African Journal Of Reproductive Health[JOURNAL]
Sun
200 papers
Association of serum levels of zinc and copper with pathophysiological features of polycystic ovary syndrome.
Chaabouni K, Jallouli D, Mzid K … +6 more , Guidara W, Khanfir F, Hassen KB, Mseddi MF, Elleuch A, Ayadi FM
Afr J Reprod Health · 2026 May · PMID 42137979 · Publisher ↗
Trace elements may play a role as initiating environmental factors in polycystic ovary syndrome (PCOS). This study was designed to assess the relationship between circulating levels of zinc (Zn) and copper (Cu) and the p...
Trace elements may play a role as initiating environmental factors in polycystic ovary syndrome (PCOS). This study was designed to assess the relationship between circulating levels of zinc (Zn) and copper (Cu) and the pathophysiological features of PCOS. A cross-sectional study was conducted. Clinical data were recorded and blood samples were taken to analyze biochemical and hormonal parameters. The subgroup of participants defined with abnormal background had body mass excess, insulin resistance, or subclinical inflammation. In PCOS patients with insulin resistance, elevated Cu, Zn, and Cu/Zn ratio levels were observed. However, the Zn/Cu ratio was lower in those with body mass excess and subclinical inflammation. Significant correlations within PCOS patient subgroups, linking trace elements to anthropometric, metabolic, inflammatory, and hormonal variables, were revealed. Interactions of trace elements in PCOS pathophysiology are likely complex. Hence, supplementation, if considered, should be approached cautiously.
From legal exception to lived reality: Examining health exceptions in the context of abortion and reproductive justice.
Okonofua F
Afr J Reprod Health · 2026 May · PMID 42137961 · Publisher ↗
The article published in this issue of the journal titled "Examining implementation of health exception laws in six countries"1 arrives at a critical juncture in global reproductive health discourse. Across much of the d...
The article published in this issue of the journal titled "Examining implementation of health exception laws in six countries"1 arrives at a critical juncture in global reproductive health discourse. Across much of the developing world, abortion law - often framed around narrow "health exceptions" - exist in statute but fail in practice. This disjuncture between legal permission and lived access is not merely a technical gap; it is a profound social justice failure with implications for women's health, autonomy, and dignity. Health exception laws typically allow abortion where a woman's physical or mental health is at risk. In theory, they represent a compromise between restrictive legal regimes and broader reproductive rights and social justice. However, evidence consistently shows that legal allowances alone do not guarantee access. Comparative research demonstrates that in many countries, even where abortion is technically legal under health grounds, women are denied services due to poor implementation, lack of guidelines, and restrictive interpretations.2This important article in this issue of the journal extends this insight through a six-country comparative lens, echoing earlier multi-country analyses such as the study by Wendy Chavkin and colleagues3, which examined reforms and implementation strategies across diverse settings including Ethiopia, Ghana, and South Africa. Together, these studies reinforce a crucial point: the effectiveness of abortion law lies not in its wording, but in its operationalization.
Diagnosis and management of uterocutaneous fistula following cesarean section: A case report.
Hammadi J, Jaballah S, Ali YB … +5 more , Haj JB, Rouis N, Knaz S, Ghades S, Fatnassi MR
Afr J Reprod Health · 2026 Apr · PMID 42047266 · Publisher ↗
Uterocutaneous fistula following cesarean delivery is an exceptionally rare complication, defined by an abnormal tract between the uterine cavity and the abdominal scar. We report a 28-year-old woman who presented three...
Uterocutaneous fistula following cesarean delivery is an exceptionally rare complication, defined by an abnormal tract between the uterine cavity and the abdominal scar. We report a 28-year-old woman who presented three months and half after a cesarean section with cyclical bloody discharge from a Pfannenstiel scar, preceded by a superficial wound infection. Pelvic magnetic resonance imaging (MRI) precisely delineated the tract, revealing a 21 mm anterior uterine wall defect communicating with a 25 mm subcutaneous collection, and informed surgical planning. Management included complete fistulectomy with layered uterine repair, followed by a three month course of a gonadotropin-releasing hormone (GnRH) analogue. Postoperative recovery was uneventful, with no recurrence during follow-up. This case highlights an infection-associated delayed presentation and illustrates the value of quantitative MRI mapping combined with short-course hormonal suppression to achieve durable closure while preserving fertility. (Afr J Reprod Health 2026; 30 [8]: 140-146).
