Pregnancy
Nigeria accounts for a very large share of global maternal deaths, driven by low rates of skilled attendance, distance and the cost of emergency care. Maternity leave at federal level is twelve weeks, though several states provide more. Free maternal health programmes exist in a number of states but not nationally, and out-of-pocket payment remains the norm elsewhere.
Nigeria has among the highest maternal mortality in the world, and the reasons are structural: distance to facilities, cost at the point of care, shortages of skilled attendants and blood, and delays in reaching referral hospitals. Federal employees get twelve weeks of maternity leave; state rules differ, and Lagos and a few other states have gone further. Free maternal care exists in some states only.
Key points
| Maternal mortality | Among the highest absolute numbers in the world |
|---|---|
| Maternity leave | Twelve weeks at federal level; several states provide more |
| Free care | Available in some states through state programmes, not nationally |
| Antenatal care | At least four visits recommended; coverage varies sharply by region |
| Skilled attendance | A minority of births in some northern states |
| Emergency care | Cost and distance are the main barriers |
| Health insurance | State schemes expanding, with maternal packages in several states |
In practice
- Check whether your state runs a free maternal health programme: several do, and few people know.
- Identify the nearest facility that performs caesareans, and how you would get there at night.
- Register for the state health insurance scheme if one exists: maternal packages are usually included.
- Attend antenatal care early; the first visit determines the risk plan.
Cost and coverage
Costs vary by state; several run free maternal care programmes, elsewhere payment is out of pocket.
Recent changes
Several states have expanded free maternal and child health schemes and the national health insurance framework was reformed in 2022 to make enrolment mandatory, though implementation is gradual.
Where to go
- Primary health centres and state maternal health programmes.
- General hospitals with emergency obstetric capacity.
- State health insurance agencies.
Worth knowing
The decisive factor is not antenatal care but what happens in an obstetric emergency. Know before the eighth month which facility can perform a caesarean and how you will reach it.
Frequently asked questions
Is maternal care free in Nigeria?
It depends on the state. Several states operate free maternal and child health schemes covering antenatal care and delivery in public facilities; others charge. The national health insurance scheme covers registered members. Ask at the state ministry of health which scheme applies where you live.
How long is maternity leave?
Twelve weeks for federal public servants under the Labour Act framework, with some states providing more — Lagos and a few others have extended it substantially. Private employers set their own terms above the statutory minimum.
The general article: Pregnancy · Compare with another country
Periods and period products
Nigeria's Finance Act 2019, in force from February 2020, added locally manufactured sanitary towels and pads to the VAT-exempt list when the standard rate rose to 7.5 %; imported pads, which dominate the market, remain taxed and subject to customs duty. There is no national programme of free provision: state governments, first ladies' initiatives and NGOs run distributions in some schools, with no legal entitlement. No menstrual leave exists in the Labour Act.
Endometriosis is treated in the gynaecology departments of teaching hospitals and federal medical centres, with laparoscopy available in a limited number of centres, and in private clinics in Lagos and Abuja. Awareness campaigns by the Endometriosis Support Group Nigeria have improved recognition, but diagnosis is late and costs fall on patients; the national insurance schemes cover little gynaecological surgery.
Reusable pads are promoted by NGOs as the affordable option; nothing is reimbursed.
Key points
| VAT | Locally made pads exempt since February 2020; imported pads taxed |
|---|---|
| Free provision | No national scheme; state and NGO distributions |
| Menstrual leave | None |
| Endometriosis | Teaching hospitals and federal medical centres; private clinics; out of pocket |
| Reusable products | NGO programmes |
In practice
- Locally made brands are cheaper on the shelf partly because of the exemption; compare.
- Ask the school whether a state or NGO programme supplies pads.
What it costs
A cycle costs from several hundred to a few thousand naira in disposables, rising with inflation. Nothing is reimbursed; no national free provision.
What has changed recently
The Finance Act 2019 exemption has not been extended to imported products; several bills on free provision in schools have been introduced without passing.
Where to find help
- Federal Inland Revenue Service: VAT exemption list.
