By David Torough, Abuja

As Nigeria marks Universal Health Coverage (UHC) Day 2025, new findings suggest that adolescent girls and young women continue to face serious barriers in accessing basic health services, despite years of policy commitments aimed at expanding coverage.

The assessment, released by the Gem Hub Initiative, points to rising out-of-pocket costs, weak primary healthcare capacity and limited youth-focused services as key obstacles preventing young people—particularly females—from obtaining timely and confidential care.

Nigeria has pledged to achieve universal health coverage, ensuring that all citizens can access essential services without financial hardship.

According to Gem Hub, many young women are unable to afford services such as testing and treatment for sexually transmitted infections, especially those not enrolled in health insurance schemes. The financial burden often leads to delays or avoidance of care altogether, increasing health risks.

The findings are based on a rapid assessment of youth-friendly health services and a perception survey conducted in Rivers State, which the organisation said reflects challenges seen in other parts of the country. The review found that several primary health facilities lacked key sexual and reproductive health commodities, including emergency contraception, while shortages of trained staff and inconsistent application of youth-friendly service guidelines were also reported.

Infrastructure challenges were another recurring concern. Poor road networks, seasonal flooding, irregular clinic hours and unreliable electricity were cited as factors limiting physical access to care, particularly in rural and hard-to-reach communities. The report also notes low levels of community and parental engagement, which can discourage adolescents—many of whom depend on family members for health decisions—from seeking services.

A frontline health worker interviewed during the assessment said many young women were reluctant to return to facilities where they felt judged or lacked privacy. “When adolescents feel exposed or uncomfortable, they simply stop coming,” the provider said.

Universal Health Coverage Day is observed globally to highlight the importance of affordable and accessible healthcare. This year’s theme focuses on the burden of health costs, a challenge that remains acute in Nigeria, where out-of-pocket spending continues to account for a large share of healthcare financing.

Gem Hub Initiative says its findings underline the gap between national health policies and the lived experiences of young people, particularly girls and young women, whose health needs are often overlooked within the broader system.

The organisation works with adolescents and young adults across Nigeria on health, education and empowerment programmes, with a focus on generating evidence to inform public debate and policy.

The World Bank Group, global partners and countries on Saturday announced continued progress toward the goal of delivering affordable and quality health services to 1.5 billion people by 2030.

A statement by the World Bank Online Media Briefing Centre said 15 countries introduced National Health Compacts, outlining practical five-year reforms aimed to expand primary healthcare, improve affordability and support job-rich economic growth.

The statement said that since the goal was set in April 2024, the Bank and partners had supported countries to provide quality and affordable care to 375 million people.

It said work was underway with roughly 45 countries to scale proven primary care approaches that strengthen health outcomes while generating employment across health workforces, local supply chains and supporting industries.

“This progress comes as governments confront aging populations, rising chronic disease, and financial pressures.”

The statement said the 2025 Global Monitoring Report released at the Tokyo Universal Health Coverage (UHC) High-Level Forum showed that 4.6 billion people globally still lacked access to essential health services.

It said the report also revealed that 2.1 billion people faced financial hardship due to health expenses.

“These challenges underscored the need for long-term, coordinated reforms that help countries build more resilient and equitable health systems.”

World Bank Group President, Ajay Banga, is quoted in the statement as saying, “strong primary healthcare systems are central to both health protection and economic growth.

“Strong primary health systems do more than safeguard health, they support jobs and economic opportunity.

“Countries are stepping forward with clear priorities, and we are working alongside them to deliver practical solutions at scale.”

According to the statement, the 15 countries that introduced National Health Compacts at the forum in Tokyo are Bangladesh, Egypt, Ethiopia, Fiji, Indonesia, Mexico, Morocco, Nigeria, Philippines, Sierra Leone, Syria, Tajikistan, Uganda, Uzbekistan and Zambia.

The statement said the compacts, which were endorsed at the highest levels of government, outlined five-year, country-led reforms aimed at expanding the reach and quality of primary healthcare, improving financial protection and strengthening health workforces.

“They also align Health and Finance Ministries behind measurable targets, provide a roadmap for coordinated action and guide support from development partners across country-led priorities.”

It said key commitments by countries include mobilising new financing, growing and digitally enabling their health workforce, modernising health facilities, expanding insurance coverage, and digitising service delivery.

“For example, in terms of boosting regional manufacturing of health products and technologies, Nigeria will train 10,000 pharmaceutical and biotech professionals and establish Centres of Excellence.

“Nigeria will also provide tax incentives to expand local production of vaccines, medicines, diagnostic and health technologies, strengthen regulatory agencies through digital systems and global alignment.”

It said that to help countries advance their compacts and broader reforms, the World Bank Group, Gavi and the Global Fund announced aligned financing, including two billion dollars in co-financing with each institution.

The statement added that philanthropic partners working through the Global Financing Facility and the Health Systems Transformation and Resilience Fund aim to mobilise up to 410 million dollars for critical health areas.

It said Seed Global Health was working with compact countries to build capacity and provide support for assessment, planning and policy development, with a focus on advanced health workforce development.

The statement said Japan, the United Kingdom and other partners were also providing technical assistance.

“Japan, WHO and the World Bank jointly launched a Universal Health Coverage Knowledge Hub to support countries with practical evidence-based solutions and peer learning.”

It said the UHC High-Level Forum, co-hosted by the Japanese Government, the WHO, and the World Bank Group, brought together ministers of health and finance, business leaders, philanthropies, global health agencies and civil society.

The UN Women has reaffirmed its commitment to strengthening policy frameworks, enhancing digital safety, and promoting accountability for online harms in Nigeria.

Deputy Executive Director for Normative Support, UNWomen, Nyara Gumbonzvanda, said this at a press conference on Saturday in Abuja.

The press conference was on Gumbonzvanda’s high-level mission to Nigeria and commemoration of the 2025 16 Days of Activism Against Gender-Based Violence (GBV).

She said that the visit was to deepen partnerships, reinforce national leadership, and accelerate collective action to advance gender equality and the empowerment of women and girls in Nigeria.

“A critical area of concern remains technology-facilitated GBV, which is rising globally and nationally.

“Between 16 per cent and 58 per cent of women worldwide experience some form of online or technology-facilitated GBV, depending on the region.

“UN Women is supporting the government and stakeholders in strengthening policy frameworks, enhancing digital safety, and promoting accountability for online harms,” she said.

She commended the National Assembly’s commitment to strengthening legislation that protects women and girls and advance women’s participation in governance, and called for effective legal frameworks and inclusive governance.

Gumbonzvanda decried low representation of women at the National Assembly, which she said stood at only 3.8 per cent, far below the global average of 27.2 per cent.

She, therefore, emphasised the need for legislative reforms such as affirmative action, quotas, and the proposed special seats bill, which she described as globally recognised tools to accelerate women’s participation.

”This is critical because globally, nearly one in three women experiences physical or sexual violence in their lifetime.

”Effective legal frameworks and inclusive governance are essential to reversing this trend,” she said.

On insecurity in Nigeria, she called for the release of abducted girls and reaffirm the need to ensure that every girl has the right to security and education.

She listed the impact of UN Women’s work in communities, including the commissioning of new WASH facilities.

She said that there was also rehabilitation of agro-processing centre in Kwali to improve women’s safety, reduce time burdens, and expand income-generating opportunities.

”UN Wornen will continue to mobilise partnerships across government, development partners, and the private sector to ensure that frontline organisations and national institutions have the resources required to deliver lasting change,” she said.

On her part, Beatrice Eyong, UN Country Representative to Nigeria and ECOWAS, commended the media for amplifying issues affecting women and girls in the country.