Comparative analysis of livelihood vulnerability and resilience to climate hazards in Bangladesh and China: A systematic review.
Hossain B, Iqbal K, Sarker MNI … +2 more , Sifullah MK, Hossain MS
Afr J Reprod Health · 2026 Apr · PMID 42047249 · Publisher ↗
This study systematically compares livelihood vulnerability and resilience to climate-induced natural hazards in Bangladesh and China, two nations with different socioeconomic systems, governance structures, and climatic...
This study systematically compares livelihood vulnerability and resilience to climate-induced natural hazards in Bangladesh and China, two nations with different socioeconomic systems, governance structures, and climatic exposures. The comparison is justified by their shared exposure to frequent climate disasters, such as floods, droughts, and cyclones, despite contrasting adaptation strategies and institutional responses. Using a systematic literature review guided by the PRISMA framework, this research examines 77 peer-reviewed articles. The analysis focuses on three key dimensions of vulnerability: exposure, sensitivity, and adaptive capacity, using clearly defined indicators and sub-indicators derived from literature. Results show Bangladesh's vulnerabilities are influenced by dependence on agriculture, limited infrastructure, poverty, health risks, and reliance on traditional coping mechanisms. Conversely, China's vulnerabilities arise from ecological degradation, demographic pressures, regional disparities, and rapid urbanization, often addressed through state-led technological and infrastructural adaptation measures. Bangladesh emphasizes community-based responses, while China focuses on large-scale policy measures, disaster-resilient infrastructure, and the integration of climate adaptation into broader development planning. Both countries face ongoing barriers to effective adaptation. This comparative analysis highlights how different development paths and institutional contexts shape livelihood resilience, emphasizing the importance of context-specific adaptation, cross-country learning, and inclusive policy frameworks.
Impact of COVID-19 on female reproductive health and communication post-pandemic: A scoping review.
Bashir HM, Ciftci D
Afr J Reprod Health · 2026 Apr · PMID 42047233 · Publisher ↗
The COVID-19 pandemic significantly affected Female Reproductive Health (FRH), intensifying physiological and psychological conditions such as amenorrhea and postpartum related issues. While clinical studies have well-do...
The COVID-19 pandemic significantly affected Female Reproductive Health (FRH), intensifying physiological and psychological conditions such as amenorrhea and postpartum related issues. While clinical studies have well-documented these impacts on FRH, no studies empirically tested health communication interventions, revealing a significant research gap. This scoping review bridges this gap, mapping evidence on the impact of COVID-19 on FRH and probing the untapped potential of communication strategies to mitigate these impacts. Following PRISMA-ScR guidelines, we systematically searched PubMed, PsycINFO, BMJ Global Health, and Frontiers (2021-2024) for peer-reviewed studies. The 13 included studies documented menstrual irregularities in 50-67% of women post-infection/vaccination, fertility rate declines of 18 per 100,000 women, and postpartum depression prevalence of 25.27%. Eligibility criteria included Women of reproductive age (15-49 years) affected by COVID-19's impact and implemented strategies addressing these impacts post-pandemic. We proposed integrating robust trauma-informed communication road map such as digital health literacy programs and community-led strategic initiatives.
Effects of IT-enabled entrepreneurship on gender equality in a digital economy: Evidence from Qualitative Studies.
Xu L, Zhu H, Jiang S … +2 more , Zheng Q, Yu C
Afr J Reprod Health · 2026 Apr · PMID 42047208 · Publisher ↗
Persistent digital divides and gendered health inequalities constrain women's participation in the digital economy, even in highly connected contexts like China. This study develops an explanatory framework for how infor...
