Implementation of Reproductive Health Policies and Laws in the Nigerian National Health Policy: A Policy Brief, 15 April 2016

According to 2006 census, out of 140 million people in Nigeria, more than 69 million were women. More than half of these women live in the rural communities and are ignorant of their reproductive rights. As a result, they have their health at a very high risk due to inaccessibility of reproductive health information and services. Still, Nigeria is yet to reform restrictive domestic laws and policies that place women’s and girls’ health and lives at risk and prevent them from exercising their reproductive rights – to which the Nigerian government has promised under international laws.…Nigeria as a member of the global community and in the interest of her people’s health and development is committed to the implementation of the concept of reproductive health and reproductive rights as agreed at the ICPD, and has adopted and launched the African regional strategy. This commitment would enable the country to effectively address the major reproductive health challenges and the current trend of poor reproductive health status and services. This policy document is, among others, an expression of the desire and determination of Generation Initiative For Women and Youth Network (GIWYN) and The National Coalition Member Organizations in this regard urging the government to reform restrictive domestic laws and policies that place women’s and girls’ health and lives at risk and prevent them from exercising their reproductive rights to which the Nigerian government has promised under international law.…The criminal law in Nigeria makes the performance of an abortion a criminal offence unless it is performed to save a pregnant woman’s life. Hence abortions are illegal regardless of the duration of pregnancy; the laws prohibit abortions performed at all stages of fetal or embryonic development from the time of fertilization. However, the laws do not clearly distinguish between abortions performed by registered medical practitioners and unregistered medical practitioners. The restriction of the grounds upon which abortion may be performed to saving the woman’s life is too narrow and may be insensitive to the difficulties posed by peculiar experiences of women. For example in terms of rape… [although the law on violence says “the court shall award appropriate compensation to the victim of rape as it may deem fit in the circumstance”, a rape survivor who becomes pregnant is not entitled to abortion… There should be an express provision in this law that a rape or incest survivor with unwanted pregnancy should be able to secure a legal abortion service on consent.… Given Nigeria’s high rate of mortality in the female adolescent population resulting from unsafe abortion, there is need for urgent and serious rethink of the restrictive abortion laws.… In 2012, about 212,000 women were treated for complications of unsafe abortion, and an additional 285,000 experienced serious health consequences but did not receive the treatment they needed.…the National Health Policy fails to provide for comprehensive reproductive health concerns including safe abortion, and focuses primarily on family planning, maternal and child health care. Likewise, the National Adolescent Health Policy falls short, by neglecting to integrate contraception provision into adolescent health program. Furthermore, the RH Policy noted that while the various laws in force in Nigeria address different areas of reproductive health, many of these laws, however, do not reflect the reproductive health concept and so are inadequate to meet the needs of actualizing reproductive rights as contemporarily understood. While the provisions of many of the policies in the health sector are relevant to promotion of reproductive health, their targets are sometimes contradictory or outdated or both.The report recommends:1. Prevent unsafe abortion, including by amending restrictive laws…2. Provide legal abortion in cases where the continued pregnancy endangers the health of women, including adolescents. It is therefore essential that there are trained providers of abortion services, that services are available and known, and that treatment for complications of unsafe abortion is widely available. Saving a woman’s life might be necessary at any point in the pregnancy and, when required, abortion should be undertaken as promptly as possible to minimize risks to a woman’s health.3. Make express provision of legal abortion in cases of rape and incest. Prompt, safe abortion services should be provided on the basis of a woman’s complaint, rather than requiring forensic evidence or police examination. Administrative requirements should be minimized and clear protocols established for both policy and health-care providers, as this will facilitate referral and access to care.PHOTO: Courtesy Worldpulse, 2014