1. Sexual and Reproductive Health and Rights

Nigeria’s Constitution provides that state policy shall ensure that there are adequate medical and health facilities for all persons.

2. Restrictions on Sexual and Reproductive Health and Rights

Abortion is criminal in Nigeria, prohibited by the Criminal Code in southern states and by the Penal Code in northern states. The difference between the two statutes is that the Criminal Code applies to anyone ‘acting with the intent of procuring the miscarriage’ of a woman regardless of whether she is pregnant (“whether or not she is with child”) while the Penal Code applies to those cases where a woman is in fact pregnant (“with child”). The country has not had any litigation challenging the constitutionality, legality, or propriety of its abortion restrictions. The country has had a handful of criminal cases that have been prosecuted using based on the above provisions. These criminal cases are obviously unable to interpret or clarify reproductive or abortion rights. The question, therefore, becomes whether the political and socio-cultural environment is likely to be receptive to constitutional or other legal challenges to the country’s abortion restrictions.

3. Policies

The National Health Policy aims to reduce maternal, neonatal, child and adolescent morbidity and mortality in Nigeria, and promote universal access to comprehensive sexual and reproductive health services for adolescents and adults throughout their life cycle through many interventions including promoting mechanisms to ensure access to quality reproductive health services and integration of reproductive, maternal, neonatal and child and adolescent health services. The National Policy On The Health And Development Of Adolescents And Young People In Nigeria (2020-2024) focuses on ensuring adequate access to health for adolescents and young people with several key priority areas including in investments in appropriate sexual and reproductive health and family planning services to achieve an economically favourable age structure is critical in this respect, along with the provision of quality education and opportunities for decent employment and recreation. In utilizing innovative ways for promoting health in Nigeria, the Federal Ministry of Health Nigeria National Guideline on Self-Care for Sexual, Reproductive, and Maternal Health was developed.

The Code Of Medical Ethics In Nigeria entails that disclosure of information on the patient by the doctor can only be made following informed consent of the patient (preferably in writing) including such information as on criminal abortion and concealed birth.

The political environment in Nigeria is fraught with hostility towards abortion law reform from strong religious and ethnic opposition and a very conservative social attitude towards abortion. In 2007, attempts to reform the country’s restrictive abortion laws were opposed by women’s groups and a very active anti-abortion lobby. Two proposed laws designed to improve the country’s ability to implement reproductive rights were stymied in parliament. One bill was designed to fully domesticate the Convention for the Elimination of all Forms of Discrimination Against Women (CEDAW) and the other to establish an Institute of Reproductive Health in the country. Both were withdrawn due to fears that they sought to liberalize abortion laws in the country. As such, there are currently no initiatives by policymakers to review the law or formulate specific policies to address the high rate of abortion-related maternal mortality in Nigeria. The country is a constitutionally secular state but the increasing militancy of religious bodies and anti-choice organizations on abortion have hindered progress on any abortion law reform.

4. Cases

Other than criminal prosecutions, there is no reported case of abortion-related litigation in Nigeria from the available literature. Abortion in Nigeria is illegal and carries a heavy jail sentence – up to 14 years imprisonment – unless it is performed to save the life of a pregnant woman. Still, many clandestine abortions continue to be carried out in the country often with dire consequences for the lives and health of the women involved. Statistics indicate that over 1,000,000 abortions occur in the country annually, representing about 33 abortions per 1,000 women of childbearing age. Illegal abortion is responsible for about 11 percent of maternal deaths in Nigeria and 50 percent of such deaths involve adolescents and young women.

Although reproductive health advocates and pro-choice organizations have made some effort to counter anti-abortion efforts. The Campaign Against Unwanted Pregnancy (CAUP) was launched in 1991 to address this public health crisis through advocacy for reform of the abortion law, research, and preparation of service providers as well as the development of a constituency to support the provision of safe abortion to the extent that the law allows. Nigeria’s governance system also makes legal reform on abortion an uphill battle. The country has a federal system of government comprised of the central government and 36 federal states. Any initiative to change the country’s abortion law from the central government has to be ratified by two-thirds or 24 federal states. Given the strong near-universal opposition to expanding abortion rights in the country, obtaining this quorum appears to be unlikely in the near future. Lagos state is a clear example of this state of affairs. In June 2022, Lagos State published the Guidelines on Safe Termination of Pregnancy for Legal Indications to provide evidence-based data and information for health workers in the public and private sectors and to equip them with information on relevant laws applicable to abortion and post-abortion care in the state. Following an outcry from the public, the Guidelines were suspended.