Janet Ogundepo
Following a recent report from the World Health Organisation and the Society for Family Health that abortions and sexually transmitted infections are on the rise in Nigeria, the Second Vice President, Society of Gynaecologists and Obstetricians of Nigeria, Professor Christopher Aimakhu, has advocated for contraceptives to be made more accessible and affordable.
The increase in STIs is because individuals now engage more in unprotected sex, have multiple sexual partners, and experiment with various sexual behaviours.
PUNCH Healthwise reported that SFH, a non-governmental organisation revealed that the abortion rate among married women has been on the rise.
SFH further noted that most married women decide to abort without informing their husbands because of the rising inflation in the country.
The WHO also reported a rise in sexually transmitted infections in the Americas and the African regions.
It noted that STIs such as chlamydia, gonorrhoea, syphilis and trichomoniasis account for over one million infections daily.
The organisation reported a surge in adult and maternal syphilis and associated congenital syphilis, noting that 1.1 million cases and 523 cases per 100,000 live births, respectively, were recorded during the COVID-19 pandemic.
The WHO and SFH’s reports confirmed PUNCH Healthwise’s predictions of the possible increase in STIs and unwanted pregnancies when prices of goods and services, including the prices of drugs and contraceptives, especially condoms started rising astronomically.
The report captured the lamentation of sex workers, men with several sexual partners and married men who use condoms as a form of family planning about their inability to afford condoms due to high prices.
The experts predicted a reduction in the usage of condoms and a consequent rise in STIs and unwanted pregnancies.
But the Federal Government has in September 2023, reiterated its commitment to achieving a modern contraceptive prevalence rate of 27 per cent by 2024.
Further speaking on the issue, Aimakhu, a Consultant Obstetrician Gynaecologist at the University College Hospital, Ibadan, Oyo State, noted that a significant causative factor is unprotected sex and underutilisation of condoms, which offer dual protection against pregnancy and STIs.
He noted that clinically, there has been a rise in patients reporting to the hospitals with STIs and abortion complications, a further confirmation of the WHO and SFH’s report.
Aimakhu, who is a professor of Obstetrics and Gynaecology at the University of Ibadan, Oyo State, noted that women often harbour STIs without showing symptoms, leading to untreated and undiagnosed infections.
He warned that the long-term impact of rising STIs includes increased infertility rates.
The don also noted that the rise in STIs is affected by inadequate treatment practices, noting that many individuals self-medicate with inappropriate drugs from pharmacies, leading to persistent infections and increased drug resistance.
“Generally, there is an increase in STIs because people still want to have unprotected sex, and multiple sexual partners and are experimenting with all sorts of things and people.
“So, I have noticed an upsurge in sexually transmitted diseases and people don’t even go to treat them. Some treat them properly or with the right medications based on their diagnosis, while others just go to pharmacies and somebody would just prescribe something and they think they have been treated meanwhile, they still have the infection,” the gynaecologist said.
The don pointed out that due to the illegality of abortion in Nigeria and the consequent complications attached to the rise of unsafe abortions among married women, the country’s maternal health outlook amid the goal to reduce maternal mortality to 70 per 100,000 live births was unpredictable.
High treatment cost
Aimakhu noted that the high price of medications, such as Augmentin, discourages people from seeking proper medical treatment and instead, opt for cheaper, less effective alternatives, which can lead to complications and drug resistance.
The gynaecologist said, “So, it’s really basic things you need to do. Create awareness. Then even if you have to treat, you can make these drugs cheaper for patients to reach.
“Augmentin is not N7,000 for the dose that used to be N2,000 about a year and a half ago. How much do people earn that will make them buy it at such a price? So people would still treat themselves with something else and the complications would arise from there.
“Now, we are going to have a bigger problem because the cost of treatment is enormous. People no longer bother about taking tests because they are expensive; so many of them just get drugs off the shelf and use them. Many of those drugs are wrong choices and many don’t take them the right way. This will further encourage drug resistance.”
To combat these issues, Aimakhu said contraceptives should be made more accessible and affordable and government should create policies to enhance awareness and the promotion of contraceptives.
He advocated for the implementation of policies to make testing and treatment more affordable and accessible for the general population.
“You can’t force people to get treated and go for tests but you can have a policy that allows people to create awareness, provide information and make these things less expensive so that they can easily afford and use them.
“Primary prevention and awareness creation is important. This will make people to know what to do even if they have STIs. Secondary prevention, if they have it, what do they do? When they have complications like what is being seen right now, what do they do? Contraceptives are supposed to be free but most people can’t access it. The ones that are accessible are expensive,” he said.
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