Persistent digital divides and gendered health inequalities constrain women's participation in the digital economy, even in highly connected contexts like China. This study develops an explanatory framework for how information-technology-enabled entrepreneurship (ITEE) affects women's economic security, health, and capabilities. Using a constructivist grounded theory approach based on 80 interviews in China, the analysis reveals four themes. Capability formation shows how increased income and flexibility allow women to invest in health. Algorithmic exposure highlights the dual nature of platform visibility, boosting sales but also enabling harassment and anxiety. Care negotiation examines how unpaid care duties and infrastructure impact sustainability, showcasing adaptive strategies. Trajectory configuration integrates these into differentiated pathways, from vulnerable to healthenhancing, depending on aligned support. The findings position health centrally in digital capability and link platform governance and care ecologies to sustainable empowerment, suggesting safe platforms, caring support, and integrated policies are essential for women's wellbeing.
Socio-economic determinants of female vulnerable employment in China.
Xiong T, Wang D
Afr J Reprod Health · 2026 Apr · PMID 42047186 · Publisher ↗
This analysis investigated the socio-economic factors that affect female vulnerable employment in China, utilizing graphical & correlation analysis in World Development Indicators, covering the time span of 1990 to 2020....
This analysis investigated the socio-economic factors that affect female vulnerable employment in China, utilizing graphical & correlation analysis in World Development Indicators, covering the time span of 1990 to 2020. Analysing the results, the trend of decline in female vulnerable employment remained consistent during the time span, coupled with diverse movements in economic development, foreign direct investments, dependency ratios, as well as fertility rates. During the periods of high economic development and foreign investments, the decline in women's employment vulnerability turned out to be steeper, indicating the impact of industrialization, urbanization, and formal employment. Social terms, specifically dependency ratios and fertility rates, remained significantly correlated to female vulnerable employment, indicating the impact of taking care of dependents & demographic factors. When the trend of declining female vulnerable employment turned persistent in 2010, in spite of low economic development & growing dependency ratios, it is evident that deep structural transformations, such as the impact of education, employment, & institutional development, turned influential in women's employment.
The causality between gut microbiota and ectopic pregnancy based on genome-wide association: A Mendelian randomization study.
Zhang N, Wang Z, Yang F … +2 more , Liu T, Ji D
Afr J Reprod Health · 2026 Apr · PMID 42047173 · Publisher ↗
Ectopic pregnancy represents a prevalent gynecological emergency with incompletely characterized pathophysiology, creating substantial clinical challenges in timely diagnosis and effective management. The causal interpla...
Ectopic pregnancy represents a prevalent gynecological emergency with incompletely characterized pathophysiology, creating substantial clinical challenges in timely diagnosis and effective management. The causal interplay between gut microbiota and ectopic pregnancy, particularly through plasma proteomics mediation, remains undefined. We derived Gut microbiota GWAS data (n=412) from the Dutch Microbiome Project meta-analysis and Ectopic pregnancy data from IEU OpenGWAS and FinnGen project. The results revealed nine kinds of gut microbiotas demonstrating causal associations with ectopic pregnancy risk. A total of 67 plasma proteins causally impact the risk of ectopic pregnancy. In addition, three kinds of gut microbiotas were mediated by 25 kinds of plasma proteins on ectopic pregnancy. Microbiota enriched in L.rhamnose.degradation.I affected ectopic pregnancy through 22 kinds of plasma proteins. This study establishes causal relationships between specific gut microbial pathways and ectopic pregnancy risk, mediated through distinct plasma protein signatures, providing directions for clinical interventions and future research.
Urbanization, contraceptive uptake and childbearing patterns in selected African countries.
Lei A, Yang C, Li Q … +1 more , Yang L
Afr J Reprod Health · 2026 Apr · PMID 42047119 · Publisher ↗
Using a qualitative interpretive descriptive-analytical approach, this study analysed harmonised secondary data from the World Bank World Development Indicators covering six countries between 2000 and 2024. Longitudinal...
