Understanding Barriers to SRH Access for Individuals with Mental Illness in Nigeria
A Review of Individual and Environmental Factors
Abstract
Background: Access to sexual and reproductive health (SRH) services is a major challenge for individuals with mental illness, in resource-limited settings, like Nigeria, where cultural beliefs and stigma impact access and rights to care. This group often remains overlooked despite global efforts to promote equitable health access. This situation underscores the urgent need for prompt measures through effective policies and strategic interventions to address these growing concerns.
Objectives: This scoping review aims to identify and analyze the barriers and enablers affecting access to SRH services for people with mental illness in Nigeria.
Methods: A literature search was conducted across multiple databases, including PubMed and Google Scholar, focusing on peer-reviewed articles and credible reports published between 2010 and 2024. A standardized data extraction form was used to chart relevant information on individual and environmental factors influencing SRH service access.
Results: The review highlights key barriers such as cultural stigma, inadequate healthcare infrastructure, lack of provider training, and financial constraints. Enablers, although less frequently documented, suggest that community engagement and targeted interventions could enhance service accessibility.
Conclusions: Addressing the identified barriers is crucial for improving SRH service access for individuals with mental illness in Nigeria
References
World Health Organization. (2017). Promoting rights and community living for people with
psychosocial disabilities. Retrieved from
http://www.who.int/mental_health/world-mental-health_day/2017/en/
World Health Organization. (2010). Closing the gap in a generation: Health equity through action
on the social determinants of health. World Health Organization Commission on Social
Determinants of Health. Retrieved from
https://www.who.int/social_determinants/thecommission/finalreport/en/
World Health Organization. (2018). Mental health aspects of women’s reproductive health. World
Health Organization, 61(4), 1–7.
Federal Ministry of Health, Nigeria. (2023). Ministry of Health. Retrieved from www.fmoh.gov.ng
Federal Ministry of Women Affairs and Social Development. (2014). National standards for
improving the quality of life of vulnerable children in Nigeria (pp. 1–41).
Federal Ministry of Health, Nigeria. (2017). National reproductive health policy of Nigeria.
Armatas, V. (2014). Mental retardation: Definitions, etiology. Journal of Sport and Health
Research, 1(2), 112–118.
Iheanacho, T., Kapadia, D., Ezeanolue, C. O., Alice, A., Ogidi, A. G., Ike, A., et al. (2016).
Attitudes and beliefs about mental illness among church-based lay health workers: Experience from
prevention of mother-to-child HIV transmission trial in Nigeria.
Iliyasu, Z., Abubakar, I. S., & Aliyu, M. H. (2015). Health and human rights village in Northern
Nigeria. BMC International Health and Human Rights, 1–6.
Lasebikan, V. O. (2016). Profile and determinants of disability in psychotic disorders in Nigeria.
Community Mental Health Journal, 0(0), 1–7.
Jack-Ide, I. O., Uys, L. R., & Middleton, L. E. (2013). Caregivers’ experiences of families of
persons with serious mental health problems in the Niger Delta region of Nigeria. International
Journal of Mental Health Nursing, 22(2), 170–179.
Aderemi, T. J., & Pillay, B. J. (2013). Sexual abstinence and HIV knowledge in school-going
adolescents with intellectual and psychosocial disabilities and non-disabled adolescents in Nigeria.
Ofuani, A. I. (2017). Protecting adolescent girls with intellectual disabilities from involuntary
sterilization in Nigeria: Lessons from the Convention on the Rights of Persons with Disabilities,
–570.
Okpalauwaekwe, U., Mela, M., & Oji. (2017). Knowledge of and attitude to mental illnesses in
Nigeria: A scoping review. Integrative Journal of Global Health, 1(5), 1–14.
Adyemi, T., & Toyin, J. (2014). Teachers’ perspectives of sexuality and sexuality education of
learners with intellectual disability in Niger State, Nigeria.
Armiyau, A. Y. (2015). A review of stigma and mental illness in Nigeria. Journal of Clinical Case
Reports, 5(1), 1–3.
Awotidibe, T. O., Bisiriyu, L. A., Ativie, R. N., Oke, K. I., Adedoyin, R. A., Nabakwe, E. C., et al.
