The International Journal of Interdisciplinary Social and Community Studies thesocialsciences.com VOLUME 10 ISSUE 3 IDONGESIT ESHIET ________________________________________________________________________ Gender and Reproductive Health Religious and Social Perspectives to Women’s Health Rights in Nigeria THE INTERNATIONAL JOURNAL OF INTERDISCIPLINARY SOCIAL AND COMMUNITY STUDIES thesocialsciences.com First published in 2015 in Champaign, Illinois, USA by Common Ground Publishing LLC www.commongroundpublishing.com ISSN: 2324-7576 © 2015 (individual papers), the author(s) © 2015 (selection and editorial matter) Common Ground All rights reserved. Apart from fair dealing for the purposes of study, research, criticism or review as permitted under the applicable copyright legislation, no part of this work may be reproduced by any process without written permission from the publisher. For permissions and other inquiries, please contact cg-support@commongroundpublishing.com. The International Journal of Interdisciplinary Social and Community Studies is peer-reviewed, supported by rigorous processes of criterion- referenced article ranking and qualitative commentary, ensuring that only intellectual work of the greatest substance and highest significance is published. The International Journal of Interdisciplinary Social and Community Studies Volume 10, Issue 3, 2015, www.thesocialsciences.com, ISSN 2324-7576 © Common Ground, Idongesit Eshiet, All Rights Reserved Permissions: cg-support@commongroundpublishing.com Gender and Reproductive Health: Religious and Social Perspectives to Women’s Health Rights in Nigeria Idongesit Eshiet, University of Lagos, Nigeria Abstract: The paper assesses the religious and social perspectives on women’s reproductive health rights in Nigeria. Reproductive health deals with the physical, mental, and social well-being of individuals in all matters relating to their reproductive system. Reproductive health rights, therefore, imply that individuals should be able to have a satisfying and safe sexual life, with the capability to reproduce and the freedom to decide if, when , and how often to do so. However, these rights are oftentimes hindered by socio-cultural and religious barriers. The paper assesses the socio-cultural and religious barriers to women’s reproductive health rights in Nigeria, based on secondary data. The sociological theories of gender roles serve as the theoretical underpinning of the paper. Findings reveal that socio-cultural and religious attitudes have affected women’s reproductive health in Nigeria, thus resulting in high incidence of unwanted pregnancies, abortions, maternal mortality and sexually transmitted infections. The paper recommends value reorientation as a panacea for this ugly situation. This should be done through community participatory approach, in which community members are involved in decision-making in devising culturally and religiously oriented reproductive health programs to meet men and women’s reproductive health needs. Keywords: Gender, Reproductive Health, Health Rights, Women, Religion Introduction eproductive health issues constitute some of the challenges facing the developing world today. For example, in recent times, the HIV/AIDS epidemic has resulted in a high level of mortality among the populace in the developing world. According to the Joint United Nations Programme on HIV/AIDS (UNAIDS 2013), about 35.3 million people were living with the HIV infection globally in 2012, while 2.3 million new infections were also reported in the same year. Sub-Saharan Africa is , however, disproportionately represented in this statistic, as it was home to about 70% of all the new HIV infections in 2012. UNAIDS attributes the continuous high prevalence of HIV/AIDS in sub-Saharan Africa to the decrease in condom use, as well as an increase in sexual partners, as revealed by recent surveys conducted in several countries within the region (UNAIDS 2013). With regard to Nigeria, the Population Reference Bureau Report (2013) shows that out of the 4.9% of the population of persons ages 15-49 that lived with HIV infections in 2013 globally, about 3.7 % of them lived in Nigeria. Also in 2011, about 3 million out of the 23.5 million people that lived with the virus lived in Nigeria (UNAIDS 2012). Similarly, the fertility rate in sub-Saharan Africa has remained all time high, despite the global decline in fertility rate. Thus, while the world fertility rate stands at 2.5 children per woman that of Sub-Saharan Africa is still high, standing at 5.2 children per woman. And within the region, West Africa has the second largest average of 5.7 children per wo man, which is next to the Middle Africa’s 6.1 children per woman. For Nigeria, the fertility rate is equally high and stands at 6.0 children per woman (Population Reference Bureau 2013). Correspondingly, there is a high maternal mortality rate in sub-Saharan Africa as well as in Nigeria. According to the World Health Organization (WHO), about 289,000 women died from largely preventable and treatable pregnancy and childbirth-related causes in 2013, globally. About 99% of these deaths took place in developing countries, while more than half of them occurred in sub-Saharan Africa (WHO 2014). Thus, while the maternal mortality ratio in developed countries was 16 per R THE INTERNATIO NAL JO URNAL OF INTERDISCIPLINARY SOCIAL AND COMMUNITY STUDIES 100 000 live births in 2013, that of developing countries was 230 per 100 000 live