Health
Unravelling Pain, Stigmatisation: Lots of Infertile women in Nigeria
Are you a woman struggling and praying to have a baby? Are you sharing in the pains of an infertile relative? You are not alone.According to the World Health Organisation (WHO), infertility is a disease of the male or female reproductive system defined by the failure to achieve a pregnancy after 12 months or more of regular unprotected sexual intercourse.
It noted that infertility affects millions of people of reproductive age worldwide and has an impact on their families and communities. Estimates suggest that between 48 million couples and 186 million individuals live with infertility globally.Infertility may be caused by a number of different factors, in either the male or female reproductive systems. However, it is sometimes not possible to explain the causes of infertility.With these information, the way and manner Africans stigmatise infertile women makes it look as if infertility only occurs in women in the continent.Although both women and men can experience infertility, a woman in a relationship with a man without a resultant pregnancy, is often perceived to be infertile, regardless of whether she is infertile or not.Infertility has significant negative social impacts on the lives of infertile couples and particularly women, who frequently experience violence, divorce, social stigma, emotional stress, depression, anxiety and low self-esteem.Being able to get pregnant is a big part of the marriage institution, especially in the African cultural context; hence infertility is associated with a lot of negative psychosocial and other consequences such as infidelity.In an interview with the Newsmen,most respondents concurred that infertility stigmatisation has led women into doing what they would ordinarily not have done just to have a child or children of their own.Various studies suggest that there is greater stigma for infertile women than men, and in developing countries, the infertile women experience the negative consequences of childlessness to a greater degree.The shame associated with infertility is so bad that none of our respondents wanted their names to be mentioned.Mrs Nkiru Ogbonna (not real name) told NAN that her mother-in-law and husband called her a witch and declared that she had no womb.Being the only child of her mother, she was deemed to have come from a home of infertile people.“They threw me out of the house after five years of marriage to their son.“I thank God they did that because after two years God gave me another husband and I now have four children with him while my former husband is still without a child, even though he remarried.“It was latter I discovered that the problem of our childlessness was my former husband’s fault but he and his family put the whole blame on me’’ because it was in their interest to do so.Hajia Amina Musa (not real name) said, “it is God that gives children but if He decides not to give me, who am I to question him?“My husband has other wives with children and I take them as my own, although sometimes I wished I had one of my own”.Some others said that they would be prepared to try other means of getting their own babies instead of being subjected to ridicule.From their responses though, it could be seen that ignorance probably played a major role in arriving at that mind-set.When asked if they would go for “In Vitro Fertilisation or adoption”, they reluctantly chose IVF, saying that adoption stigmatisation is still the same as that of infertility.Majority said they will prefer to do whatever they did secretly, while some said they would prefer to have another man impregnate them secretly just to cover their husbands’ shame of being infertile.They said adoption would simply tell the world that they are infertile, and that therefore they would have preferred IVF to adoption, if it is affordable and reliable.Little wonder, a recent publication by the Premium Times showed that six of 10 children in Nigeria brought for DNA testing were not fathered by their supposed fathers.Infertile women have been known to cope with infertility by infidelity, leading to the prevalent situation of women having children that are fathered by men other than their husbands.“Our findings showed that most of these women sought medical help alone without their husbands.In most cases, when a couple does not have a child, the only option is for the man to marry another wife that will give him children.Bassey Emem, one of our male respondents who is a health worker, frowned at how infertility is usually wrongly regarded as a female problem in the continent.“It is all about giving every woman the respect and the help she deserves to live a fulfilling life, with or without a child.“It is sometimes difficult to get the male partner to bring a semen sample for analysis, more so if he has more than one wife or other children; though who is to say those children are actually his?”He said basic investigations for infertility should assess both male and female factors.