(2017). Prevalence of physical inactivity among Nigerian women: Do socio-demographic
characteristics, women’s personal attributes, and psychosocial factors play any role? Journal of
Public Health Research, 4(1), 33–45.
Ebuenyi, I. D., Syurina, E. V., Bunders, J. F. G., & Regeer, B. J. (2018). Barriers to and facilitators
of employment for people with psychiatric disabilities in Africa: A scoping review. Global Health
Action, 11(1). https://doi.org/10.1080/16549716.2018.1463658
Amusat, N. (2011). Disability care in Nigeria: The need for professional advocacy. African Journal
of Physiotherapy and Rehabilitation Science, 1(1), 30–36.
Hodson, N., & Bewley, S. (2017). Social exclusion and human rights at the intersection of HIV and
severe mental illness. The Lancet Psychiatry, 4(12), 898–899.
Tracy, B. E. (2017). The impacts of mental disability: Implications for social work practice. Social
Work Journal, 7(1), 1–8.
Brooke-Sumner, C. (2012). Perceptions of psychosocial disability amongst psychiatric service users
and caregivers in South Africa. Journal of Psychiatric Nursing, 1–10.
Etieyibo, E., Omiegbe, O., Africa, S., & State, D. (2007). Religion, culture, and discrimination
against persons with disabilities in Nigeria.
Martinello, E. (2015). Reviewing risk factors of individuals with intellectual and mental disabilities
as perpetrators of sexually abusive behaviors, 269–278.
Hunt, X., Carew, M. T., Braathen, S. H., Swartz, L., & Rohleder, P. (2017). The sexual and
reproductive rights and benefits derived from sexual and reproductive health services of people
with disabilities in South Africa: Beliefs of non-disabled people. Agenda, 8080(May).
Burke, E., Kébé, F., Flink, I., Reeuwijk, M. V., & May, A. (2017). A qualitative study to explore the
barriers and enablers for young people with disabilities to access sexual and reproductive health
services in Senegal. Agenda, 8080(May).
Baines, S., Emerson, E., Robertson, J., & Hatton, C. (2018). Sexual activity and sexual health
among young adults with and without mild/moderate intellectual and mental disability.
Sediqi, S. (2019). The impact of addiction on access to sexual and reproductive health. Journal of
Health Research, 16(2018), 283–286.
Rohwerder, B. (2018). Disability stigma in developing countries. K4D Helpdesk Report. Institute of
Development Studies.
Mavuso, S. S., & Maharaj, P. (2015). Access to sexual and reproductive health services:
Experiences and perspectives of persons with disabilities in Durban, South Africa. Agenda, 29(2),
Ganle, J. K., Otupiri, E., Obeng, B., Edusie, A. K., Ankomah, A., & Adanu, R. (2016). Challenges
women with disability face in accessing and using maternal healthcare services in Ghana: A
qualitative study. PLoS ONE, 11(6), 1–13.
British Council. (2012). Improving the lives of girls and women in Nigeria: Issues, policies, and
action. Retrieved from
https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/6
/Gender-Nigeria2012.pdf
Krahn, G. L., Walker, D. K., & Correa-De-Araujo, R. (2015). Persons with disabilities as an
unrecognized health disparity population. American Journal of Public Health, 105(S2), S198–S206.
Kleintjes, S., Lund, C., & Swartz, L. (2013). Barriers to the participation of people with
psychosocial disability in mental health policy development in South Africa: A qualitative study of
perspectives of policymakers, professionals, religious leaders, and academics. BMC International
Health and Human Rights, 13(1), 1–11.
Odimegwu, C., Adedini, S. A., & Ononokpono, D. N. (2013). HIV/AIDS stigma and utilization of
voluntary counseling and testing in Nigeria. BMC Public Health, 13(1).
Tanabe, M., Nagujjah, Y., Rimal, N., Bukania, F., & Krause, S. (2015). Intersecting sexual and
reproductive health and disability in humanitarian settings: Risks, needs, and capacities of refugees
with disabilities in Kenya. Sexuality and Disability, 33(4), 411–427.