- State ministries of education and women's affairs: school distributions.
- Endometriosis Support Group Nigeria.
- Teaching hospitals and federal medical centres.
Worth knowing
With most pads imported and taxed, the exemption changes little for many buyers; the price gap between brands is the real lever, along with reusables.
Frequently asked questions
Are sanitary pads taxed in Nigeria?
Locally made pads are VAT-exempt since 2020; imported ones carry VAT and customs duty.
Are pads free in schools?
Not by law. Some states and NGOs distribute them in some schools.
Is there menstrual leave?
No.
Sources
- Federal Inland Revenue Service — VAT exemption list
The general article: Periods and period products · Compare with another country
Sex therapy
No licence for sex therapists and no register to check outside medicine; teaching hospitals provide the reliable care, and insurance pays little for outpatient therapy.
Nigeria licenses doctors through the Medical and Dental Council but has no statutory register of psychologists or counsellors in force, so “sex therapist”, “sexologist” and even “psychologist” are words anyone may use. The Mental Health Act signed in January 2023 modernised the legal framework for mental-health care without creating a licence for therapists. The reliable markers are therefore a medical registration and a verifiable university degree in psychology.
Qualified care comes from psychiatrists, urologists and gynaecologists in the teaching hospitals and federal medical centres, and from clinical psychologists attached to them; a small number of private practitioners in Lagos and Abuja hold overseas sex-therapy credentials. The Nigerian Psychological Association and the Association of Psychiatrists in Nigeria are the professional bodies.
Costs fall largely on the patient. The National Health Insurance Authority's schemes cover registered employees for basic care in accredited facilities, with limited outpatient mental-health benefits; private health plans focus on hospitalisation. A consultation at a teaching hospital costs a modest registration and consultation fee; private specialists and therapists charge from a few thousand to several tens of thousands of naira a session, rising with inflation.
The market for “sexologists”, herbalists and “men's clinics” promising cures is large, in the street and online, and counterfeit erectile-dysfunction drugs are common.
Key points
| Title | Unregulated; no statutory register of psychologists or counsellors in force |
|---|---|
| Regulated profession nearby | Doctors (Medical and Dental Council of Nigeria) |
| Who is qualified | Psychiatrists, urologists, gynaecologists; clinical psychologists with university degrees |
| Public services | Teaching hospitals and federal medical centres, modest fees |
| Insurance | NHIA schemes for basic care in accredited facilities; outpatient therapy rarely covered |
| Private cost | From a few thousand to several tens of thousands of naira a session |
In practice
- Verify a doctor on the Medical and Dental Council's register; ask a psychologist for the university degree and hospital affiliation.
- Prefer teaching hospitals and federal medical centres for evaluation; their psychiatry and urology clinics see sexual complaints.
- Do not buy erectile-dysfunction drugs outside a licensed pharmacy with a prescription.
- Ask your employer whether the health plan includes mental-health consultations.
Cost and reimbursement
Teaching hospital: modest fees. Private specialist or therapist: from a few thousand naira upwards, out of pocket; insurance seldom covers outpatient therapy.
What has changed recently
The Mental Health Act of 2023 created a department of mental-health services and set patients' rights, but licensing of psychologists and counsellors is still at the bill stage.
Where to go
- Medical and Dental Council of Nigeria: register of doctors.
- Teaching hospitals and federal medical centres: psychiatry, urology and gynaecology clinics.
- Nigerian Psychological Association; Association of Psychiatrists in Nigeria.
- National Health Insurance Authority: accredited facilities and benefits.
Worth knowing
Without a register, the burden of checking falls on you. A practitioner who cannot name a university, a hospital or a registration number, or who sells a cure, is not a clinician.
Frequently asked questions
Is there a licensed sex therapist in Nigeria?
No licence exists for the title, nor a statutory register of psychologists. Doctors are licensed; psychiatrists and urologists in teaching hospitals are the safest route.
Does health insurance cover therapy?
Rarely. NHIA schemes cover basic care in accredited facilities with limited mental-health benefits; private plans focus on hospitalisation.