“Some couples prefer to opt for traditional assistance so as to avoid detection of a male factor and the accompanying social blame.Some men and women even patronise quacks where their medical records will not be taken, while some treat the perceived source of their infertility without their spouses.“These unqualified health practitioners cannot prescribe appropriate dosages, don’t consider drug interactions, therefore successes of these herbs are difficult to ascertain and may sometimes cause more harm than good’’.Emem said a lot of women still resort to the use of traditional medicines, mainly herbs which may not be as effective as conventional treatment.“These women resort to different forms of treatment from faith healing to traditional medicine and even to patronising quacks.“Vast herbal resources remain unexplored and studies need to be conducted to see if they have any potential for infertility treatment, and to ensure proper regulation, safety and non-exploitation of desperate women’’.However, cultural and religious beliefs, and societal pressure to conceive may influence a woman’s decision to seek traditional treatment.Most of the women shared bitter experiences on what they have been through to satisfy the people around them and end their suffering.Dr Toochi Nwoye, Consultant Obstetrician and Gynaecologist, Federal Medical Centre (FMC), says fertility care encompasses the prevention, diagnosis and treatment of infertility.He said that infertility amongst couples is a shared responsibility; therefore, both the man and the woman involved should seek fertility care together, and early, too.“To conceive a child, a man’s sperm must combine with a woman’s egg.“The testicles make and store sperm, which are ejaculated by the penis to deliver sperm to the female reproductive tract during sexual intercourse’’.Nwoye noted that many different medical conditions and other factors can contribute to fertility problems, and an individual’s case may have a single cause, several causes, or in some cases no identifiable cause.“According to statistics, one-third of infertility cases are caused by male reproductive issues, one-third by female reproductive issues, and one-third by both male and female reproductive issues or by unknown factors.“In male reproductive system, infertility is most commonly caused by problems in the ejection of semen, absence or low levels of sperm, abnormal shape or motility of the sperm, and bad lifestyle habit.“In the female reproductive system on the other hand, infertility may be caused by a range of abnormalities of the ovaries, uterus, fallopian tubes, and the endocrine system, among other possible factors.“Infertility can be primary or secondary. Primary infertility is when a pregnancy has never been achieved by a person, and secondary infertility is when at least one prior pregnancy has been achieved’’.Nwoye noted that many risk factors for both male and female infertility are the same fortunately, so there are many safe and effective therapies that significantly improve the chances of getting pregnant.He advised that if you are a woman in a heterosexual relationship with regular intercourse and menstrual cycles, you should see your doctor after 12 months of trying to conceive or six months if you are over the age of 35.Also, surrogacy – another way childless couples could use for having children of their own – has been labelled taboo in Nigeria due to cultural and religious factors.A survey, conducted by reporters showed that although there is no law prohibiting such practice, people consider the act as taboo.This is just as the two prominent religions of Islam and Christianity prohibit same.Although in a state like Adamawa in north-eastern Nigeria, the state government has only child fostering policy, and no adoption, no surrogacy.Dr Aisha Liman, a Gynaecologist and mother of two residing in Maiduguri, also said that a woman who adopts the option of surrogacy would not be seen as being ‘woman’ enough. “People see being able to get pregnant as a mark of womanhood, so surrogacy will affect womanhood negatively, especially where people place a lot of emphasis on a woman’s ability to get pregnant, gestate and carry the child,” she said.However, Dr Usman Sunusi, a Consultant Gynecologist, described surrogacy as a normal practice in the medical field as it enables childless couples to have their own children, noting, however, that ‘the practice is against cultural and religious tenets’.Therefore, there is the need to scale up campaign against infertility stigmatisation against women and change the mind-set of the public towards the childless couple.This awareness will encourage and enhance access to regulated, safe, effective and equitable fertility care solutions. (NAN)
The Niger State Private Health Facilities Agency (NiSPHFA) has sealed 12 unregistered Islamic medicine stores in Minna and a health facility in Katcha Local Government Area (LGA).
The Executive Chairman of NiSPHFA, Dr.