births in the same year. In view of this, Sub-Saharan African women have a 1 in 160 lifetime risk of maternal death, as compared to a risk of 1 in 3,700 for women in developed regions (WHO 2014). The Nigerian case is even worse as the maternal mortality ratio stands at about 500 per 100 000 live births, making Nigeria one of the countries with the highest rate of maternal mortality in the world. In fact, UNICEF (2009) State of The World Children Report acknowledges that one out of nine global maternal deaths occur in Nigeria as about 144 girls and women die every day from complications at childbirth (cited in Daily Independent 2010). These growing incidents of reproductive health issues may make a cursory observer to assume that African and Nigerian governments have not made considerable efforts to address the reproductive health needs of its citizenry. However, the reality is that African government in response to international and regional instruments, such as the Universal Declaration on Human Rights, the International Convention on Population and Development, The Convention on the Elimination of all Forms of Discrimination against Women, the Millennium Development Goals, The African Charter on Human Rights, The Child Rights Act, etc., have taken considerable steps to address the reproductive health needs of its citizenry. For example, in Nigeria, the government has prohibited female genital mutilation and girl child marriage through the Child’s Rights Act, 2003 (Olakanmi and Co. 2008). Similarly, various reproductive health programs have been instituted such as Voluntary Counseling and Testing (VCT) for HIV infection; encouragement of safe motherhood by provision of free ante and post - natal care for pregnant women; inclusion of sexuality education in secondary school cu rriculum, etc. (Esiet et al 2001; Rosen et al 2004). Besides the government efforts, the civil society has equally become more concerned about addressing sexual and reproductive health issues. Thus, many Non Governmental Organizations (NGOs) such as the International Center for Reproductive Health and Sexual Rights (2009) are working to improve reproductive and sexual health through advocacy and prevention programming. These laudable policies and programs have nevertheless, not been effective in tackling th e reproductive health needs of men and women, hence the growing incidents of reproductive health challenges, as afore-discussed. This scenario is an indication of the need for further interrogations of the structures and processes that shape sexual and reproductive health behavior of women and men in Africa. This paper is an attempt to do such with a focus on how gender, mediated by culture and religion, shapes men and women’s reproductive health behavior in Nigeria. The paper is structured into five parts. Part one assesses the relationship between gender and reproductive health, while part two discusses the theoretical framework. Part three looks at the socio-cultural and religious context of women’s reproductive behaviour in Nigeria. Part four assesses the impact of socio-cultural and religious barriers to women’s reproductive health in Nigeria, while part five concludes the paper with some recommendations. Gender and Reproductive Health Gender is the socially constructed meaning attached to being a male o r female in the society. It is concerned with the psychological, social and cultural differences between males and females, rather than with the anatomical and physiological differences that define male and female bodies (Giddens 2006). Gender leads to social exclusionary practices, which limit women’s access to tangible and intangible societal resources needed to improve their socio -economic well being. However, this varies overtime and from society to society and is thus an outcome that is malleable to change. According to Shaw & Lee (2004), gender is the social definition of womanhood and manhood. It deals with the way society creates patterns and rewards our understandings of femininity and masculinity. In other words, gender relates t o the way society 26 ESHIET: GENDER AND REPRO DUCTIVE HEALTH organizes understandings of the sexual differences between being a male or female. For example, females due to their biological predispositions to menstruate, gestate and lactate are seen as soft and nurturing, and so incapable of handling tough tasks. On the other hand males, due to their ‘human biogrammer’ (the genetically based determinant of behaviuor) are expected to be dominant and aggressive (George 1990). Reproductive health on the other hand, is a state of complete physical, ment al and social well-being in all matters relating to the reproductive system and to its functions and processes and not merely the absence of disease or infirmity (United Nations 1995). Similarly, Alubo (2000) defines reproductive health as the whole array of counsel, information and services required and necessary for safe and healthy sexual expression. But to Akhter (2009) reproductive health implies that people are able to have a satisfying and safe sexual life, with the capability to reproduce and the freedom to decide if, when and how often to do so. Akhter’s definition of reproductive health is not as simple and straight forward in practice. This is because gender mediates on individuals’ reproductive behavior, thus affecting their ability to make choic es, as well as to access reproductive health information and services. For instance, in some