Religion and Customs are harming Progress in Women’s Health in Nigeria

Numerous countries have committed themselves to promote the sexual and reproductive health of women and girls by ratifying international human rights treaties. These include the Convention on the Elimination of Discrimination against Women and the Convention on the Rights of the Child.

Nigeria ratified the convention on women’s rights in 1985 and the convention on child rights in 1991. But sexual and reproductive health among women and girls in Nigeria remains poor. The country has the second largest HIV epidemic in the world. And the women making up more than half of people living with HIV. It also has persistently high rates of maternal and perinatal mortality. In 2013, Nigeria accounted for about 14% of the global burden of maternal mortality. Nigeria has high rates of unsafe abortion (approximately 33 unsafe abortions per 1000 women of reproductive age). The country also has high levels of female genital cutting, and low levels of contraceptive use.

In multiple countries, customary and religious laws have been found to uphold practices that discriminate against women and undermine gender equality. Customary and religious laws have been linked to high rates of child marriage, decreased female autonomy, and limited access to justice for women and girls.

When girls marry very young, they often drop out of school and start a family early. In customary and religious marriages they may not be allowed to make their own decisions about contraception, healthcare and childbirth. And other people’s decisions may put their health at risk.

Yet previous studies have not directly examined the relationship between customary and religious laws and a range of sexual and reproductive health outcomes.

We conducted a study to explore the issue. We found a clear relationship existed between these laws and outcomes. Nigeria’s plural legal system appears to drive poor health outcomes. We suggest there is a need to harmonize customary and civil laws to promote access to health.

Analyzing the Relationship

In our paper, we examined indicators of family planning, maternal health, fertility, and HIV/AIDS. Since some states in Nigeria follow customary and religious laws, such as Sharia laws, while others do not, we compared the health indicators in relation to state laws.

We found that states with customary and religious laws had significantly worse sexual and reproductive health outcomes compared to states without such laws. The outcomes were worse in terms of getting antenatal care, use of contraception among married women, births delivered in a health facility, total fertility rate, and median age at first birth.

  • In 2013, 47.89% of women who gave birth in states with customary and religious laws, in the five years preceding the survey, received any antenatal care. This is in comparison to 85.44% of women in states without customary and religious laws.
  • Less than 4% of married women used any method of contraception in states with customary and religious laws, while 26.4% of married women did in other states.
  • In customary and religious law states, 14.5% of births were delivered in a facility. In other states, 62.1% of births were delivered in a facility.
  • The total fertility rate was 6.71 children per woman in customary and religious law states and 4.74 in other states.
  • The median age at first birth was 18.37 in customary and religious law states and 21.74 elsewhere.

Even when we accounted for the wealth of the states as a factor, the difference to sexual and reproductive health was still significant. For example, the 22 percentage point difference in contraceptive use between the types of states remained an estimated 16 percentage point difference after accounting for states’ per capita gross domestic product.

Why plural Legal Systems may place Women and Girls at Risk

Nigeria, along with more than half of the countries in Africa, has a plural legal system. In these systems, additional sources of law, based on local customs or religious texts and traditions, can undermine treaty obligations and national laws. They can also permit discriminatory cultural and religious practices to persist.

This makes it difficult to fully implement national and local laws that reflect international human rights standards.

In Nigeria, customary and religious laws directly conflict with international human rights commitments. In 2003, Nigeria adopted the Child Rights Act in compliance with the UN Convention on the Rights of the Child and established the age of marriage as 18 for both sexes. However, Nigeria runs a federal system of government where individual states must incorporate the act into their legislation in order to give it force. Some states have refused to adopt national legislation on this issue because of their adherence to customary and religious laws, which can set the age as young as nine years old or by the “age of puberty”.

Way Forward

The Convention on the Elimination of Discrimination against Women committee has expressed concern at contradictions and inconsistencies created by the application of Sharia law with regard to marriage. The contradictions lead to the continuing discrimination against women. Additionally, the Convention on the Rights of the Child Committee has directed Nigeria to review the compatibility of customary laws with that of the values of the Convention on the Rights of the Child, especially in regard to child marriage. But the response has been inadequate, especially in northern Nigeria where 11 states have failed to domesticate the Child Rights Act.

Nigeria, and other countries with plural legal systems, should encourage compliance with international standards on access to sexual and reproductive health. They can adopt a rights-based approach that explicitly links customary and religious laws that promote discrimination against women to development and social indicators. For example, attributing the 36 million Nigerian women and girls who do not have education or to broader economic impacts to child marriage. Nigeria should create incentives for the harmonization of laws that protect and promote access to sexual and reproductive health, including child marriage, gender parity, and anti-discrimination laws.

Eka Williams, independent consultant, is a co-author of this study.The Conversation

Terry McGovern is Chair in the Heilbrunn Department of Population and Family Health at Columbia University Medical Center; Monique Baumont is a Research & Policy Analyst at Columbia University, and Samantha Garbers is an Associate Professor at Columbia University Medical Center.

First appeared in The Conversation.

Photo Credit: AMISOM via Iwaria.