By Aminu Adamu
A comprehensive review of sexual and reproductive health and rights (SRHR) research in West and Central Africa has identified widespread neglect in key areas, exposing structural gaps that continue to put millions of women, girls, adolescents and other marginalised groups at risk.
The SRHR Review Report, conducted in June 2025 by the African Health Economics and Policy Association (AfHEA), analysed 94 research studies from countries across the sub-region. Its findings reveal persistent weaknesses in policy implementation, service delivery and research focus on sexual and reproductive health and rights.
The review, led by public health researcher Esther Abikoye, was undertaken as part of AfHEA’s role as the West and Central Africa Health Policy and Research Organisation under the Addressing Neglected Areas of Sexual and Reproductive Health and Rights in Sub-Saharan Africa initiative. The programme is supported by Global Affairs Canada, the Canadian Institutes of Health Research and the International Development Research Centre.
“Our findings show a pattern of systemic neglect in areas that directly affect the most vulnerable individuals,” Ms Abikoye said. “These gaps undermine progress toward gender equality, human rights and universal health coverage.”
Neglected priority areas
The report identifies seven major SRHR areas that remain largely overlooked across the region.
Infertility and subfertility, despite rates estimated to be twice the global average, are still missing from many national health agendas. Limited access to affordable biomedical services has pushed many women to rely on traditional remedies, often with little success.
Adolescent sexual and reproductive health also remains inadequately addressed, particularly for young people with disabilities, street-involved youth and displaced adolescents, who face significant barriers to accessing accurate information and essential services.
Unsafe abortion continues to pose a major public health challenge. An estimated 1.8 million unsafe abortions are carried out annually in West Africa, driven by restrictive laws, stigma and shortages of trained healthcare providers. These factors contribute to avoidable complications and maternal deaths.
Sexual and gender-based violence remains alarmingly high across the region. In one country alone, more than 11,000 cases were reported within six months, with women with disabilities and female sex workers facing the highest risks.
The review further highlights a striking lack of attention to the intersection between mental health and sexuality. Only one study across the entire West and Central African region examined this link, despite evidence that mental health strongly influences sexual behaviour, vulnerability to abuse and reproductive health outcomes.
Harmful traditional practices linked to sexual and reproductive health, including female genital mutilation and female genital schistosomiasis, were also found to be underestimated in SRHR programming, despite their lifelong physical and psychological consequences.
In addition, the report points to persistent inequalities in access to sexual and reproductive health services among marginalised groups such as people with disabilities, rural women, street hawkers and ethnic minorities, who face multiple layers of discrimination.
Uneven research coverage
Beyond thematic gaps, the review found significant geographic imbalances in SRHR research. Only 13 countries in West and Central Africa were identified as having sufficient SRHR-related studies, leaving nearly half of the region with little or no evidence to inform effective policy and programming.
“This imbalance undermines the ability of governments and development partners to design interventions that are context-specific and inclusive,” Ms Abikoye said during a webinar organised by AfHEA to present the findings.
The report calls for urgent and coordinated action by governments, development partners, health institutions and civil society groups.
It recommends strengthening national SRHR policies to address infertility, adolescent health, sexual and gender-based violence and safe abortion, alongside expanding education and awareness programmes tailored to vulnerable populations.
The review also urges increased investment in mental health services within SRHR frameworks, the promotion of disability-inclusive and youth-friendly services, and greater research efforts in countries with limited evidence to guide policy reforms.
It further calls for stricter enforcement of existing laws against harmful practices such as female genital mutilation and sexual violence.
“This review provides clear evidence and a roadmap for action,” Ms Abikoye said. “Governments must demonstrate political will and commit to addressing the neglected areas of sexual and reproductive health. The wellbeing of millions of women and girls depends on it.”
The SRHR Review Report, published in June 2025, is intended to support policymakers, health professionals and development partners in designing inclusive and evidence-based sexual and reproductive health interventions across West and Central Africa.
