New Evaluation Reveals Critical Sexual and Reproductive Health Gaps in West and Central Africa

Introduction

A groundbreaking regional evaluation published in December 2025 has exposed severe disparities in sexual and reproductive health and rights (SRHR) across West and Central Africa. Conducted by the African Health Economics and Policy Association (AfHEA), the study analyzed 94 research papers from nations throughout the region, revealing systemic failures in policy implementation, service delivery, and research coverage.

The findings raise urgent concerns for the health and well-being of millions of women, girls, adolescents, and marginalized groups. Led by public health expert Dr. Esther Abikoye under the Addressing Neglected Areas of Sexual and Reproductive Health and Rights in Sub-Saharan Africa (ANeSA) initiative, the report provides a clear roadmap for policymakers, health systems, and development partners to prioritize long-overdue interventions.

Key Points

Background

The SRHR Review Report was commissioned by AfHEA in June 2025 as part of the ANeSA initiative, funded by Global Affairs Canada, the Canadian Institutes of Health Research, and the International Development Research Centre. The evaluation employed a scoping review methodology to map existing research and identify knowledge gaps across 94 studies from 24 countries.

Dr. Esther Abikoye, the study’s lead researcher, emphasized: “Our findings reveal a pattern of systemic neglect in areas that directly affect the most vulnerable individuals. These gaps undermine progress toward gender equality, human rights, and universal health coverage.”

The report underscores a stark imbalance in research distribution: only 13 countries in the region had sufficient data to guide policy, leaving nearly half of West and Central Africa without evidence-based insights for planning.

Analysis

Systemic Policy Implementation Failures

Many countries lack comprehensive SRHR frameworks or fail to enforce existing laws. For instance, while most nations have legal restrictions on FGM, inadequate monitoring and culturally sensitive enforcement mechanisms allow the practice to persist. Similarly, policies on adolescent SRH often exist on paper but are not translated into accessible services.

Service Delivery Shortcomings

Health systems are plagued by shortages of trained providers, especially in rural and conflict-affected areas. Limited funding for sexual health clinics, inadequate supply chains for contraceptives, and insufficient infrastructure hinder service delivery. Marginalized groups frequently encounter discriminatory attitudes from healthcare workers, further deterring utilization.

Research Gaps and Data Deficits

The asymmetric distribution of SRHR research limits evidence-based decision-making. Countries with robust data collections can design targeted interventions, while others rely on assumptions that may not reflect local realities. This disparity perpetuates cycles of neglect and inefficient resource allocation.

Socio-Cultural and Economic Barriers

Cultural norms, gender inequities, and poverty deeply influence SRHR outcomes. For example, harmful traditional practices persist due to deeply rooted beliefs, while economic dependence often forces young women into unsafe abortions or early marriages. Addressing these underlying factors requires multi-sectoral strategies beyond healthcare alone.

Practical Advice

Strengthening National Policies

Governments should revise and enforce SRHR policies to include marginalized groups. This includes decriminalizing abortion where permitted by law, expanding legal protections against SGBV, and integrating infertility care into national health plans.

Expanding Education and Awareness Programs

Comprehensive sexuality education should be mandated in schools and community settings, with tailored curricula for adolescents, persons with disabilities, and ethnic minorities. Public awareness campaigns can reduce stigma around topics such as mental health, infertility, and safe abortion.

Increasing Funding for Mental Health Services

Dedicated budgets should allocate resources to mental health facilities that offer integrated SRHR care. Training healthcare workers to recognize and address psychological issues related to sexuality is essential for holistic patient support.

Promoting Inclusive and Youth-Friendly Care

Health facilities must adopt disability-inclusive designs, offer confidential services for adolescents, and train staff to deliver non-discriminatory care. Mobile clinics and telehealth platforms can extend reach to remote and underserved populations.

Improving Research Capacity

Regional bodies should prioritize funding for SRHR research in countries with limited data. Collaborative studies across borders can identify cross-cutting challenges and solutions, ensuring interventions are context-specific and evidence-based.

Enforcing Laws Against Harmful Practices

Governments must strengthen enforcement of bans on FGM and other harmful traditions through community engagement, law enforcement training, and robust reporting mechanisms. Support networks for survivors should be expanded.

Frequently Asked Questions (FAQ)

What is the primary focus of the SRHR Review Report?

The report evaluates gaps in sexual and reproductive health and rights across West and Central Africa, identifying key areas requiring urgent intervention and policy reform.

Which groups are most affected by SRHR disparities?

Women, adolescents, persons with disabilities, ethnic minorities, street-connected youth, and displaced populations face disproportionate barriers to SRHR services.

How many unsafe abortions occur annually in West Africa?

More than 1.8 million unsafe abortions are estimated to take place each year in West Africa due to restrictive laws and limited access to care.

What actions are recommended to address infertility in the region?

The report calls for integrating infertility prevention and treatment into national health plans, increasing funding for diagnostic services, and reducing stigma through public education.

Why is research distribution uneven across the region?

<pOnly 13 countries maintain sufficient SRHR research capacity, leaving nearly half of West and Central Africa without adequate data to guide policy and program development.

Conclusion

The SRHR Review Report serves as both an alarm and a guide. It highlights systemic neglect in sexual and reproductive health across West and Central Africa while providing a concrete framework for action. Governments, health systems, civil society, and development partners must act decisively to close policy gaps, expand inclusive services, and invest in research.

As Dr. Abikoye asserts, “The wellbeing of millions of women and girls depends on political will and commitment to addressing neglected areas of sexual and reproductive health.” By prioritizing SRHR, the region can advance gender equality, protect human rights, and move closer to universal health coverage for all.