In Nigeria, reproductive health discussions have traditionally focused on women, overlooking the significant influence men have on household decisions that affect women's reproductive healthcare. Women bear the biological experience of pregnancy and childbirth, but decisions about their reproductive health are often influenced by partners and family structures. These dynamics are shaped by gender roles, economic realities, cultural expectations, and social norms. As a result, men may have considerable influence over reproductive health decisions while receiving limited information, support, or encouragement to participate meaningfully in reproductive healthcare.
Research has found that male partners play a significant role in women's use of reproductive health services, influencing decisions on family planning and timely access to maternal healthcare. However, influence does not necessarily translate into meaningful participation. A study by Adelekan et al. found that only about 30.9% of men studied were actively involved in reproductive healthcare practices. This presents a significant gap: men can be influential in reproductive health outcomes while remaining largely absent from the systems and spaces designed to support those outcomes.
In many Nigerian communities, men continue to have considerable influence over household health spending and healthcare decisions. Research involving community conversations with male elders in rural Edo State found that a husband's financial position and personal views could significantly influence whether his wife used a health facility or a traditional birth attendant. Men were more comfortable providing financial support than participating directly in pregnancy-related issues. This paradox of male influence and male absence is at the center of the challenge.
The gap between male influence and participation in reproductive healthcare did not emerge by accident. For decades, reproductive health programming has often been designed primarily around women. While this focus is understandable given the direct biological and health consequences women experience, it has sometimes left men at the margins of reproductive healthcare conversations. The result is a system in which influence can outpace information. Men may be expected to make or participate in important household decisions without necessarily having access to the information, services, or conversations needed to make those decisions responsibly.
Cultural and social norms also play a significant role in limiting male engagement in reproductive healthcare. In many communities, reproductive health is still regarded as "women's business." Traditional expectations around masculinity may position men primarily as providers and decision-makers rather than caregivers and partners. As a result, a man may consider paying for hospital bills or providing financial resources as sufficient involvement, without recognizing that emotional support, communication, and accompanying a partner to care are equally important.
The health system can also limit men's participation in reproductive healthcare. Many reproductive health services are designed primarily around women, and some facilities may not intentionally create spaces that encourage male participation. Clinic hours may conflict with men's working schedules, health education materials may primarily target women, and service environments may not always make male partners feel that their participation is expected or welcomed. Research published in BMC Public Health highlights the importance of accessible, welcoming services in encouraging greater male engagement.
The consequences of limited male engagement in reproductive healthcare extend beyond individual households. Nigeria continues to face a substantial maternal mortality burden, with an estimated 993 maternal deaths per 100,000 live births. To sustainably improve reproductive health outcomes, Nigeria must deliberately engage men as informed, supportive, and accountable partners. A reproductive health strategy that ignores the realities of household decision-making is incomplete. By engaging men and addressing the systemic barriers that limit their participation, Nigeria can work towards improving reproductive health outcomes for all.
Key points
- Men play a significant role in household decisions affecting women's reproductive healthcare in Nigeria.
- Cultural and social norms, as well as health-system barriers, limit male engagement in reproductive healthcare.
- Deliberately engaging men in reproductive healthcare is crucial to sustainably improving reproductive health outcomes in Nigeria.