Using a qualitative interpretive descriptive-analytical approach, this study analysed harmonised secondary data from the World Bank World Development Indicators covering six countries between 2000 and 2024. Longitudinal trend assessment and crosscountry comparisons were employed to examine urban population, modern contraceptive prevalence, and total fertility rates. The findings indicate sustained urban expansion across all countries, accompanied by gradual increases in contraceptive uptake and fertility decline. However, these patterns remain uneven across national contexts. Ghana and Sierra Leone combine relatively high urbanisation with stronger improvements in contraceptive prevalence and faster fertility decline. In contrast, Nigeria and Guinea maintain comparatively high fertility levels despite substantial urban growth and weaker contraceptive uptake. The Gambia and Liberia display intermediate trajectories characterised by moderate urbanisation, rising contraceptive use, and gradual fertility reduction. The results indicate that urbanisation alone does not generate uniform reproductive outcomes; rather, fertility transitions are mediated by contraceptive access and the effectiveness of urban health service. The study recommends integrating family planning into urban development strategies and strengthening reproductive health service delivery in rapidly expanding urban and peri-urban settlements to reduce persistent reproductive health inequalities.
Effects of multivitamin supplement, elevit on liver function and maternal-infant outcomes in hepatitis B positive pregnant women.
Zeng N, Liu T, Zhan X
Afr J Reprod Health · 2026 Apr · PMID 42047092 · Publisher ↗
This study investigates the effects of elevit supplementation on liver function and maternal-neonatal outcomes in HBsAg-positive pregnant women. A total of 160 participants were divided into a control group (routine care...
This study investigates the effects of elevit supplementation on liver function and maternal-neonatal outcomes in HBsAg-positive pregnant women. A total of 160 participants were divided into a control group (routine care) and an observation group (routine care plus elevit). Liver function markers (alanine aminotransferase, aspartate aminotransferase, alkaline phosphatase) were measured in early, mid, and late pregnancy. Maternal complications and neonatal outcomes were recorded, along with adverse reactions. No significant differences in liver enzymes were noted in early pregnancy. However, the observation group showed elevated alanine aminotransferase, aspartate aminotransferase, alkaline phosphatase in mid and late pregnancy, indicating possible liver damage from prolonged elevit use. Despite this, the observation group experienced lower rates of hypertensive disorders, gestational diabetes, intrahepatic cholestasis, postpartum hemorrhage, low birth weight, and preterm birth, as well as higher Apgar scores. Adverse effects were slightly more frequent but not statistically significant. These findings suggest that while elevit may mildly affect liver function, it potentially improves pregnancy outcomes in HBsAg-positive women.
Assessing the burden of primary dysmenorrhea and its association with quality of life among school adolescents in Jizan, Saudi Arabia: A cross-sectional study.
Alotaibi AA
Afr J Reprod Health · 2026 Apr · PMID 42047040 · Publisher ↗
Primary dysmenorrhea affects females worldwide, impairing physical, mental, and social well-being. Related research among Saudi school adolescents remains limited. This cross-sectional study was undertaken to assess the...
Primary dysmenorrhea affects females worldwide, impairing physical, mental, and social well-being. Related research among Saudi school adolescents remains limited. This cross-sectional study was undertaken to assess the severity levels of primary dysmenorrhea, its association with self-care practices, and the quality of life among 850 school students aged 13-19 years in Jizan City, Saudi Arabia. Data were collected using a pre-tested online questionnaire. Primary dysmenorrhea severity was measured using the Numerical Rating Scale, while quality of life was assessed with the 12-item Short-Form Health Survey. Results showed that 96% of the participants reported primary dysmenorrhea, with moderate pain being the most commonly reported level (64.6%), followed by severe pain (24.6%). Most of the participants used home remedies (91.1%), and 67.2% reported analgesic use, which was strongly associated with pain severity. Only 23.5% sought medical consultation. Quality-of-life scores significantly declined with increased pain severity level, particularly in bodily pain, mental health, and social functioning. These findings emphasize the need for adolescent-focused programs promoting effective lifestyle and self-care management strategies.