United Nations Population Fund (UNFPA). (2009). A situational analysis of the sexual and
reproductive health of women with disabilities.
Lin, L., Lin, J., Chu, C. M., & Chen, L. (2011). Caregiver attitudes to gynecological health of
women with disability. Journal of Intellectual and Developmental Disability, 36(3), 149–155.
Lin, L., Lin, P., Chu, C. M., & Lin, J. (2011). Predictors of caregiver supportive behaviors towards
reproductive health care for women with disabilities. Research in Developmental Disabilities,
(2), 824–829.
Miller, H. L., Pavlik, K. M., Kim, M. A., & Rogers, K. C. (2017). An exploratory study of the
knowledge of personal safety skills among adults with disabilities. Journal of Applied Research in
Intellectual and Mental Disabilities, 30(2), 290–300.
Olayode, K. (2014). Rethinking African development: A gender-responsive governance agenda in
Nigeria.
World Bank. (2017). Nigeria report. Retrieved from http://data.worldbank.org/country/nigeria
Women's Rights Advancement and Protection Alternative (WRAPA). (2008). Report on gender
equality and women empowerment in Nigeria: The place of affirmative action.
British Council. (2012). Improving the lives of girls and women in Nigeria: Issues, policies, and
action. Retrieved from
https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/6
/Gender-Nigeria2012.pdf
World Health Organization. (2018). Sexual and reproductive health of women with disabilities: A
global perspective.
United Nations. (2014). Mental health matters: Social inclusion of youth with mental health
conditions. New York: United Nations.
Desrosiers, A., Betancourt, T., Kergoat, Y., Servilli, C., Say, L., & Kobeissi, L. (2020). A systematic
review of sexual and reproductive health interventions for young people in humanitarian and
lower-and-middle-income country settings. BMC Public Health, 20, 666.
https://doi.org/10.1186/s12889-020-08852-1
Åkerman, E., Östergren, P. O., Essén, B., Fernbrant, C., & Westerling, R. (2016). Knowledge and
utilization of sexual and reproductive healthcare services among Thai immigrant women in
Sweden. BMC International Health and Human Rights, 16, 25.
https://doi.org/10.1186/s12914-016-0090-0
Hope, H., Pierce, M., Johnstone, E. D., Myers, J., & Abel, K. M. (2022). The sexual and
reproductive health of women with mental illness: A primary care registry study. Archives of
Women's Mental Health, 25, 585–593. https://doi.org/10.1007/s00737-022-01257-y
Coverdale, J., Balon, R., Beresin, E. V., Brenner, A. M., Guerrero, A. P. S., Louie, A. K., et al.
(2018). Family planning and the scope of the “Reproductive Psychiatry” curriculum. Academic
Psychiatry, 42, 183–188. https://doi.org/10.1007/s40596-017-0861-3
Khalifeh, H., Moran, P., Borschmann, R., Dean, K., Hart, C., Hogg, J., et al. (2015). Domestic and
sexual violence against patients with severe mental illness. Psychological Medicine, 45, 875–886.
https://doi.org/10.1017/S0033291714002280
Tumwakire, E., Ashaba, S., Mubangizi, V., & Gavamukulya, Y. (2022). Sexual and reproductive
health knowledge and practices among youth with and without mental illness in Uganda: A
comparative study. Tropical Medicine and Health, 50(1), 51.
https://doi.org/10.1186/s41182-022-00444-1
Raja, M., & Azzoni, A. (2003). Sexual behavior and sexual problems among patients with severe
chronic psychoses. European Psychiatry, 18(2), 70–76.
https://doi.org/10.1016/S0924-9338(03)00009-9
Deckman, T., & DeWall, C. N. (2011). Negative urgency and risky sexual behaviors: A clarification
of the relationship between impulsivity and risky sexual behavior. Personality and Individual
Differences, 51(6), 674–678. https://doi.org/10.1016/j.paid.2011.06.004
Dickerson, F., Brown, C., Kreyenbuhl, J., Goldberg, R., Juan, L., & Dixon, L. (2004). Sexual and
reproductive behaviors among persons with mental illness. Psychiatric Services, 55(11),
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