Forty-five per cent of women giving birth in Nigeria make fewer than four antenatal care visits, while 51 per cent do not deliver in a health facility, according to the Guttmacher Institute.
The figures are contained in the institute’s Adding It Up 2024: Investing in Sexual and Reproductive Health in Low- and Middle-Income Countries, released ahead of World Contraception Day on September 26 and International Safe Abortion Day on September 28.
The report also found that 86 per cent of women in Nigeria do not receive the necessary care after a major obstetric complication, while 52 per cent of newborns do not receive needed care for complications.
According to the institute’s 2025 Nigeria country profile, based on 2024 data, 8.51 million women aged 15 to 49 use modern contraceptive methods, while 2.19 million use traditional methods.
The data showed that injectables and intrauterine devices and implants each account for 22 per cent of contraceptive use, while condoms account for 19 per cent.
Pills, patches and rings account for 12 per cent, other modern methods three per cent, while sterilisation accounts for less than one per cent.
The report estimated that 4.6 million women in Nigeria have unmet demand for contraception, while 3.7 million do not intend to use contraception.
The institute defines unmet demand as women who want to avoid pregnancy but are not currently using contraception and express a desire for future family planning.
The findings were highlighted during a virtual SHE and Rights session organised ahead of World Contraception Day and International Safe Abortion Day by the Global Center for Health Diplomacy and Inclusion, Guttmacher Institute, Asian-Pacific Resource and Research Centre for Women, International Planned Parenthood Federation, CNS and partners.
Speaking at the session, Elizabeth A. Sully, Director of International Research at the Guttmacher Institute, presented evidence on the health and economic implications of investment in sexual and reproductive health and rights.
The institute’s analysis estimates that meeting the full need for modern contraception, maternal and newborn care, abortion services and treatment for four curable sexually transmitted infections in low- and middle-income countries in Asia would require increasing annual spending from $5.87 to $8.61 per person.
This represents an additional $2.74 per person, or $12.4 billion annually, the report said.
It also estimated that every additional dollar invested in family planning and contraceptive care could save $1.97 in pregnancy-related and newborn care costs.
According to the analysis, meeting sexual and reproductive health needs across Asia could reduce unintended pregnancies by 26 per cent, maternal deaths by 65 per cent and newborn deaths by 62 per cent.
The report further noted that investment in contraception could have broader economic effects, including increased workforce participation and greater control over earnings and savings.
Sully said the institute’s analysis was designed to move beyond simply measuring ‘unmet need’ by considering women’s preferences and choices in assessing contraceptive requirements.
The session also focused on the gap between policy commitments, budget allocations and actual delivery of sexual and reproductive health services.
Riju Dhakal, Programme Officer at ARROW, said governments should be assessed not only on commitments made to sexual and reproductive health and rights but also on whether funds are budgeted, released and ultimately reach health services and communities.
She said ARROW was working with partners in 12 countries to examine financing for sexual and reproductive health and rights and engage governments on investment and impact.
In Kenya, Jane Nyanjom, Associate Director, Advocacy and Partnerships, Reproductive Health Network Kenya, said shortages of contraceptive commodities, particularly in rural and hard-to-reach communities, remained an access concern.
She also identified youth-friendly services, accurate information, referral systems and informed choice as important components of reproductive healthcare.
Nawmi Naz Chowdhury, Executive Director of the Women’s Global Network for Reproductive Rights, said access to reproductive healthcare was affected by factors including shortages of trained providers and medicines, weak referral systems, administrative requirements, cost, geographical barriers, stigma and misinformation.
Dr Imran Pambudi, Director of Vulnerable Groups Health Services at Indonesia’s Ministry of Health, called for sexual and reproductive health services to be integrated into primary healthcare.
He identified persons with disabilities, remote island populations, survivors of violence, older people, women and adolescents among groups requiring particular attention.
The experts said financing alone would not guarantee access, stressing the need for adequately staffed and equipped facilities, medicines, referral systems and services responsive to vulnerable populations.
The Guttmacher Institute also provides a Family Planning Investment Impact Calculator and Safe Abortion Calculator designed to estimate the potential health and financial effects of investments in reproductive health services.
The calculators allow users to assess potential outcomes including contraceptive access, unintended pregnancies prevented, unsafe abortions averted and health-system costs saved.