Effect of predictive nursing on preventing postpartum hemorrhage in parturients undergoing vaginal delivery.
Sun B, Shen P
Afr J Reprod Health · 2026 Apr · PMID 42047019 · Publisher ↗
The aim of this paper was to assess the impact of predictive nursing on preventing postpartum hemorrhage in parturients undergoing vaginal delivery. From January 2020 to December 2022, eighty parturients who underwent va...
The aim of this paper was to assess the impact of predictive nursing on preventing postpartum hemorrhage in parturients undergoing vaginal delivery. From January 2020 to December 2022, eighty parturients who underwent vaginal delivery at The Second People's Hospital of Lianyungang were selected as study participants. They were randomly divided into a control group (Routine nursing) and a study group (Predictive nursing, a forward-looking nursing model that employs various methods to analyze and predict the potential health issues that patients may encounter, and then formulates intervention measures in advance, aiming to prevent problems before they occur). Compared to the control group, the study group had shorter labor time at the first, second and third stages, less postpartum blood loss 2 h and 24 h after delivery, lower scores of depression and anxiety, higher quality of life scores, lower incidence of complications and higher nursing satisfaction. Our study indicates predictive nursing model can effectively reduce postpartum bleeding, decrease the risk of neonatal asphyxia, promote maternal quality of life, and achieve the nursing goal of optimizing pregnancy outcomes for parturients who underwent vaginal delivery.
Addressing learning gaps to improve access to assisted reproductive technology in low-resource settings: Development and evaluation of a low-cost oocyte retrieval simulator.
Sefogah PE, Pansare R, Patel R … +4 more , Moyer C, Oppong SA, Swarray-Deen A, Rooney DM
Afr J Reprod Health · 2026 Apr · PMID 42046976 · Publisher ↗
Infertility is highly prevalent (20-40%) in sub-Saharan Africa, with limited access to assisted reproductive technology services. This study describes the development and evaluation of a low-cost oocyte retrieval simulat...
Infertility is highly prevalent (20-40%) in sub-Saharan Africa, with limited access to assisted reproductive technology services. This study describes the development and evaluation of a low-cost oocyte retrieval simulator designed for use in resource-constrained environments. We developed and evaluated a low-cost oocyte retrieval simulator in Ghana. The exterior housing consists of a 3Dprinted vaginal canal. The interior design supports identifying mature follicles and retrieval skills with a web camera mounted to simulate an ultrasound view of the ovaries. Key considerations were low material cost, material availability in Ghana, and replication of the 'ultrasound view'. The simulator was evaluated across four domains: physical attributes, realism of experience, value, and relevance using 4-point rating scales (4=highest). Ability to perform tasks (5-point scales), and global value were evaluated. Mean ratings are reported. Across the four domains: physical attributes, realism of experience, value, and relevance, we report the evaluation scores using 4-point rating scales (4=highest). The ability to perform tasks was measured using the 5-point scales, and its global value was also scored. Given the ordinal nature of Likert-scale data and the small sample size, non-parametric statistical procedures were used. Group comparisons were conducted using the Mann-Whitney U test. The simulator demonstrated promising preliminary face and content validity, with higher ratings for value and relevance than for physical realism. This low-cost simulator represents an important step toward expanding ART training capacity in sub-Saharan Africa. Further iterative refinement and expanded validation are warranted.
Whither the specialist hospital?
Edouard L
Afr J Reprod Health · 2026 Apr · PMID 42046898 · Publisher ↗
Clinical developments during the nineteenth century having convinced the public of the value of medical specialisation, the concept of the specialist hospital became so popular as to unduly influence the delivery of heal...
Clinical developments during the nineteenth century having convinced the public of the value of medical specialisation, the concept of the specialist hospital became so popular as to unduly influence the delivery of health care. However, scientific progress after World War II led to an emphasis on a multidisciplinary approach with a major reversal in policy-formulation pertaining to capital building for medical services. Mega hospitals now encompass a comprehensive range of specialties thereby facilitating clinical referrals and research besides community care. As a result, the value of the stand-alone specialist hospital should be reviewed in the context of health service planning.