How do I avoid quacks?
Verify the medical registration, prefer hospital-based practitioners, and walk away from anyone selling a guaranteed cure or unprescribed drugs.
Sources
- Medical and Dental Council of Nigeria — register of doctors
- National Health Insurance Authority — schemes and accredited facilities
The general article: Sex therapy · Compare with another country
Mental health
The 2021 Mental Health Act displaced colonial-era law, while the treatment gap stays among the widest anywhere.
A modern Mental Health Act in 2021 retired Nigeria's colonial-era lunacy legislation, set out patients' rights and banned chaining.
Nigeria replaced its colonial-era Lunacy Act with a Mental Health Act in 2021, introducing rights-based provisions on consent, involuntary treatment and non-discrimination. Delivery remains the problem: a few hundred psychiatrists for over two hundred million people, most services concentrated in eight federal neuropsychiatric hospitals, and out-of-pocket payment for nearly everything. Faith and traditional healers remain the first port of call for most people.
Key points
| Legal framework | Recently modernised, rights-based, replacing colonial-era statutes |
|---|---|
| Treatment gap | More than nine in ten affected people receive no care |
| Strategy | Integration of mental health into primary care |
| Specialist provision | Concentrated in a few referral hospitals |
| Essential medicines | On the national list, with frequent stock-outs |
| Traditional healing | Commonly the first recourse |
| Chaining | Prohibited by the new statutes, still practised for lack of alternatives |
Frequently asked questions
What did the 2021 Act change?
It repealed the Lunacy Act, which dated from the colonial period, and replaced detention-focused provisions with rules on consent, capacity, voluntary and involuntary admission and protection from discrimination. Implementation depends on regulations and funding at state level.
Where is specialist care available?
At the federal neuropsychiatric hospitals in Lagos, Enugu, Kaduna, Calabar, Benin, Sokoto, Maiduguri and Uyo, and at teaching hospital psychiatry departments. Consultations are relatively inexpensive, but medication and repeat visits are paid out of pocket, which is the main barrier to continuity.
The general article: Mental health · Compare with another country
Dental care
National health insurance covers only limited dental care; extraction is the public mainstay and the rest is private.
The National Health Insurance Authority scheme anchors dental care, though its benefit package includes only limited dental treatment.
The general article: Dental care · Compare with another country
HIV and AIDS
One of the largest epidemics in absolute numbers, with free treatment heavily dependent on international funding.
Nigeria has one of the largest numbers of people living with HIV of any country, although prevalence in the general population is moderate. Antiretroviral treatment is provided free through government and partner-supported facilities, with a very large share of the programme financed by international donors — a dependence that makes funding decisions abroad a direct issue for patients.
Nigeria has one of the largest HIV treatment programmes in the world by number of patients, free through designated facilities and heavily supported by international funding — a dependence that makes the programme vulnerable to shifts in donor policy. Testing is widely available, and PrEP has been introduced for key and priority populations.
Key points
| Scale | Among the largest epidemics in the world in absolute numbers |
|---|---|
| Treatment | Free at government and partner-supported facilities |
| Funding | Heavily dependent on international financing |
| Testing | Free at public facilities; self-tests increasingly available |
| PMTCT | A priority programme; antenatal testing is the main entry point |
| PrEP | Being scaled up for key and priority populations |
| Anti-discrimination | The HIV and AIDS Anti-Discrimination Act 2014 prohibits discrimination |
In practice
- The 2014 Act prohibits discrimination in employment and healthcare and can be relied on.
- Never allow your supply to run down to the last few days: stock-outs happen.
Cost and coverage
Testing and antiretroviral treatment are free; transport is the real cost.
Where to go
- Government and partner-supported treatment facilities.
- National Agency for the Control of AIDS and state agencies.
Worth knowing
Because so much of the programme is externally funded, supply can be disrupted by decisions taken far away. Keeping a buffer of medication and knowing an alternative facility is practical insurance.
Frequently asked questions
Is treatment free in Nigeria?
