Lagos

Nigeria / Southwest Nigeria / Lagos

OVERVIEW

As the largest city in Africa, Lagos is a mega-city with an estimated population of 17.5 million. Regarding women's health care, Lagos seems to be a bit of a mixed bag. On the one hand, contraceptives are available, including emergency contraceptives, throughout the city. 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 yers to come.

Contraception

Laws & Social Stigmas

In Nigeria, you can buy contraception over the counter. 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." (Source: Nigeria Tested by Rapid Rise in Population, 2012).

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

Some common oral contraceptive brands include Microgynon, Lo-Femenal, Nordette, Marvelon, and Yasmin. Some other brands include Logynon, Trinordial,Biphasil, Ovanon and Normovlar.

Emergency Contraception

Laws & Social Stigmas

Emergency contraception is legal in Nigeria, and there are no age restrictions. 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 at private clinics, pharmacies, IPPF-affiliated system, social marketing programs (eg PSI, DKT, MSI and PSIA), etc. 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.

Medication & 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

What to Get & Where to Get It

Sanitary pads, usually under the brand name "Always," and cotton pads are very common. Tampons are both 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.

Gynecological Exams

STD Tests

What to Get & Where to Get It

• National Orthopaedic Hospitals - Offers HIV/AIDS screenings. 20/124 Ikorodu Road, Igbobi, Lagos, Nigeria0706 640 4598, 0812 287 9302http://www.nohilagos.org.ng/

Pregnancy

Abortion

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. Website: https://www.facebook.com/msrosyhotline/info?tab=page_info

Advocacy & Counseling

List of Additional Resources

• Giwyn - http://giwyn.org/
• Center for Adolescent Research Education and Sexuality (CARES)
• Grassroots Health Organization of Nigeria (GHON)
• Positive Health Youth Squad
• Awaka Go Forward International
• Women’s health organisation of nigeria
• International Centre For Sexual and Reproductive Rights(INCRESE) - www.increse-increse.org (AIM)
• BAOBAB for Women's Human Rights
• Girls Power Initiative (GPI) www.gpinigeria.org
• Women Information Network (WINET)