cultures, health workers do refuse or are reluctant to provide unmarried or adolescent women with contraceptive or relevant sexual health information. While for the males, the influence of masculinity and perceived ‘machismo’ also limit their use of sexual and reproductive health services. Young men, often, believe that the use of health services and other positive -seeking behaviors signifies a sign of weakness (Burket 2006). This has correspondingly resulted in differential health outcomes for men and women. However, women tend to be more at a disadvantage. Thus, while both men and women are faced with reproductive health challenges, women’s reproductive health challenges are particularly made more complicated, due to their status as the subordinate and marginalized gender in the gender ranking. This has resulted in women being faced with all kinds of reproductive health issues , such as unwanted pregnancy, unsafe abortion, forced early marriage, early childbearing, save motherhood issues (breastfeeding, antenatal, postnatal), post abortion care, the spread of HIV/AIDS and other sexually transmissible infections (STIs), female genital mutilation and maternal mortality , among others. These are issues that have affected not only the reproductive health of women but their general well being and life course. The next section of the paper attempts a theoretical exposition of the impact of gender on reproductive health behavior. Sociological Theories of Gender Roles While sex that is being male or female is biologically determined, gender on the other hand is the social conception of the expectations and behavior considered appropriate for those identified as males and females. Thus, gender is linked to socially constructed notions of masculinity and femininity, which are not necessarily a direct product of an individual’s biological sex (Giddens 2006). In view of this, some roles are typified as males’ roles and others as females’ roles, however, most cultures tend to assign higher values to males’ roles, while females’ roles are devalued (Giddens 2006). The devaluation of females’ roles has correspondingly resulted in the marginalization of women in all spheres in the society. This is reflected in differential economic benefits, dependent relations and social inferiority. Sociological attempt at explaining these role differentials is eclectic anchored on biology, culture and materialism. For Sociobiologists, the subordination of women in the society is justifiable, as this is physiologically determined. According to them, the biological predispositions of women to menstruate, gestate and lactate are major hindrances to their full and active participation in all spheres in the society. While they further argue that the ‘human biogrammer’ (the genetically based determinant of behaviuor) of males predisposes them to be more dominant and aggressive (George 1990). From this vein, masculinity in sexual relationship, 27 THE INTERNATIO NAL JO URNAL OF INTERDISCIPLINARY SOCIAL AND COMMUNITY STUDIES is constructed as being intelligent, courageous, aggressive, sexually potent, ambitious, etc., while femininity means being soft, passive, emotional, nurturing, dependent, sensitive, fearful, etc. (Giddens 2006; Shaw & Lee 2004). It therefore follows that men are expected to demonstrate sexual prowess and potency in sexual relationship, while women should be passive and subservient. However, Ortner, a culturalist disagrees with the biological explanation of gender roles. Observing the universal secondary status of women, Ortner argues that although men and women are significantly different, it is however, culture and not nature that accentuates these differences. It is culture that assigns superiority/inferiority labels to the respective sexes and women and all they stand for are assigned the inferiority label (George 1990). From this vein, women’s reproductive issues are perceived as inferior. For example, women are not expected to derive sexual satisfaction or negotiate safe sex. Hence, they are married off at an early age or are circumcised to prevent them from enjoying sex and therefore, becoming promiscuous (USAID 2009). The socialist and radical feminists’ conception of gender roles is different from that of sociobiologists and culturalists. According to socialists and radical feminists, women’s subjugation is a basic fact of every society, in all spheres of life and over all times. This oppression, they explain is tied to patriarchy, which they define as a system of male dominance over women in all spheres of life (Walby 1990). However, socialist feminists emphasize a view of patriarchy that integrates male power within the social structures in the society. Thus, they situate male dominance within class, the state and ideology. They argue that an end to this dominance could only result from a transformation of these structures (Rowbotham 1992). On the other hand, radical feminists’ analysis puts greater emphasis on the biological, cultural and psychological determinants of women’s oppression. According to them, the ‘perso nal is political’, thus domestic relations is a key factor in shaping gender roles. They therefore, examine how human reproduction is controlled and socialized through the institutions of marriage, compulsory heterosexuality and motherhood (Morgan 1975; Haralambos 1980; Giddens 2006). In the light of these arguments, it means that the erotic attractions, identity and practices involved in human sexuality are displayed