Nigeria

OVERVIEW

Regarding women's health care, Nigeria seems to be a bit of a mixed bag. On the one hand, contraceptives are available, including emergency contraceptives, in larger cities. However, abortion is only legal under certain circumstances, even in the liberal south of the country, and it seems to remain taboo. As the Nigerian population continues to grow, the government will most likely increase interest in family planning in the years to come.

Contraception (Birth Control)

General Note: There are many types of contraceptives, also known as "birth control," including IUDs, oral contraceptives, patches, shots, and condoms, etc. If you would like to view a full list, click here.

Laws & Social Stigmas

In Nigeria, you can purchase condoms and birth control pills at pharmacies without a prescription. While you may technically need a prescription for birth control pills, this is not typically enforced, and birth control pills are available over-the-counter. However, for other forms of contraception, such as implants, injectables, and IUDs, you may need to directly visit a hospital or clinic to obtain them.

While contraception is available, it is not widely used. It is estimated that less than 20-24% of married women in Nigeria use modern contraceptives. An additional 16% want to delay childbirth but are not using any form of contraception. In 2013, the World Bank estimated that 24% of Nigerian young men (ages 15-24) used condoms. As the NYTimes reported, "In a deeply religious country where many Roman Catholics and Muslims oppose contraception, politicians and doctors broach the topic gingerly, and change is slow. Posters promote 'birth spacing,' not 'birth control.' Supplies of contraceptives are often erratic."

The Nigerian government, however, is very interested in population control. The United Nations has estimated that the country's population could grow to 400 million by 2050. For these reasons, the government has tried to encourage contraceptive use. In 2012, President Goodluck Jonathan instructed Nigerians to limit the number of children in their families and encouraged the use of contraceptives. He also caused controversy by suggesting that Nigeria may want to adopt a policy similar to China's "One Child Policy."

What to Get & Where to Get It

• Tip: You can use the free online Choice service, produced by Marie Stopes Nigeria, to find which contraceptive option may be best for you.
• You can obtain male condoms at pharmacies, kiosks, clinics, NGOs, various vendors, and online stores in Nigeria. You can contact Marie Stopes Nigeria to learn about condoms in Nigeria.
• You can find female condoms in Nigeria. You can contact Marie Stopes Nigeria to learn about condoms in Nigeria.
• You should be able to purchase oral contraceptives (birth control pill) at pharmacies, and no prescription is typically required. Both the combined pill and mini-pill are available. Some brands you may find are Biphasil, Levofem, Lo-Femenal, Logynon, Nordette, Marvelon, Microgynon, Normovlar, Ovanon, Trinordial, and Yasmin. You can contact Marie Stopes Nigeria to learn about condoms in Nigeria.
• You can find intrauterine devices (IUDs) in Nigeria. For example, DKT International distributes the Lydia IUD in health centers in Nigeria, which comes in many forms (including copper). You can contact your nearest health center or Marie Stopes Nigeria to learn about IUDs in Nigeria.
• You can find contraceptive injectables/shots in Nigeria, such as DMPA Sc (which prevents pregnancy for 3 months). You can contact Marie Stopes Nigeria to learn about shots in Nigeria.
• You can find contraceptive implants in Nigeria, such as Implanon NXT or Jadelle. You can contact https://www.mariestopes.org.ng/what-we-do/contraceptive-implant/ Marie Stopes Nigeria] to learn about impants in Nigeria.
• You can obtain tubal litigation (female sterilization) services in Nigeria. You can contact Marie Stopes Nigeria to learn more.
• You can obtain vasectomy (male sterilization) services in Nigeria. You can contact Marie Stopes Nigeria to learn more.

Emergency Contraception (Morning After Pill)

Important Notes: Emergency contraception may prevent pregnancy for three days (72 hours) and sometimes five days (120 hours) after unprotected sex. Take EC as soon as possible after unprotected sex to prevent pregnancy. If you don't have access to dedicated EC, oral contraceptives can be used as replacement EC, but remember the following: 1) Only some contraceptives work as EC 2) Different contraceptives require different dosages and time schedules to work as EC 3) You must only use the first 21 pills in 28-day packs and 4) They may be less effective than dedicated EC. For general information on emergency contraceptives, click here and here.

Laws & Social Stigmas

Emergency contraceptive options, including pills and IUDs, are legal in Nigeria. There are no age restrictions to purchase emergency contraceptive pills at pharmacies. Though only 2.8% of Nigerian women had ever used EC, according to a 2008 study, it can certainly be purchased.