Unlocking fiscal space for reproductive health in Nigeria: A rapid assessment.
Cummins M
Afr J Reprod Health · 2026 Apr · PMID 41995059 · Publisher ↗
Nigeria continues to face a persistent reproductive health (RH) financing gap despite decades of policy commitments. This rapid fiscal space analysis evaluates how the country can expand investment in RH services while m...
Nigeria continues to face a persistent reproductive health (RH) financing gap despite decades of policy commitments. This rapid fiscal space analysis evaluates how the country can expand investment in RH services while maintaining macro-fiscal stability. Six domains were examined at the federal level: budget reprioritization, improvements in health sector efficiency, revenue enhancement, official development assistance, debt restructuring, and innovative financing mechanisms. The findings indicate that reallocating public expenditures, reducing inefficiencies, and introducing modest tax reforms could mobilise significant additional resources for RH by 2030. Strategic borrowing and blended finance instruments could further complement domestic funding. Realising these opportunities will depend on sustained political leadership, transparent and accountable budget execution, and stronger coordination across government and development partners. Implemented collectively, these measures provide a credible pathway to closing Nigeria's RH financing gap and advancing the country's demographic dividend.
Expanding family planning services in Sierra Leone: A transformative, smart investment.
Novignon J, Shogo GG, Cummins M
Afr J Reprod Health · 2026 Apr · PMID 41995033 · Publisher ↗
Sierra Leone continues to face significant constraints in financing family planning, marked by limited fiscal space, declining government allocations, and high dependence on external partners. This study models the finan...
Sierra Leone continues to face significant constraints in financing family planning, marked by limited fiscal space, declining government allocations, and high dependence on external partners. This study models the financial needs, expected health outcomes, and economic returns under alternative coverage scenarios. Achieving a modern contraceptive prevalence rate of 50% by 2030 would require an additional USD 65 million and is projected to avert more than 3.1 million unintended pregnancies and 10,000 maternal deaths. These improvements would generate approximately USD 640 million in socioeconomic benefits, representing nearly a ten-fold return on investment. In contrast, failure to scale up family planning services could result in economic losses exceeding 0.8% of gross domestic product (GDP). Closing the financing gap will require strengthened domestic revenue mobilisation, greater efficiency in public spending, and fulfilment of national health financing commitments. Overall, the evidence shows that family planning is a highly cost-effective investment that improves health outcomes, promotes gender equality, and accelerates economic growth, making it one of Sierra Leone's most powerful strategies for achieving sustainable development.
Informing reproductive, maternal, neonatal, child, and adolescent health and nutrition priority-setting and financing in Guinea: Findings from a national investment case study.
Bilivogui JP, Kekana L, Toure AA … +3 more , Diallo N, Torres-Rueda S, Kaba DF
Afr J Reprod Health · 2026 Apr · PMID 41995022 · Publisher ↗
Guinea faces high maternal and child mortality, low coverage of essential reproductive, maternal, neonatal, child and adolescent health and nutrition (RMNCAH+N) services, and major financing constraints. This study devel...
Guinea faces high maternal and child mortality, low coverage of essential reproductive, maternal, neonatal, child and adolescent health and nutrition (RMNCAH+N) services, and major financing constraints. This study developed a national investment case for 2026-2030 to estimate the costs, health gains, economic returns, and fiscal feasibility of scaling up priority interventions. The analysis integrated situational, budget, costing, cost-benefit, cost of inaction, and fiscal space assessments, and modelled four scenarios. Despite broad service availability, major gaps persist in quality, continuity, and effective coverage. Health expenditure reached USD 776 million in 2022 but remained heavily reliant on household spending. Scale-up would require an additional USD 200-447 million above the baseline, could avert about 334,000 disability-adjusted life years (DALYs) by 2030, and would generate benefit-cost ratios ranging from 6.7 by 2030 to more than 110 by 2050. By contrast, the cost of inaction would reach USD 1.6-2.8 billion by 2030. These findings indicate that scaling high-impact interventions is economically justified and fiscally feasible.