and interpreted by individuals based on socially constructed sexual scripts (although sexual scripts are not static but dynamic and do vary across cultures and over time) (Shaw & Lee 2004). However, by implication it means human sexuality is as much about society as it is about biological urges. Thus, when men and women enter into sexual relationships, men bring into the relationship, the power that they possess as the dominant gender in the society. This is demonstrated through sexual prowess and potency, while women as the subordinate gender strive to live up to the social expectation of bein g subservient. They therefore become passive, both sexually and emotionally. This means that sexual intimacy although ‘personal’ is also ‘political’, since issues and problems involve in sexual relationships transcend personal boundaries to incorporate broader social, political and economic issues. Thus, sexual intimacies are enmeshed in unequal power relations and this in turn affects men and women’s reproductive health behaviour and rights. For example, the power enthroned upon men encourages them to engage in risky sexual behaviour, thus making them susceptible to reproductive health risks, while the powerlessness of women similarly exposes them to harmful sexual practices and reproductive health risks. Shaw & Lee (2004: 160) aptly describe this situation as preventing men and women ‘to love in healthy ways’. In Nigeria, the social and religious context has similarly impacted on men and women’s reproductive behaviour and rights. Erotic attractions and practices involve in sexual relationships are interpreted and displayed by men and women based on socially and religiously constructed sexual scripts. Thus, the next section of the paper assesses the social and religious construction o f sex and sexuality in Nigeria. 28 ESHIET: GENDER AND REPRO DUCTIVE HEALTH Social and Religious Perspectives to Women and Men’s Reproductive Health Rights in Nigeria In most societies, the moral imperatives of religion and cultural representations dictate the behaviours of men and women, as they ensure that what the society demands, permits and tabooed for each gender is well known and adhered to by most individuals (Davies 1982). For example, some religious sects forbid its members from practicing family planning, while others who allow such puts the sole responsibility for taking such decisions on the husband (the head of the family) and adherents of such sects have been observed to abide by these tenets (Burket 2006). Similarly, most cultures in Africa permit males to have multiple sexual partners and this has dictated men’s sexual attitude and behavior as shown by various studies (Barnett 2009; Orubuloye et al 1992). In Nigeria, cultural norms and religious beliefs similarly, dictate men and women’s reproductive health behaviours. However, it is important to note that Nigeria as a geographical expression is quite diverse and complex. It comprises of diverse cultures and religions and these have given rise to a multiplicity of sexual behaviours and practices. For example, Nigeria has two dominant religions – Christianity and Islam alongside some other minor religions such as traditional religion, Eckankar, etc. While the Christian faith predominant in southern Nigeria advocates for monogamous marriages, Islamic religion equally predominant in Northern Nigeria, on the other hand allows polygnous and girl child marriages (Erulkar and Bello 2007, Burket 2006). Similarly, while some ethnic groups such as the Edos and some other tribes in south eastern Nigeria indulge in female genital mutilation, some others do not. Equally, while premarital and extramarital sexual practices are more permissive among the yorubas of the southwest (Orubuloye et al 1991), the Ibos on the other hand are more restrictive in their sexual behaviour (Adegbola and Babatola 1999). This therefore, makes it a bit difficult to universalise reproductive health behaviour. However, despite this diversity, some studies have demonstrated some commonalities in sexual behaviour and practices among the diverse cultures and religions (see Araoye and Fakeye 1998; Adegbola and Babatola 1999; Alubo 2000; Esiet, et al 2001; Izugbara 2001, 2004; Odimegwu, et al 2008). Thus, it will not be totally misleading to discuss the social and religious perspectives to men and women’s sexual behaviour in Nigeria from a universalizing perspective. Traditionally, sexual and reproductive health needs of men and women have been shrouded in mystery in most communities in Nigeria. This is because sex is often seen as a subject that should not be discussed in the open. Similarly, words commonly used to depict parts of the body, sexual desires and acts are often framed in ambiguous and indirect terms (Izugbara 2005). This social conservatism about sex has made its discussion sensitive, inhibited, and often a taboo, although the situation is changing in recent times due to the influence of modernity. Globalization and the media have granted some Nigerians, especially the youths access to western notions of sex and sexuality and these have similarly influenced their notions of sex and sexuality. Thus, Adegbola and Babatola (1999) observe the changing attitude towards premarital and extramarital sex in contemporary Nigeria, with such changes towards anomalous sexual behaviour observed to be stronger in urban than rural areas. Similarly, Esiet et al (2001) observe that in contemporary Nigeria, sexuality has