Understanding Barriers to SRH Access for Individuals with Mental Illness in Nigeria

A Review of Individual and Environmental Factors

Authors

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),

–1301. https://doi.org/10.1176/appi.ps.55.11.1299

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Published

2025-01-26

How to Cite

Usman, I., R.A.C, R., & Dilana, S. (2025). Understanding Barriers to SRH Access for Individuals with Mental Illness in Nigeria: A Review of Individual and Environmental Factors. The International Journal of Comprehensive Health, Medicine, & Dentistry, 1(1), 239–248. Retrieved from https://halafoundation.com/index.php/ijchmd/article/view/22