Endometriosis: Advocates seek policy action in Nigeria
Health experts and advocates in Nigeria are urging the federal government to integrate endometriosis care into national reproductive health policies, warning that diagnostic gaps and poor data collection are leaving countless women without proper treatment and support. The calls, which coincide with renewed attention to the condition during Endometriosis Awareness Month, come as the World Health Organization presses countries including Nigeria to move beyond awareness campaigns toward concrete policy action. Endometriosis, a chronic condition in which tissue similar to the uterine lining grows outside the uterus, affects an estimated one in ten women and girls of reproductive age globally, yet in Nigeria it remains widely underdiagnosed and frequently mistaken for ordinary menstrual pain. Advocates argue that without dedicated budgetary provisions, trained specialists and a national registry, the condition will continue to impose a heavy physical, emotional and economic burden on women and their families.
Endometriosis has long been a neglected area of women's health in Nigeria, where reproductive health policy has historically prioritised maternal mortality, family planning and infectious diseases such as HIV and malaria. The condition is characterised by severe pelvic pain, heavy bleeding, fatigue and in some cases infertility, symptoms that are often dismissed as normal menstrual discomfort by families, communities and even some health workers. Because diagnosis typically requires laparoscopy, an invasive and relatively costly procedure that is available in only a limited number of Nigerian hospitals, many women wait years before receiving confirmation of their condition. Experts note that the resulting delays allow the disease to progress, worsening pain and increasing the risk of complications, including fertility challenges that carry significant social stigma in many Nigerian communities.
The World Health Organization has consistently described endometriosis as a condition that significantly impacts the quality of life of those affected and has called on health systems to improve early diagnosis, treatment and research. In Nigeria, the absence of reliable national prevalence data makes it difficult for policymakers to allocate resources or plan services, a gap advocates say reflects a broader weakness in health information systems. Specialists also point to a shortage of gynaecologists trained in minimally invasive surgery, limited availability of hormonal therapies and the high cost of treatment, much of which is borne out of pocket by patients. Civil society groups working on women's health have begun documenting patient experiences to build an evidence base, but they acknowledge that formal, government-backed data collection remains essential.
Reactions from advocates and patient communities have focused on the human cost of inaction. Women living with endometriosis in Nigeria frequently describe years of misdiagnosis, being told their pain is psychological, and struggling to access care that is affordable and competent. Health professionals have echoed these concerns, noting that awareness campaigns alone cannot close the gap between recognition of symptoms and the delivery of quality care. They argue that endometriosis should be included in the training curricula of health workers, from primary health centres to tertiary hospitals, so that frontline staff can recognise symptoms early and refer patients appropriately. There is also a push for the condition to be recognised under workplace and school policies that accommodate chronic pain and related absences.
The Nigerian advocacy push fits into a wider global movement to elevate endometriosis on public health agendas. The World Health Organization has highlighted the condition as part of its broader work on noncommunicable diseases and women's health, and several countries have launched national strategies that combine clinical guidelines, patient registries and public awareness. In Africa, where reproductive health funding is often donor-driven and focused on infectious disease, chronic gynaecological conditions such as endometriosis receive comparatively little attention. Advocates caution that Nigeria's large population means even modest improvements in diagnosis and treatment could have a substantial impact, while also noting that the condition intersects with poverty, gender inequality and limited access to specialist care in rural areas.
Historically, the recognition of endometriosis as a serious public health concern has followed a long and uneven path globally. It took decades of activism before the condition gained mainstream medical attention in high-income countries, and even there, diagnostic delays of several years remain common. Nigeria's experience mirrors this trajectory but is compounded by resource constraints: where wealthier health systems have gradually built referral pathways and subsidised treatment, Nigeria's fragmented system leaves many women navigating care alone. Previous efforts to strengthen women's health policy in Nigeria have tended to succeed when they combine government ownership, professional training and community-level awareness, a model advocates believe could be replicated for endometriosis.
Looking ahead, advocates are expected to continue pressing for the inclusion of endometriosis in the national reproductive health strategy, with specific asks including a national prevalence survey, subsidised diagnostic services and training for health workers at all levels of the system. Whether these proposals translate into policy will depend on engagement with the Federal Ministry of Health and its agencies, as well as on budget allocations in the coming fiscal cycle. For now, the immediate priority is to keep the conversation alive beyond awareness months and ensure that women with endometriosis are counted, diagnosed and treated. As experts put it, the shift from awareness to action will be the true measure of progress.