become one of the key issues that is commonly and publicly commented upon, through a variety of discursive activities such as through the media, schools, churches etc. Nevertheless, despite this changing attitude about the discussion of sex, the cultural quietude on sexual matters still impedes effective communication on sex by the generality of the populace. This has invariably affected family communication on sex as well as formal reproductive health education. The resultant effect is of course the lack of adequate information and knowledge on how men and women should protect their reproductive health. For women, the situation is further worsened by discriminatory cultural practices that work against them. According to Izugbara (2005:22) ‘male socialization practices in many Nigerian 29 THE INTERNATIO NAL JO URNAL OF INTERDISCIPLINARY SOCIAL AND COMMUNITY STUDIES cultures aim largely to train them to be domineering, ruthless and in control and to see themselves as naturally superior to women. On the other hand, female socialization o ften aims at making girls and women submissive, easily ruled or controlled and to see themselves as naturally inferiors to men’. This unequal ratings and power relation between men and women is often replicated in sexual relations. Therefore, women enter into sexual relationships as inferiors. Thus, they are not expected to enjoy sex in order not to become promiscuous. Their role in the sexual act is to gratify the sexual cravings of the men and in order to curb women’s sexual desires, their genitalia is mutilated (this involves removing all or part of the external genitalia and/or stitching and narrowing the vaginal opening) in some communities and in others they are given out in early marriage (USAID 2009). On the contrary, the men are expected to demonstrate strength, a desire for sex and not allowing themselves to be dominated by women (Odimegwu et al 2008). For example, Caldwell et al (1999) study of the obstacles to behavior change to lessen the risk of HIV infection in Nigeria reveals that among the yorubas of south western Nigeria, there is a strong cultural belief that men are unable to have just one female sexual partner. Thus, males’ indulgence with multiple sexual partners is not frowned at and tends to enjoy social acceptance, while such social acceptance is not equally bequeath upon females who have multiple sexual partners. Similarly, Izugbara (2004) empirical study of local notions of sexuality and relationships among rural Nigerian adolescents supports the assertion of males’ sexual prowess and superiority. The study reveals that male dominance of the sexual scene and act; sexual aggression and indifference to the voices of women, were the cherished values among the boys studied. Based on these observations, it therefore follows that in male-dominated relationships, men may be less likely to accept a woman’s request to use a condom or her desire to abstain from sexual engagement entirely (if she even dares), as culturally she has been conditioned to believe that it is her husband/boyfriend’s right to control her body. In fact, Orisaremi and Alubo (2012) empirical study of gender and reproductive rights of Tarok women in central Nigeria illustrates the vulnerability of Nigerian women in negotiating safe sex. Findings of the study reveal that married Tarok women do not negotiate safe sex with husbands, as husbands are the sole decision-makers in sexual matters. A refusal of sex by a wife or a request for the use of a condom by her husband, often results in beating and being accused of infidelity by the husband. This scenario equally replicates in other parts of Nigeria. Hence, the National Bureau of Statistics (2012) finding reveals that condom use among married women still stands at a paltry 4.0 percent. On the whole, a fall out of the social power conferred on men on sexual matters is the tendency for men to limit the use of sexual and reproductive health services . Odimegwu et al (2008) study of men’s perceptions of masculinities and sexual health risks in Igboland supports this assertion. The study reveals that men often perceive the use of sexual and reproductive health services as well as other positive-seeking behaviors by men as portraying a sign of weakness . Of course, this negative attitude towards reproductive health services by the men has adverse effect on both men and women’s reproductive health, as it enables the spread of sexually transmitted diseases . With regard to the use of contraceptives by women, there are similarly social stigmas associated with its use especially by unmarried women. Since culturally, femaleness is defined in terms of shame, lack of interest in sexual matters and the ‘other’ to be conquered (Izugbara 2005), women (especially unmarried) who dare to use contraceptives are seen as promiscuous and prostitutes. On the other hand, ‘good women’ are depicted as those who lack sexual desires (Izugbara 2004). Therefore, to fulfill this cultural sexual script, women often do not want to be caught obtaining or possessing contraception, neither do they want to appear as not being naïve and inexperienced in sexual matters. Thus, many women do not negotiate contraceptive use with their partners in order to maintain these impressions of sexual innocence. Apart from these, there are also some other erroneous cultural beliefs and myths about contraceptives, which have discouraged their usage among men and women. Some people believe that contraceptives