. Violence is often dismissed as “discipline” or a private family affair. These norms are reinforced by:
• Patriarchal interpretations of religion
• Bride price systems that commodify women
• The stigmatization of divorced or single mothers
• Poor legal enforcement of existing protective laws, such as the Violence Against Persons (Prohibition) Act (VAPP Act) of 2015, which remains unadopted in several Nigerian states.
As a result, maternal silence becomes survival, even when that silence compromises infant health.
Recommendations: Multisectoral Action is Imperative
Addressing the impact of GBV on breastfeeding and infant health requires coordinated efforts across health, legal, and community systems. The following actions are recommended:

1. Integrate GBV Screening into Maternal and Child Health Services
Health workers at antenatal, delivery, and postnatal care points must be trained to screen for and respond to GBV sensitively and confidentially.
2. Strengthen Legal Protection and Enforcement
Full domestication and enforcement of the VAPP Act in all 36 states is non-negotiable. Legal systems must prioritize survivor protection, not the preservation of abusive family structures.
3. Community Education and Norms Change
Religious and traditional leaders must be engaged as advocates for safe motherhood. Community dialogues can play a key role in dismantling harmful gender norms.
4. Expand Access to Psychosocial Support
Psychological care, trauma counseling, and peer-support networks for survivors should be embedded within maternal health programs.
5. Data Collection and Research
More localized data is needed to map the intersection of GBV and breastfeeding outcomes in Nigeria. Without robust data, interventions risk being misaligned or underfunded.

Conclusion
Breastfeeding is not only a health practice; it is an act of nurturing, safety, and trust. When a mother is forced to feed through fear, we undermine not just her health but the health of the next generation. Ending GBV is not a side issue in public health; it is central to child survival, gender equity, and national development.
This week, as we celebrate World Breastfeeding Week, we must reaffirm that the ability of Nigerian women to breastfeed in safety and dignity is a national imperative. Silence and cultural complicity can no longer be tolerated. The future of our children, indeed, of our nation, depends on it.
Speak Wednesday is an initiative of CFHI to address issues around gender-based violence and gender bias.
#WorldBreastfeedingWeek #EndGBV #InfantHealth #MaternalHealth #BreastfeedingMatters #SafeMotherhood #SupportSurvivors #NutritionJustice #HealthEquity #VAPPAct #WomensRights
References
• World Health Organization (2017). Protecting, promoting and supporting breastfeeding in facilities providing maternity and newborn services. https://www.who.int
• National Population Commission (NPC) [Nigeria] and ICF. (2019). Nigeria Demographic and Health Survey 2018. Abuja, Nigeria, and Rockville, Maryland, USA.
• UNICEF (2019). Programming Guidance: Infant and Young Child Feeding in Emergencies. https://www.unicef.org
• Kendall-Tackett, K. A. (2007). Violence against women and the perinatal period: The impact of lifetime violence and abuse on pregnancy, birth, and breastfeeding. Trauma, Violence, & Abuse, 8(3), 344–353.
• Silverman, J.G., Decker, M.R., Reed, E., & Raj, A. (2006). Intimate partner violence around the time of pregnancy: Association with breastfeeding behavior. Journal of Women’s Health, 15(8), 934–940.
• Kumar, M., Huang, K., Othman, S., Rahman, M., & Lee, S. (2017). Effect of intimate partner violence on breastfeeding behavior: A systematic review. BMJ Open, 7:e014439.
• UNHCR (2021). Nigeria Factsheet – Gender-Based Violence. https://www.unhcr.org/ng
• World Health Organization (2021). Infant and Young Child Feeding. https://www.who.int/news-room/fact-sheets/detail/infant-and-young-child-feeding

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SPEAK WEDNESDAY ON BREAKING THE SILENCE: MEN’S MENTAL HEALTH MATTERS TOO

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At CFHI, we recognize that mental health is just as important as physical health. As part of our commitment to holistic well-being, this week’s Monday Health Burst shines a light on an often-neglected issue – men’s mental health. For generations, society has woven a narrative around masculinity that leaves little room for vulnerability. Men are expected to be strong, stoic, and impervious to emotional struggle. Yet behind many quiet smiles or firm handshakes lies a hidden truth: men suffer from mental health challenges too and often in silence.

The Hidden Crisis

The stigma attached to mental health, coupled with societal expectations of masculinity, pushes many men to bottle up their emotions, fearing they will be seen as weak or “less manly.”

But silence can be deadly. Unaddressed mental health issues can manifest in substance abuse, violence, risky behavior, chronic stress, and even premature death.

Several myths fuel this crisis:

Real men don’t cry. Tears are a human response to emotion, not a sign of weakness.
Talking about problems won’t change anything. In truth, talking is often the first step toward healing.
Mental health issues are a sign of failure. Mental illness is not a character flaw; it’s a health condition deserving care like any physical illness.

These misconceptions keep men locked in isolation, denying them the support and resources that could save lives.

Breaking the silence around men’s mental health is essential. Here’s how we can help:

Normalize Conversations: Speak openly about mental health in families, workplaces, and communities. The more we talk, the less shame there is.
Challenge Stereotypes: Redefine masculinity to include emotional expression, empathy, and vulnerability.
Provide Accessible Resources: Ensure men have safe, judgment-free spaces to seek help from therapy and support groups to online resources.
Check on Your Loved Ones: A simple, “How are you really doing?” can open doors to crucial conversations.
Promote Self-Care: Encourage men to prioritize activities that support mental well-being, from exercise to meditation to creative outlets.

To all men reading this: your feelings are valid. Seeking help is not weakness; it’s courage. You deserve support, understanding, and the chance to thrive mentally and emotionally.

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MONDAY HEALTH BURST ON POSITIVE PARENTING FOR ADOLESCENT HEALTH: SHOWING UP MATTERS MOST

Uncategorized / cfhinitiative

Raising teenagers isn’t always easy, one moment they’re craving attention, the next they want their space. But here’s the truth: your presence and support as a parent or caregiver make all the difference.

Adolescence is a time of change, physically, emotionally, and socially. Young people are trying to figure out who they are, what they believe, and where they belong. In the midst of this, positive parenting helps guide them toward healthier choices and stronger self-esteem.

So, what does positive parenting look like?

💬 It’s talking openly even when the topic feels uncomfortable. Conversations about puberty, peer pressure, sex, and mental health are important, and teens want honest, non-judgmental input.

👂 It’s listening really listening without immediately reacting or correcting. Sometimes, teens just want to feel heard.

🚦 It’s setting fair boundaries and sticking to them. Rules and expectations give structure, and consistency helps teens feel safe.

💡 It’s modeling what you want to see. Teens may not always say it, but they watch how you handle stress, relationships, and your own health.

And the results? They’re real.

Research shows that teens who feel connected to their parents are 55% less likely to attempt suicide, 40% less likely to engage in risky sexual behaviors, and 30% less likely to use drugs or alcohol (CDC, Youth Risk Behavior Survey, 2021).

Positive parenting doesn’t mean being perfect. It means showing up with patience, empathy, and a willingness to grow together.

At CFHI, we believe that strong families create a solid foundation for healthy adolescents. That’s why we continue to support parents and young people through community programs, education, and health advocacy.

Let’s raise a generation that is not only healthy, but heard, supported, and empowered.

Being there consistently is the most powerful thing a parent can do.

Monday Health Burst is an initiative of Centre for Family Health Initiative (CFHI) to tackle issues of basic health concerns. Join us every Monday on all our social media platforms for more health-focused articles.

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