As Nigeria marks Universal Health Coverage (UHC) Day 2025, new findings suggest that adolescent girls and young women continue to face serious barriers in accessing basic health services, despite years of policy commitments aimed at expanding coverage.
The assessment, released by the Gem Hub Initiative, points to rising out-of-pocket costs, weak primary healthcare capacity and limited youth-focused services as key obstacles preventing young people—particularly females—from obtaining timely and confidential care.
Nigeria has pledged to achieve universal health coverage, ensuring that all citizens can access essential services without financial hardship. However, the report says progress remains uneven, with adolescents among the least served groups within the health system.
According to Gem Hub, many young women are unable to afford services such as testing and treatment for sexually transmitted infections, especially those not enrolled in health insurance schemes. The financial burden often leads to delays or avoidance of care altogether, increasing health risks.
The findings are based on a rapid assessment of youth-friendly health services and a perception survey conducted in Rivers State, which the organisation says reflects challenges seen in other parts of the country. The review found that several primary health facilities lacked key sexual and reproductive health commodities, including emergency contraception, while shortages of trained staff and inconsistent application of youth-friendly service guidelines were also reported.
Infrastructure challenges were another recurring concern. Poor road networks, seasonal flooding, irregular clinic hours and unreliable electricity were cited as factors limiting physical access to care, particularly in rural and hard-to-reach communities. The report also notes low levels of community and parental engagement, which can discourage adolescents—many of whom depend on family members for health decisions—from seeking services.
A frontline health worker interviewed during the assessment said many young women were reluctant to return to facilities where they felt judged or lacked privacy. “When adolescents feel exposed or uncomfortable, they simply stop coming,” the provider said.
Universal Health Coverage Day is observed globally to highlight the importance of affordable and accessible healthcare. This year’s theme focuses on the burden of health costs, a challenge that remains acute in Nigeria, where out-of-pocket spending continues to account for a large share of healthcare financing.
Gem Hub Initiative says its findings underline the gap between national health policies and the lived experiences of young people, particularly girls and young women, whose health needs are often overlooked within the broader system.
The organisation works with adolescents and young adults across Nigeria on health, education and empowerment programmes, with a focus on generating evidence to inform public debate and policy.