Investing more and better: The case for ending maternal deaths and meeting family planning needs in Ghana.
Novignon J, Ochan W, Naphambo E … +2 more , Gle DB, Atanga V
Afr J Reprod Health · 2026 Apr · PMID 41995007 · Publisher ↗
This article presents an investment case for advancing Ghana's reproductive health agenda, using nationally representative data and cost-benefit modelling to estimate the investments required and the expected health and...
This article presents an investment case for advancing Ghana's reproductive health agenda, using nationally representative data and cost-benefit modelling to estimate the investments required and the expected health and economic returns from 2024 to 2030. The analysis identifies a substantial financing gap of USD 430 million under the ambitious scenario, while demonstrating the potential gains from scaling up evidence-based interventions. Expanded access to reproductive health services is projected to avert about 8 million unintended pregnancies and prevent 8,000 maternal deaths, yielding benefit-cost ratios of roughly 23:1 for family planning and 7:1 for maternal health. These returns represent an estimated twenty-fold gain on investment. Conversely, failure to invest risks forfeiting up to 1.6% of GDP in lost productivity. Overall, the findings show that investing in reproductive health is both a moral imperative and a sound economic strategy for sustainable development and gender equity in Ghana.
An investment case for reducing unmet need for family planning and improving maternal health outcomes in Gabon.
Smith E, Rueda ST, Kekana LL … +5 more , Aliga D, Tchan YB, Cummins M, Joudane L, Keba P
Afr J Reprod Health · 2026 Apr · PMID 41994954 · Publisher ↗
This study presents an investment case for reducing unmet need for family planning and improving maternal health outcomes in Gabon between 2025 and 2030. Using the Spectrum software suite and a bottom-up costing approach...
This study presents an investment case for reducing unmet need for family planning and improving maternal health outcomes in Gabon between 2025 and 2030. Using the Spectrum software suite and a bottom-up costing approach, four scenarios were modelled to estimate financial requirements, health impacts, and socioeconomic returns from scaling up family planning, periconceptual, and maternal health interventions. Results show that scaling up services generates substantial health and economic gains while reducing overall system costs through lower demand for emergency obstetric care. Under the most ambitious scenario, scale-up could avert more than 15,000 unintended pregnancies, over 340 maternal deaths, and more than 2,100 child deaths, generating USD 793 million in socioeconomic benefits and a benefit-cost ratio of 63:1. Failure to scale up could result in losses of up to USD 780 million. Although short-term financing gaps remain, domestic revenue mobilisation, efficiency gains, and innovative financing mechanisms could support sustainable implementation and strengthen long-term human capital development.
Financing reproductive health in Ebonyi State, Nigeria: An investment case for equity and economic growth.
Kirima A, Addico G, Kuawu K … +1 more , Okoro A
Afr J Reprod Health · 2026 Apr · PMID 41994928 · Publisher ↗
This article presents the findings from the Ebonyi State Reproductive Health Investment Case. Drawing on situation analysis, budget analysis, costing, cost-benefit analysis, and fiscal space analysis, the study estimates...
This article presents the findings from the Ebonyi State Reproductive Health Investment Case. Drawing on situation analysis, budget analysis, costing, cost-benefit analysis, and fiscal space analysis, the study estimates the resources required to achieve universal access to reproductive health services across the state. The results show that health sector allocations averaged less than 8% of the total state budget, with only 1.4% directed specifically to reproductive health. Achieving full-scale provision of services would require ₦20 billion (USD 13.3 million) by 2030. This investment is projected to avert 130,000 unintended pregnancies and prevent 1,300 maternal deaths, translating into ₦1,624 billion (USD 1.1 billion) in social and economic benefits-a benefit-cost ratio of 19:1. Equity analyses reveal particularly strong gains for rural and low-income households. Overall, increasing investment in reproductive health is a highly cost-effective and equitable strategy for improving health outcomes and advancing sustainable development in Ebonyi State.
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