Fund family planning to fight insecurity in West Africa, gynaecologists tell govts

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Renowned obstetricians and gynaecologists have asserted that the high fertility rate and rapid population growth across the West African sub-region are fuelling regional instability, economic frustration and vulnerability to violent extremism, urging African leaders to invest more in family planning.

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They explained that population growth was putting intense pressure on limited resources and opportunities, including food, water, land, infrastructure, schools, health facilities and jobs, creating conditions for frustration, displacement, forced migration and violent conflict.

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They stressed that investment in family planning, girls’ education and youth empowerment was a critical measure to tackle population pressure and insecurity in West Africa.

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The maternal health experts spoke at the 5th Congress of the Association of West African Societies of Obstetrics and Gynaecology and the West African College of Obstetricians and Gynaecologists, held from September 2 to 5, 2026, in Lagos.

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Delivering the keynote address titled “The Demographic-Security Nexus: Reproductive health, population Dynamics and Regional Stability in West Africa,” a Professor of Obstetrics and Gynaecology, Emmanuel Otolorin, established the link between demography, poor reproductive health choices and the security crises plaguing West Africa.

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Otolorin stated that the region’s population, estimated at 477 million in 2026, could exceed one billion by 2100 if current demographic trends continued.

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“We have a population explosion in West Africa and limited resources. In 2026, the population of West Africa stands at roughly 477 million, and by 2100, it is estimated to cross one billion. When opportunities fail to keep pace with this population growth, the praised ‘demographic dividend’ turns into frustration, grievance, irregular migration, and widespread insecurity,” he stressed.

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The don noted that the situation was compounded by limited access to reproductive health services, especially family planning, stating that only about 17 per cent of women in the region use modern contraceptives while 24 per cent had an unmet need for family planning.

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The reproductive health expert said persistent high fertility, combined with a growing youth population and inadequate opportunities, was creating a pool of young people vulnerable to poverty, unemployment, migration and recruitment by criminal and extremist groups.

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Otolorin linked demographic pressure to conflicts over scarce resources, including land and water, as well as farmer-herder clashes, communal conflicts, displacement and migration.

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Drawing comparisons within the sub-region, Otolorin noted that while Cape Verde had lowered its fertility rate to 1.8, below replacement level, through a 52 per cent modern contraceptive prevalence rate, Nigeria remained in a critical state.

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“On average, only 17% of women use modern contraceptives across West Africa, leaving an unmet family planning need of 24%. Nigeria sits in the red with a mere 15% contraceptive usage, a fertility rate hovering between 4.5 and 5 children per woman, and a maternal mortality ratio that the WHO estimates is still over 1,000 deaths per 100,000 live births,” he stated.

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He urged governments in the region to invest in girls’ education, vocational training, job creation, entrepreneurship and women’s economic empowerment, saying these measures were necessary to create opportunities for the growing youth population.

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Otolorin also called for family planning to become an integral part of reproductive healthcare, urging obstetricians and gynaecologists to offer counselling during antenatal, postnatal, post-abortion care and other gynaecological services.

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He said, “We should be discussing healthy birth spacing and preparing for postpartum contraception. And in postnatal services, we offer the same. There are methods that can be offered immediately.”

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He further advocated immediate postpartum family planning, task-shifting to trained midwives, nurses and community health workers, and greater use of modern contraceptive methods.

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Otolorin said reducing fertility through voluntary access to family planning would not only improve maternal and child health but also ease demographic pressure and contribute to regional stability.

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He also urged reproductive health professionals to be trained to counter myths surrounding contraception, particularly misconceptions that family planning causes infertility.

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He proposed that by 2035, every WACOG member should be able to confidently provide the full range of family planning methods, while the region should reduce the unmet need for family planning from 24 per cent to below 15 per cent.

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He added that maternal mortality should also be reduced to below 70 deaths per 100,000 live births.

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Otolorin said, “Reproductive health is a population stabilising policy. We need to invest in family planning, in girls’ education, and create more youth opportunities to meet the youth bulge.

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“Obstetricians and gynaecologists do not just protect maternal health; they act as vital architects of peace, easing the demographic pressures that strain our resources and helping to defuse the silent catalysts of regional insecurity.”

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The First Lady of Lagos State, Dr Ibijoke Sanwo-Olu, represented at the congress by Dr Modupe Bowale, a consultant orthodontist at Lagos State University Teaching Hospital, Ikeja, said the Lagos State Government remained committed to initiatives that promoted access to quality healthcare and protected the health and dignity of women and children.

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Sanwo-Olu highlighted the Multiple Birth Assistance Programme, which she initiated to provide support for mothers of triplets and higher-order multiple births, particularly those from low-income families.

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“The initiative focuses on maternal and child healthcare sensitisation, postnatal support and socio-economic empowerment, with the goal of helping families navigate the challenging aspects of their lives,” she said.

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The first lady asserted, “Behind every statistic is a mother, a child, a family and a life that matters. Our collective responsibility is to ensure that every woman receives the care, dignity and support she deserves regardless of her socio-economic status.”

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The Special Adviser on Health to the President, Dr Salma Anas, who addressed the congress virtually, said reproductive health should be regarded not merely as a medical issue but as a human developmental issue cutting across all sectors.

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She pointed to family planning as a fundamental game-changer for maternal and child health outcomes, citing an example from work in one Nigerian state where family planning service uptake improved from below 0.5 per cent to above 10 per cent in five years through community empowerment and male involvement.

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“Family planning is a game-changer to development. Investment in family planning should be regarded not as simply a health expenditure but as an investment in national development,” Anas said.

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She further noted that the localisation of contraceptive commodities and essential maternal health medicines was a current administration priority.

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“Innovation must not become a privilege for a few but a pathway for equitable reproductive health for every woman, every girl, every adolescent and every family across the African continent,” Anas noted.

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In his speech, the Chairman of the Local Organising Committee, Dr Joseph Akinde, said the congress provided an opportunity to form new alliances and networks in the effort to improve maternal and child health indices in the region.

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“If you want to go fast, go alone, but if you want to go far, go with others,” he said, citing the African proverb as the philosophical foundation of the college’s regional approach.

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The President of AWASOG and WACOG, Prof Brian Adinma, described the college as a visionary, innovation-driven project meant to leave an indelible footprint across all 16 West African nations.

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He called on the new fellows to become actively involved in the college’s standing committees rather than fading into the background.

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The congress also witnessed the induction of 53 fellows into the association.

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A member of the Council and Board of Trustees of AWASOG/WACOG, Prof Oladapo Ladipo, urged the new generation of obstetricians and gynaecologists to help address Nigeria’s high maternal mortality and reproductive health inequalities.

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The renowned gynaecologist labelled Nigeria’s maternal mortality rate deeply embarrassing on the global stage.

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“An MMR of 996 per 100,000 live births is shameful. It will be up to this new generation of inducted fellows to fight this fight,” Ladipo said.

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Ladipo also admonished citizens against large family sizes that stretch the limits of the fragile economy, urging the new fellows to “support qualitative reproduction.”

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He said, “The association must ensure that people have only the number of children they can cater for. Don’t reproduce recklessly because you can see the evidence today in the transfer of financial responsibility to others for food and health.”

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He subsequently urged the Federal Government to increase its funding for reproductive health commodities.

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A member of the Council and Board of Trustees, Dr Abu Alasa, urged the newly inducted fellows to uphold professional ethics and serve as credible ambassadors of the college.

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He said the induction carried significant responsibilities and warned that members could lose their membership privileges if found guilty of infamous professional conduct under relevant laws and professional regulations.

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