The “Law, Rights & Community Empowerment for Social Change in HIV, TB & Malaria Response” project executed by Human Rights and Policy Advocacy front-runner organisation Lawyers Alert in partnership with Media Health & Rights Initiative of Nigeria (MHR) has been an eye-opener on many fronts. The Situational Analysis Report conducted by the project team provides a lot of insight into gender responses to HIV, TB, and malaria in Akwa-Ibom and Benue states.
Nigeria’s health landscape is a complex tapestry woven with persistent challenges, especially in peculiar regions like Akwa Ibom and Benue states that face a significant burden from TB, HIV, and Malaria, compounded by systemic issues such as entrenched patriarchal norms, economic disparities, and the lingering impacts of conflict-induced displacement. The analysis was designed to assess the roles and impact of women-led organizations in advocating for gender-responsive health strategies. In Akwa Ibom, we conducted KIIs with 16 organizations (13 women-led and 3 men-led) and engaged 30 individuals through FGDs. In Benue, our approach involved 16 women-led organizations and an additional 15 participants in FGDs. Complemented by surveys and desk reviews, this multi-method approach provided both qualitative and quantitative insights into policy frameworks, advocacy capacities, and service delivery gaps. The diverse data sources allowed us to capture a holistic view of the prevailing health challenges and the underlying socio-cultural dynamics.
Key Findings
A striking finding from the analysis is the significant policy gap in Akwa-Ibom, where 45.65% of respondents reported the absence of any relevant policies addressing TB, HIV, or Malaria. In contrast, Benue shows a notable underrepresentation of malaria-focused interventions, with only 19.35% of respondents acknowledging the existence of a malaria policy. These disparities highlight a critical need for balanced and visible health strategies that align with the actual demands of the communities.
Our analysis also reveals that advocacy capacity among local organizations is predominantly rated as moderate, with 67.39% of respondents in both states indicating a need for stronger advocacy frameworks. Additionally, systemic challenges such as the denial of infections, stigma, and limited political emerged as major barriers. For instance, in Akwa Ibom, 30.43% of respondents cited denial or disbelief in infections, while stigma and discrimination remain prevalent issues affecting both TB and HIV interventions. Economic barriers, including funding constraints and bureaucratic inefficiencies, further impede the effective delivery of health programs.
Implications for Health Outcomes
These findings carry profound implications for public health programming. The policy gaps and moderate advocacy capacities identified suggest that current health interventions are not fully addressing the needs of vulnerable populations, particularly women and girls. In a region where domestic violence and gender-based discrimination are rampant, the lack of robust policies and effective advocacy exacerbates the risks associated with TB, HIV, and Malaria. Without adequate policy communication and resource allocation, the gap between existing conditions and the necessary standards for gender equity, safety, and well-being remains wide.
Moreover, the underrepresentation of malaria interventions in Benue indicate that some critical health issues are being sidelined and the disparities in policy focus. This imbalance not only affects resource distribution but also contributes to the persistence of high disease prevalence in certain areas, underscoring the urgent need for a more holistic approach.
What Can We Do?
To bridge these gaps, our findings strongly advocate for a multi-faceted approach. First, there is an immediate need for robust capacity-building initiatives that empower women-led organizations to enhance their advocacy effectiveness. Tailored training programs, mentorship, and resource optimization can help these organizations move from a moderate to a high capacity in influencing policy and implementing interventions.
Second, better policy communication is crucial. Increased awareness and dissemination of existing policies can help align health interventions with policy frameworks, ensuring that resource allocation is responsive to actual community needs. This involves not only governmental action but also proactive engagement by civil society organizations to hold stakeholders accountable.
Lastly, strategic resource allocation must be prioritized. Addressing the identified gaps requires targeted funding and manpower to bolster advocacy efforts, improve service delivery, and ensure a balanced focus on all three critical health priorities TB, HIV, and Malaria. By integrating community-led initiatives with state-level policy reforms, we can create a more equitable health landscape.
For this, we applaud the initiative of the Gender Equality Fund in funding projects that address these approaches and appreciate the Global Fund, GSK & ViiV who support the fund.
Conclusion
Our comprehensive survey underscores the urgent need to address the policy and advocacy gaps that impede effective health interventions in Akwa Ibom and Benue states. The disparities in policy recognition and advocacy capacity reveal a landscape where systemic challenges, cultural biases, and resource constraints continue to undermine public health outcomes. By focusing on capacity-building, enhanced policy communication, and strategic resource allocation, we can empower women-led organizations and drive transformative change. Bridging these gaps is not only critical for improving the health of vulnerable populations but also for advancing gender equity and social justice across Nigeria.