Abdullahi Suleiman, disclosed this while receiving members of the Islamic and Prophetic Medicine Practitioners’ Association of Nigeria (IPMPAN) in Minna.The enforcement is part of the agency’s renewed efforts to protect residents from unsafe healthcare practices and ensure compliance with minimum standards.
Suleiman said the facilities were sealed over alleged non-compliance with regulatory standards.
According to him, the enforcement is not aimed at persecuting healthcare providers but at ensuring residents have access to safe, quality, and standard-compliant healthcare services.
“Our responsibility is to protect the people by ensuring that anyone providing healthcare services operates within the required standards,” he said.
He urged genuine alternative medicine practitioners to register with NiSPHFA, saying registration would enable the agency to identify operators, monitor their activities, and protect residents from unsafe products and practices.
Suleiman also announced plans to organise a trade fair for verified alternative medicine practitioners to promote legitimate practices and improve public confidence in alternative healthcare.
He emphasised the need for practitioners to maintain minimum standards of hygiene, sanitation, safe preparation and storage of medicines, proper packaging, and infection prevention.
“Practitioners should refer patients whose conditions are beyond their capacity to appropriate health facilities. Such referrals will help reduce avoidable health risks,” he said.
The chairman said sustained enforcement, stakeholder collaboration, and improved compliance would enable NiSPHFA to safeguard residents and promote a safer, more accountable, and quality-driven healthcare system across the state.
He said the NiSPHFA enforcement team inspected 10 health facilities in Katcha local government and identified various irregularities requiring improvement.
Suleiman said the affected facilities were issued 21-day notices to correct the identified deficiencies.
“One of the facilities inspected was sealed for non-compliance with established standards,” he said.
He added that the agency also secured the support of the local government area in identifying and addressing facilities operating with irregularities.
IPMPAN Chairman, Abdullahi Haske, commended the state government for establishing NiSPHFA.
He pledged the association’s cooperation in ensuring that its members complied with regulatory requirements.
Stakeholders have called for improved implementation, tracking and accountability of health sector budgets to strengthen healthcare delivery and advance Universal Health Coverage (UHC) in Kaduna State.
They made the call during an engagement on strengthening participatory budget processes, health budget tracking and advocacy on Saturday in Kaduna, with emphasis on the 2027 budget process and implementation of the Annual Operational Plan (AOP) for the health sector.
Seth Luke, a Civil Society Coach on strengthening participatory budget processes under the Open Government Partnership (OGP) Kaduna, said the engagement was aimed at strengthening the capacity of OGP Technical Working Groups and state and local government accountability mechanisms to effectively participate in budget processes and advocacy.
Seth said the engagement was particularly focused on the health sector, including tracking the implementation of the Annual Operational Plan as the state commenced preparations for the 2027 budget.
“We want to see how we can track the implementation of the Annual Operational Plan for the health sector and, from our findings, bring out recommendations around improving funding and other areas that require attention,” he said.
He said the government needed to prioritise health financing beyond budgetary allocation by ensuring effective implementation of approved programmes and projects.
According to him, budget allocation represents government plans based on expected revenue, but available resources should be prioritised toward activities capable of improving healthcare and service delivery at the grassroots.
Seth urged participants to use the knowledge and findings from the engagement to engage relevant government stakeholders on improving health financing and budget implementation.
He also encouraged them to extend the knowledge gained to other sectors and continuously engage government on budgeting, accountability and service delivery.
Similarly, Garba Mohammed, Co-Chair of the Kaduna Maternal Accountability Mechanism (KADMAM), said the engagement was aimed at reviewing health budget performance against key indicators linked to maternal mortality reduction and child survival.
Mohammed said participants examined first and second quarter performance, particularly in areas such as family planning, Maternal, Newborn and Child Health (MNCAH), nutrition, malaria, immunisation and essential medicines.
He said family planning interventions largely involved commodities at the primary healthcare level, while MNCAH activities remained largely donor-dependent.