Yes, antiretroviral treatment and the associated monitoring are provided free at designated facilities under the national programme. Patients sometimes face costs for other tests or transport, which is the practical barrier to staying in care rather than the drugs themselves.
Hepatitis B
High prevalence, a birth dose in policy, and coverage that collapses outside health facilities.
Nigeria has one of the larger burdens of chronic hepatitis B in the world. The birth dose is part of national policy, but a large share of births take place outside health facilities, and birth dose coverage is consequently far below the coverage of later doses. Treatment is available but generally paid for by the patient, which is the principal barrier.
Nigeria has hepatitis B in its routine immunisation schedule with a birth dose, but timely coverage is low: many births occur outside facilities, and even institutional deliveries often miss the twenty-four hour window. Prevalence is high, and most people with chronic infection are unaware of it, which is why screening campaigns matter as much as vaccination.
Key points
| Prevalence | High, among the largest burdens worldwide |
|---|---|
| Vaccination | Part of routine immunisation, in the combined vaccine |
| Birth dose | National policy, but coverage is far below that of later doses |
| Home births | The main reason the birth dose is missed |
| Antenatal screening | Increasingly offered, not yet universal |
| Treatment | Available, usually at the patient's own cost |
In practice
- Ask for the birth dose within 24 hours, and take the baby to a facility immediately if born at home.
- Have the household of a carrier tested and vaccinated: it is cheap and highly effective.
- Chronic carriers need monitoring even when treatment is unaffordable.
Where to go
- Primary health centres and routine immunisation sites.
Worth knowing
The cost of treatment, not its availability, is the binding constraint. Monitoring is far cheaper than treatment and still valuable: it identifies who genuinely needs medication and when.
Frequently asked questions
How do you get tested in Nigeria?
A rapid test at a hospital, laboratory or during a screening campaign gives a result the same day, and a positive result should be confirmed and followed by assessment of liver health. Testing is inexpensive, and many campaigns offer it free.
HPV
HPV vaccination entered routine immunisation in 2023, one of the largest such introductions anywhere.
Nigeria introduced HPV vaccination into its routine immunisation schedule in October 2023, with a mass campaign for girls aged 9 to 14 followed by routine delivery at age 9. Given the size of the birth cohort, it was among the largest single introductions of the vaccine globally. Screening remains limited and relies mainly on visual inspection where available.
Nigeria introduced HPV vaccination into its routine immunisation programme in 2023 with a large campaign targeting girls aged nine to fourteen, delivered through schools and health facilities — one of the biggest such rollouts on the continent. Screening coverage remains very low, and most cervical cancers are diagnosed at an advanced stage.
Key points
| Vaccination | Introduced into routine immunisation in October 2023 for girls aged 9 to 14 |
|---|---|
| Scale | Among the largest introductions of the vaccine worldwide |
| Routine age | Girls aged 9, following the initial campaign |
| Screening | Limited; visual inspection where available, cytology in larger centres |
| Burden | Cervical cancer is among the leading causes of cancer death in women |
| Cost | The vaccine is free through routine immunisation |
| Treatment | Concentrated in teaching hospitals |
In practice
- Have daughters aged 9 to 14 vaccinated: it is free through routine immunisation.
- Ask about visual inspection screening at a primary health centre if you are over 30.
- Bleeding after sex or between periods must be examined.
- Vaccination protects girls now; adult women still need screening.
Cost and coverage
The vaccine is free through routine immunisation; screening availability varies widely.
Recent changes
The October 2023 introduction into routine immunisation was one of the largest HPV vaccine rollouts ever conducted.
Where to go
- Primary health centres and routine immunisation sites.
- National Primary Health Care Development Agency.
- Teaching hospitals for colposcopy and treatment.
Worth knowing
The vaccine is free through routine immunisation. Private clinics charging for it are selling something the public system provides at no cost.
Frequently asked questions
Is the HPV vaccine free in Nigeria?
Yes, for girls in the target age group under the routine immunisation programme introduced in 2023, delivered through schools, health facilities and outreach. Boys are not included. Outside the programme the vaccine is available privately at significant cost.
General sources
- Nigeria.gov.ng — official government portal