What to Get & Where to Get It

• You can purchase EC pills at private clinics, pharmacies, IPPF-affiliated system, social marketing programs (eg PSI, DKT, MSI and PSIA), etc. You can contact Marie Stopes Nigeria for more information.
• If you want a dedicated EC product, take Postinor-2 or Pregnon (take 2 pills within 120 hours after unprotected sex). You can also use oral contraceptives as EC. In Nigeria, you should be able to find Ovrette (take 40 pills within 120 hours after unprotected sex), Neogynon or Nordiol (take 2 pills within 120 hours after unprotected sex and take 2 more pills 12 hours later), Lo-Femenal or Microgynon (take 4 pills within 120 hours after unprotected sex and take 4 more pills 12 hours later).

Costs

• Postinor-2 is priced at $1.20, while Pregnon is priced at $0.30.

Sexually Transmitted Infections (STIs/STDs)

Important Notes - Learn about PEP and PrEP: If you think that you've been recently exposed to HIV (i.e. within 72 hours), seek out PEP (Post-Exposure Prophylaxis). It's a month-long treatment to prevent HIV infection after exposure, and it may be available in your city. Take PEP as soon as possible. For more information, click here. If you are at risk of HIV exposure, seek out PrEP (Pre-Exposure Prophylaxis). It's a daily oral pill that can prevent HIV infection before exposure. To learn more about PrEP, click here.

Laws & Social Stigmas

In Nigeria, there are no known travel or residency restrictions for people with HIV/AIDS. This means that you can enter the country, regardless of your HIV status, and you should not be deported if you test positive for HIV while you are in the country.

What to Get & Where to Get It

• Look for local recommendations for testing facilities on city pages, like the Lagos or Abuja page.
• Marie Stopes Nigeria: They provide services for STI consultation, testing, and treatment. You can call 0800-00-22252 for a toll-free call (no charge), or you can contact them via WhatsApp at 0908-00-22252.

Medications & Vaccines

What to Get & Where to Get It

The Hepatitis B vaccine is now part of Nigeria's National Immunization Programme (NPI). As for HPV, it seems that it may be available but is simply too expensive for many Nigerians. In 2015, it was reported that Nigeria was eligible for the HPV Demo Programme, which would provide reduced-cost access, but it's unclear if anything came of this. Concerning HIV, Nigeria provides HIV/AIDS medications/treatment and antiretrovirals are available. Currently, there is also a PreP demonstration project in Plateau, Edo and Cross River State (late 2015-late 2017). But Truvada is only registered for treatment -- not prevention.

Costs

It costs about $103 to get the HPV vaccine in Nigeria.

Menstruation

Note: In addition to pads and tampons, you can also use menstrual cups and menstrual underwear for your period. To learn more about menstrual cups, click here. To learn more about menstrual underwear, click here.

What to Get & Where to Get It

Sanitary pads, usually under the brand name "Always," and cotton pads are very common. Tampons are available but they're less common, so head to larger stores like ShopRite or Spar, or pharmacies, like Med Plus. Generally, it seems that pads/pantyliners are more popular, but there is growing usage of tampons.

There are no DivaCup or Mooncup sellers in Nigeria (as of 2016), so they should be bought online.

Pregnancy

Laws & Social Stigmas

The maternal mortality rate (MMR) is 814 deaths per 100,000 live births, according to 2015 data. This MMR is ranked fourt] in the world, meaning that Nigeria has the fourth worst MMR globally.

Abortion

Important Note: There are two main types of abortions: medical (also known as the "abortion pill") and surgical (also known as "in-clinic"). For medical abortions, you take a pill to induce abortion. For surgical abortions, a procedure is performed to induce abortion. For general information about medical and surgical abortions, click here.

Laws & Social Stigmas

In Nigeria, abortion is only permitted for certain scenarios, which are: to save the life of the woman, to preserve physical health or to preserve mental health. Legal grounds of justification do not include rape or incest, fetal impairment, economic or social reasons, and it is not available on request. However, the flexibility of these laws is determined by geography. In Nigeria, abortion law differs between the South (predominantly Christian) and North (predominantly Muslim). As a southern Nigerian city, Lagos' abortion law falls under the Criminal Code of 1916, which is more liberal than in the North. In 1938 English Rex v. Bourne decision, it was found that an abortion could be performed to prevent a woman from becoming “a physical and mental wreck," which set precedent for future abortion cases. In 1982, there was an attempt to liberal the law, which was defeated.

Due to social stigma, there is little data on abortions in Nigeria. However, a 1984 study found that the majority of abortion patients at hospitals (55%) were under the age of 20.