Mohammed commended the Kaduna State Government for meeting the Abuja Declaration benchmark of allocating at least 15 per cent of its annual budget to health.
He, however, expressed concern over gaps in the implementation of some critical health budget lines, stressing that allocation alone was not enough to improve health outcomes.
“We have looked at the budget allocation, and Kaduna State has met the 15 per cent Abuja Declaration benchmark. We commend the state for that. However, there are still issues around budget performance in critical health indicators,” he said.
He said the findings would be used to identify advocacy priorities and engage key government decision-makers, including the Ministry of Health, Planning and Budget Commission, Ministry of Finance and other relevant authorities.
Mohammed said participants were expected to understand the relevant health budget lines and their implementation status and use the knowledge to undertake evidence-based advocacy in their respective organisations.
Meanwhile, Yusuf Guje, Executive Director, Civic Impact for Sustainable Development Foundation (CISDF), and a participant at the programme, told the News Agency of Nigeria (NAN) that the engagement was timely in strengthening the capacity of civil society and accountability mechanisms.
Guje said the programme would deepen participants’ capacity in budget tracking, project monitoring and social auditing, particularly within the health sector.
He described the health sector as a critical pillar of development, saying civil society organisations had an important role to play in complementing government efforts through effective monitoring and accountability.
He said CSOs needed to strengthen their ability to analyse budgets, track expenditure and visit healthcare facilities to determine whether appropriated and released funds were being properly utilised.
“Civil society needs to really improve on how effectively we analyse the budget, how we track the spending, and go down to the various facilities to see how well the money appropriated and released is being utilised,” Guje said.
He said effective monitoring would help determine the extent to which communities benefited from government investments in healthcare.
According to him, Kaduna State’s commitment to Universal Health Coverage could only be strengthened through sustainable health financing and effective accountability mechanisms.
Guje described CSOs as representatives of communities that often lacked the knowledge, skills and platforms required to engage government on public policies and resource allocation.
He therefore urged civil society actors to continuously strengthen their capacity to represent citizens effectively, particularly in health financing advocacy and accountability.
“As civil society, we need to remain committed to holding the government accountable where necessary and tracking the entire health financing process,” he said.
Guje said the ultimate objective of budget tracking and social accountability was to ensure value for money in public expenditure on health.
He added that effective monitoring of public finances would contribute to improved healthcare delivery and better health outcomes at the grassroots. (NAN)
Cross River Government has made enrolment in the state Health Insurance Scheme compulsory for all civil and public servants in the state.
The Head of Service, Bassey Okon, announced this in a circular dated Sept.
3, following the official relaunch of the Formal Sector Enrolment Programme of the Cross River State Health Insurance Agency.According to the circular in Calabar, at the weekend, the directive takes immediate effect.
Okon stated that the policy was meant to ensure that all the civil and public servants had access to affordable, quality, and timely healthcare services, while strengthening the welfare and productivity of the state workforce.
He directed all the civil and public servants to enroll in the scheme and comply with the registration and documentation requirements of the agency.
The circular also introduced a mandatory requirement for officers to attach valid health insurance enrolment cards to official correspondences relating to personnel matters.
“Correspondences concerning promotion, confirmation of appointment, loan applications, study leave, training or sponsorship, transfer or secondment, as well as other personnel-related requests or benefits, would not be processed without the attachment of a valid health insurance enrolment card,” it stated.
To facilitate the enrolment process, the government established enrolment points at the Office of the Head of Service, New Secretariat, Calabar, and the Ministry of Health, Old Secretariat, Calabar.
Okon directed all Heads of Ministries, Departments, and Agencies (MDAs) to ensure that officers under their supervision were duly informed about the circular and made to comply with the enrolment requirement without delay.
He also urged concerned officers to take advantage of the designated enrolment points for guidance and assistance and to complete their enrolment as required.
He further directed all the heads of the MDAs to bring the contents of the circular to the attention of all civil and public servants under their supervision. (NAN)
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