have 30 ESHIET: GENDER AND REPRO DUCTIVE HEALTH damaging side effects, such as sterility and cancer and are harmful to unmarried females (Burket 2006). Religious traditions also play a major role in dictating individuals’ response to reproductive health information and services. According to a World Bank (2000 a ) Report on ‘Voices of the Poor,’ people in the poorest parts of the world, both urban and rural dwellers, place a high premium on the views of religious leaders. Findings of the World Bank (2000 b ) country synthesis report for Nigeria, equally confirms this viewpoint. The report reveals that a majority of the poor in both urban and rural areas rated religious groups as one of the most important institutions in their lives. The findings of Pathfinder International on reproductive health and family planning in various parts of Africa, including Nigeria affirm this view point. The study reveals the role of religious leaders in dictating individuals’ response to reproductive health information and services. According to the report, religious leaders who are untrained in reproductive health issues, have diverse and erroneous impressions about reproductive health and family planning. This is because some religious traditions reject the use of reproductive health services such as contraception (Burket 2006). Thus, some religious sects are opposed to birth spacing and the limiting of family size. While others do accept it, they however allow such within the confines of marriage, since religious tenets prohibit premarital sex. From this premise, some religious leaders do not see the need to encourage unmarried adults to seek reproductive health information and services, since by their definition, such persons do not engage in sex (Burket 2006). However, the reality is that not all unmarried adults and even young Christians/Muslims can or will abide strictly by the tenets of the faith. Similarly, most religious tenets prescribe that wives should be submissive to their husbands. The findings by Pathfinder International reveal that men have capitalized on this religious injunction to subjugate women on reproductive health issues, such as family plan ning and contraception (Burket 2006). The report reveals that women are not allowed to take reproductive health decisions without the permission of their husbands. Equally, some men believe it is their sole right to take all family planning decisions . Such men perceive women as being incapable of learning about family planning and taking such decisions on their own. Equally, some religious leaders and adherents believe that prayer is enough to protect members from contracting HIV/AIDS and other sexually transmitted infections (Burket 2006). These attitudes often create barriers against the giving and receiving of adequate and comprehensive information and services on reproductive health by religious leaders and adherents. What are the impacts of these beliefs and behaviors on women’s reproductive health in Nigeria? This is the focus of the next section of the paper. Impact of the Socio-Religious Context of Sexuality on Women’s Reproductive Health in Nigeria The social and religious obstacles to reproductive health behaviour as afore-discussed, have caused many men and women to embark on their sexual and reproductive lives with little or no knowledge as well as with limited skills, for discussing or negotiating sexual and reproductive health preferences and needs. And the women have been worst for it. Findings by Sedgh et al (2009) show that although the use of modern contraceptives among sexually active female adolescents has increased in most parts of Nigeria, it is however, still extremely low with the national proportion of users doubling from 4% in 1990 to 8% in 2003. They similarly report that although early childbearing has declined, it still remains common as almost one in three women aged 20 - 24 had had a child by age 18 in 2003, while nearly one- third of sexually active women aged 15 - 24 had an unmet need for modern contraceptives in 2003. Guttmacher Institute (2008) also reports that over 1.3 million unintended pregnancies occur annually in Nigeria and well over half (760,000) of these result in abortion. And unsafe 31 THE INTERNATIO NAL JO URNAL OF INTERDISCIPLINARY SOCIAL AND COMMUNITY STUDIES abortion accounts for up to 40 percent of maternal deaths. On the other hand, 54,000 women die each year from pregnancy-related complications. Nothing much seems to have changed over the years, as the (2013) Population Reference Bureau Factsheet reveals that maternal mortality ratio still stands at about 500 per 100 000 live births (about one of the highest in the world), while the fertility rate is still very high, standing at 6.1 children per woman. On the other hand the use of contraception is still low, as the Factsheet reveals that only 9% of married women aged 15- 49 used modern contraception in Nigeria. With regard to harmful cultural practices that are injurious to women’s reproductive health, such as early marriage and female genital mutilation, the Nigerian National Bureau of Statistics (2012) multiple indicator cluster survey reveals the persistence of harmful cultural practices against women that adversely affect their reproductive health. The survey reveals that 78 percent of women in Nigeria marry before age 15, while 89 percent do marry before age 18. On the other hand, about 22 percent of women aged 15 – 49 years had one form or another of female