In 2008, the Center for Reproductive Rights put out a report: "Broken Promises: Human Rights, Accountability, and Maternal Death in Nigeria." The report found, "The number of maternal deaths in Nigeria is second only to that of India. The majority of these maternal deaths, as in the rest of the world, are preventable, and while the causal factors can be multiple and complex, governments must be held accountable when their actions or inaction contribute to this ongoing loss of women’s lives." It continues, "While the Nigerian government has repeatedly identified maternal mortality and morbidity as a pressing problem and developed laws and policies in response, these actions have not translated into a significant improvement in maternal health throughout the country. A number of factors inhibit the provision and availability of maternal health care in the country, including: the inadequacy or lack of implementation of laws and policies, the prevalence of systemic corruption, weak infrastructure, ineffective health services, and the lack of access to skilled health-care providers. The separation of responsibilities for the provision of health care among the country’s three tiers of government both contributes to and exacerbates the harmful impact of these various factors."

What to Get & Where to Get It

• Safe Abortion Hotline (Ms Rosy Hotline) - tel: 08097737600 or tel: 08097738001.
• Marie Stopes Nigeria: They provide post-abortion care. Call them to book an appointment or talk to a professional: 0800 00 22252

List of Additional Resources

• DKT International - Nigeria: "Since its establishment in 2012, DKT Nigeria’s nimble approach to social marketing has increased accessibility and availability of contraceptives across Nigeria. DKT Nigeria’s contraceptive and family planning services reach the poor, rural and adolescent populations who have limited access to reproductive health services. DKT is the largest private provider of reproductive health products and services in Nigeria."
• Equaldex Nigeria: This website provides information on LGBTQ rights and laws in Nigeria. It is important to know that homosexuality is illegal in Nigeria (though laws around female homosexuality are a bit unclear). The laws around changing gender are ambiguous.
• Giwyn: Vision is "a violence free society where women can enjoy social, political, cultural, economic and reproductive health rights and have their personal values and dignity maintained. The mission statement of our organization is- Building and Strengthening Women and youths in sustainable development to live a peaceful and healthier environment and to enjoy their reproductive rights... Our work is grounded in the realities of the grassroots women who lack economic, social and political power."
• Center for Adolescent Research Education and Sexuality (CARES)
• Grassroots Health Organization of Nigeria (GHON): "seeks to empower and create opportunities for women and youths through education, accurate sexual and reproductive health and rights information and services, and poverty alleviation activities."
• Women’s Health and Action Research Centre: "Grounded in a deep love of humanity and a belief in equality and dignity for all people, WHARC works to improve the reproductive health and social wellbeing of women and adolescents in Africa so they can lead productive, fulfilling lives and provide a healthy future for their children. Through its cutting edge research, WHARC educates women, youth, community gatekeepers and policymakers about sexual and reproductive health, and advocates for policy change at the local, state and federal level. WHARC also provides current and effective reproductive health services to women and adolescent girls in Africa." Tel: +2348068514848, Email: info@wharc-online.org.
• Nigerian Organisation of Women: "The Nigerian Organisation Of Women (NOW) was established in 1984, with the aim of the organisation to develop links within the UK and Nigeria to aid the well being of Nigerian women and their children. Our organisation provides a forum for Nigerian women to voice their concerns and opinions, giving them strength." Phone: 020 8880 9384.
• Positive Health Youth Squad
• Awaka Go Forward International
• International Centre For Sexual and Reproductive Rights(INCRESE)
• Girls Power Initiative (GPI): "GPI’s focus is to assist young girls live healthy lives and achieve their full potentials, towards an empowered womanhood. It is also includes assisting young girls to overcome the risk of early sexual activities, gender discrimination, harmful traditional and Contemporary social practices, adolescent/unintended pregnancies, Sexually Transmitted Infections (STIs) including HIV/AIDS, unsafe abortion, all forms of sexual abuse and harassment as well as other forms of violence against girls and women and exploitation."
• Women Information Network (WINET): " A Media Focused, Independent, Non-Governmental And Non-Profit Organization, Established In January 2000. It Is Registered With Corporate Affairs Commission Nigeria: RC: 14892. WINET Is Gender Sensitive And Works Towards The Dissemination Of Information To Promote Gender Equality, Women’s Rights, Human And Political Rights. The Organization Is For Training Of Women, Peace Building, Media Advocacy And Dissemination Of Information On All Issues Relating To The Advancement Of Women’s Rights In The Society. It Ensures That Nigerian Women And Youths Have Access To Information That Will Enable Them To Make Informed Decisions."