A new regional review has revealed serious gaps in sexual and reproductive health and rights (SRHR) across West and Central Africa, raising concern about the wellbeing of millions of women, girls, adolescents, and marginalised groups.
The SRHR Review Report, conducted by the African Health Economics and Policy Association (AfHEA) in June 2025, examined 94 research studies from countries across the region. The review found major problems in policy implementation, service delivery, and research coverage.
The review was led by public health researcher Dr. Esther Abikoye 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 (ANeSA) initiative. The initiative receives financial support from 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. These gaps undermine progress toward gender equality, human rights, and universal health coverage,” Dr. Abikoye said.
The report highlights seven key areas that urgently need action. These include infertility and subfertility, adolescent sexual and reproductive health, safe abortion services, sexual and gender-based violence (SGBV), mental health and sexuality, harmful traditional practices linked to SRH, and SRH challenges among marginalised communities.
According to the review, infertility rates in the region are twice the global average, yet the issue is mostly missing from national health plans. Adolescents, including those with disabilities, street-involved youth, and displaced young people, struggle to access basic information and services.
The report also found that more than 1.8 million unsafe abortions are performed each year in West Africa because of restrictive laws, stigma, and a shortage of trained providers.
Sexual and gender-based violence remains widespread. In one country alone, more than 11,000 cases were recorded in just six months. Women with disabilities and female sex workers are among the most affected. Only one study in the region focused on the link between mental health and sexuality, even though mental health strongly influences sexual behaviour and vulnerability to abuse.
The review also showed that harmful practices such as female genital schistosomiasis and female genital mutilation continue to be underestimated in SRH programmes. Meanwhile, people with disabilities, street hawkers, rural women, and ethnic minorities face multiple forms of discrimination, making it harder for them to access care.
A major finding from the review is the uneven distribution of SRHR research across the region. Only 13 countries had enough available research, leaving almost half of West and Central Africa without sufficient data to guide policy and planning.
“This imbalance undermines the ability of governments and development partners to design interventions that are context-specific and inclusive,” Dr. Abikoye said during a webinar organised by AfHEA to share the findings.
The SRHR Review Report calls for strong and coordinated action from governments, health agencies, civil society groups, and development partners. It recommends strengthening national SRHR policies, expanding education programmes for vulnerable groups, increasing investment in mental health services, promoting disability-inclusive and youth-friendly care, and improving research in countries with limited SRHR data.
It also stresses the need for full enforcement of laws against female genital mutilation, sexual and gender-based violence, and other harmful practices.
“This review provides clear evidence and a roadmap for action. 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,” Dr. Abikoye said.
The SRHR Review Report is a detailed scoping review that maps neglected sexual and reproductive health issues and marginalised populations across West and Central Africa. The report is intended to guide policymakers, health workers, and development partners in planning inclusive and evidence-based interventions.