genital mutilation. With regard to HIV infection, the National Agency for the Control of AIDS (NACA) reports that about 60 percent of the 3.5 million Nigerians living with the disease are women (Premium Times 2013). These alarming statistics show that women in Nigeria do not have a satisfying and safe sexual life, with the capability to reproduce and the freedom to decide if, when and how often to do so, as defined by Akhter (2009). This is because gender mediated by socio-religious factors has affected their ability to make choices and to access reproductive health information and services. Conclusion Reproductive health has become a front burner issue in Nigeria in recent times, culminating in various policies and programs, undertaken by both the government and civil society, in response to various reproductive health challenges such as maternal mortality, HIV infections, female genital mutilation, girl child marriage, etc. However, despite these laudable efforts, the reproductive health status of many Nigerians, especially women still leaves much to be desired. This is due to the socio-cultural and religious context in which reproductive health behavior occurs in Nigeria because sexual act although biological is very much enmeshed in the socio - cultural and religious context of the act. In Nigeria, some socio-cultural and religious beliefs and values and the attendant attitudes and behaviors, negate healthy reproductive health practices, especially for women. Thus, the effective implementation of reproductive health programs is marred by these values and beliefs. This has resulted in a general lack of knowledge, access and interest in reproductive health information and services by a majority of the populace. The resultant effect has been the growing incidence of reproductive health issues as afore-discussed. And both men and women have been victims of these problems; however, women are the worst hit, due to their subordinate position in the gender ranking. Thus, they are exposed to sexually transmitted infections (STIs), unwanted pregnancies, unsafe abortions, genital mutilation, early marriage, maternal deaths, etc. So how can this ugly trend be reversed? The Way Forward To reverse the tide of reproductive health issues in Nigeria, the role of culture and religion in mediating reproductive health behavior of individuals must be acknowledged and taken into consideration when designing and implementing reproductive health programs. In view of this, there is a need for sensitization and cultural reorientation of the entire populace by the respective agencies charged with such responsibilities. Femininity should be accorded equal value as masculinity. This is because the optimum functioning of both genders is 32 ESHIET: GENDER AND REPRO DUCTIVE HEALTH a requisite for a healthy and balanced society. Thus, socialization practices should not emphasize the superiority of one gender over the other. Custodians of tradition in the community (traditional rulers) should be used as the entry point to drive home this point. Similarly, religious leaders must be sensitize to understand that individuals’ reproductive health is a rights-based issue and so should be addressed from a ‘rights’ perspective, regardless of age, gender and marital status. Therefore, religious leaders should be sensitized to collaborate with relevant agencies in the implementation of reproductive health programs. The strong influence of religion in changing perception and behavior would be brought to bear when religious leaders buy into reproductive health programs and so educate their followers accordingly. Thus, Faith based advocacy, media campaigns and open dialogue can be arranged with religious leaders to address reproductive health issues of their members . From this vein, the paper makes the following recommendations:  Set up local committees within the communities, using the various communal associations (youth, women, men, trade, craft, etc. – a common feature in Nigerian communities) as platforms. The committees should work in collaboration with the relevant government agencies and civil society organizations to enlighten community members on reproductive health issues.  The committees should encourage families (couples, parents and children) on the need to acquire reproductive health information and to discuss such among themselves.  Government should create awareness on the cultural practices that endanger women’s reproductive health (female genital mutilation, early marriage, unplanned pregnancies, etc) and discourage people from engaging in such practices through legislation, while defaulters should be sanctioned.  NGOs in collaboration with communal associations should sensitize community members on the dangers of discriminatory practices against women as an impediment to the general well-being of all in the community, thus encouraging a change in gender norms in order to create gender parity.  Seminars should be organized for females, using the platforms of churches and the various female associations within the communities. 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As well as papers of a traditional scholarly type, this journal invites case studies that take the form of presentations of practice—including documentation of socially-engaged practices and exegeses analyzing the effects of those practices. The International Journal of Interdisciplinary Social and Community Studies is a peer-reviewed scholarly journal. ISSN 2324-7576