A comprehensive regional review has revealed deep-rooted gaps in sexual and reproductive health and rights (SRHR) research, policy, and service delivery across West and Central Africa, raising fresh concerns about the wellbeing of millions of women, girls, adolescents, and marginalized groups.
The SRHR Review Report, conducted in June 2025 by the African Health Economics and Policy Association (AfHEA), examined 94 research studies from countries in the region and identified seven major areas of persistent neglect. The findings point to systemic shortcomings that continue to undermine progress on gender equality, human rights, and universal health coverage.
Led by public health researcher Dr. Esther Abikoye, the review forms part of AfHEA’s work as the West and Central Africa Health Policy and Research Organization under the Addressing Neglected Areas of Sexual and Reproductive Health and Rights in Sub-Saharan Africa (ANeSA) initiative. The initiative 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,” Dr. Abikoye said. “These gaps undermine progress toward gender equality, human rights, and universal health coverage.”
Seven Neglected Priority Areas
The report identifies seven critical SRHR areas requiring urgent attention. Infertility and subfertility, despite rates in the region being more than double the global average, remain largely absent from national health agendas, forcing many women to rely on traditional remedies due to the high cost and limited availability of biomedical services.
Adolescent sexual and reproductive health also remains under-addressed, particularly for adolescents with disabilities, street-involved youth, and displaced young people who face major barriers to accessing accurate information and essential care.
On safe abortion, the review estimates that more than 1.8 million unsafe abortions are carried out annually in West Africa alone, driven by restrictive laws, stigma, and a shortage of trained providers—factors that contribute to preventable complications and deaths.
Sexual and gender-based violence (SGBV) emerged as another critical concern, with alarmingly high reported cases across the region. In one country, over 11,000 cases were recorded in just six months, with women with disabilities and female sex workers facing the highest risks.
The intersection of mental health and sexuality was found to be severely neglected, with only one study across the entire region addressing the issue, despite evidence that mental health significantly influences sexual behaviour, vulnerability to abuse, and overall SRH outcomes.
Harmful traditional practices linked to SRH, such as female genital mutilation (FGM) and female genital schistosomiasis, remain underestimated in programming, even though they have lifelong physical and psychological consequences.
The review also highlights persistent inequalities in access to SRH services among marginalized populations, including people with disabilities, rural women, street hawkers, and ethnic minorities, who often experience multiple layers of discrimination.
Uneven Research Landscape
Beyond thematic gaps, the report reveals significant geographic imbalances in SRHR research. Only 13 countries in West and Central Africa were found to have sufficient SRHR research coverage, leaving nearly half the region with limited or no evidence to guide effective policymaking.
“This imbalance undermines the ability of governments and development partners to design interventions that are context-specific and inclusive,” Dr. Abikoye said while presenting the findings at an AfHEA-hosted webinar.
Call for Coordinated Action
The report calls for urgent and coordinated action by governments, development partners, health institutions, and civil society organizations. Recommended priorities include strengthening national SRHR policies, expanding education and awareness programmes for vulnerable groups, integrating mental health into SRHR frameworks, and promoting disability-inclusive and youth-friendly services.
It also urges increased investment in research, particularly in under-studied countries, and stricter enforcement of existing laws against FGM, SGBV, and other harmful practices.
“This review provides clear evidence and a roadmap for action,” Dr. 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.”
About the Report
The SRHR Review Report (June 2025) is a scoping review designed to map neglected SRHR issues and marginalized populations across West and Central Africa. It aims to support policymakers, health professionals, and development partners in developing inclusive, evidence-based interventions to improve sexual and reproductive health outcomes across the region.