Led by Ohotu Diamond Women Initiative, a coalition of health officials, community leaders and peer ambassadors is confronting stigma and expanding access to care.
By Bunmi Yekini
Community leaders, state and local government health officials, civil society organisations, media representatives, peer educators, as well as groups of vulnerable women gathered in Lagos to discuss how reproductive healthcare can be made accessible, safe and stigma-free for the women who need it most.
The meeting, convened by the Ohotu Diamond Women Initiative, marked the beginning of the second phase of a project focused on advancing sexual and reproductive health and rights (SRHR) among vulnerable women, particularly female sex workers, in Agege and Ifako-Ijaiye local government areas.
Far from a ceremonial gathering, the stakeholders’ consultation served as a moment of reflection and recalibration. What worked in the first year? Where did advocacy stall? And how can collaboration between communities, healthcare providers and government institutions be strengthened over the next two years?
“We are here to reflect, to learn, and to strengthen collaboration,” said Dr Margaret Onah Nnang, Project Coordinator of the Ohotu Diamond Women Initiative. “Most importantly, we are here to co-create solutions that are practical, inclusive and sustainable. “Reproductive rights matter. And the voices of the most marginalized, especially sex workers and vulnerable women, must be heard, respected, and acted upon.”
Over the past year, the organisation, with support from AmplifyChange, engaged Commercial sex workers as peer ambassadors, conducted outreach across brothels in both LGAs, and facilitated dialogue between healthcare providers and marginalised women. But the discussions at this latest meeting made clear that deeper community engagement, policy alignment and sustained awareness are needed to address persistent stigma, misinformation and unsafe health practices.
This was not just another stakeholder meeting. It was a reset.
From 20 Brothels to 80: Scaling a Hard Conversation
A year ago, the initiative began its work quietly, inside 20 brothels across Ifako-Ijaiye and Agege local governments. The focus: sexual and reproductive health rights (SRHR), peer education, and access to non-judgmental healthcare.
The results were encouraging.
Sex workers were trained as ambassadors. Data was gathered from brothels to identify service gaps. Dialogue between health providers and marginalized women slowly began to chip away at layers of silence and stigma.
Now, backed by renewed support from AmplifyChange, the project is expanding dramatically.
Instead of 20 brothels, the team will now work in 80 – 40 in Agege and 40 in Ifako-Ijaiye, alongside street-based sex workers and identified “hotspots.” There will be fresh mapping, new data collection, and expanded peer ambassador training.
But Dr Nnang says the biggest shift isn’t numerical.
“In Phase One, we worked mainly with sex workers. This time, we are bringing in the entire community: adolescents, parents, leaders. Because if the community does not understand SRHR, the stigma remains.”
She recounts how early outreach sessions were often derailed by one word: abortion.
“When we said ‘safe abortion,’ they would say, ‘You want to come and tell them to kill their babies.’ But when we talked about ‘unsafe abortion,’ they listened. They understood the danger.”
Language, she learned, could mean the difference between rejection and engagement.
When Stigma Meets the Hospital Ward
If the community conversations are tense, the hospital emergency rooms are often tragic. Dr Latifat Adeleye, Coordinator of Family Planning at the Lagos State Ministry of Health, shared what she witnessed firsthand during a recent hospital stay in a gynaecology emergency ward.
“I saw many young girls, all under 19, coming in with complications from attempted septic abortions,” she said. “They take misoprostol, they’ve got somewhere. It doesn’t complete the abortion. They bleed for days. They develop sepsis. By the time they come in, it is an emergency.”
She described a teenage girl, six months pregnant without knowing it, severely malnourished and battling malaria. The father, a commercial tricycle rider, was unsure of his responsibility. The girl had no family support in Lagos.
“There are many layers to this problem,” Dr Adeleye said. “Education is key. If you know you are engaging in sex, go for family planning. Don’t make decisions based on what you see online or hear from friends. It can kill you.”
The state, she insisted, has invested heavily in prevention, free family planning products, adolescent clinics, community outreach, and health insurance through LASHMA. But she was firm about one contentious issue: access to internal state guidelines on abortion care. “That document is not for the general public,” she said. “You don’t need it. What you need is access to services that protect you. And the state is providing that.”
Her comments reflected a broader tension at the meeting: how to balance policy control with public transparency, and prevention messaging with real-life complexities.
Changing Attitudes, One Clinic at a Time
Mrs Dureke Florita, Executive Director of the New HIV Vaccine and Microbicide Advocacy Society, has been closely involved in the project from the beginning. She describes Phase One as a turning point.
“We recorded very negative attitudes from healthcare providers initially,” she said. “Female sex workers would walk into facilities and feel judged. But after advocacy sessions, roundtables, and sustained engagement, we saw change. Providers became more non-judgmental.”
Equally important was the shift among the women themselves.
“They began to understand that access to reproductive healthcare is their right,” Florita explained. “They became bold enough to walk into primary healthcare centres and demand appropriate services.”
Yet the problem remains vast. Across Lagos, teenage pregnancies continue to disrupt schooling and futures. Misinformation spreads faster than medical advice. Fear of stigma keeps many away from clinics. Scaling up within the same two LGAs, rather than moving elsewhere, was a deliberate strategy. “Phase One was like an announcement,” Dr Nnang explained. “Now we are building capacity. When the system is stronger here, then we can move outward.”
The Community Leaders Who Came to Learn
The presence of community leaders from Ifako-Ijaiye and Agege is significant to the meeting because of the respect they command in their communities. Ambassador Makinde Adesola, Baale of Shaga in Ifako-Ijaiye, said as a traditional ruler and coordinator with the Child Protection Network, he sees firsthand how health crises ripple through families.
“I have more women than men in my community,” he said. “If I don’t learn, how will I educate them? In his community, disputes often end with, “Let’s go to Baale.” That authority, he believes, must now extend to guiding women toward healthcare services without shame. “We are here so that female sex workers will not be molested or made to feel unwanted when they seek care,” he said. “They have a right.” The involvement of 21 Baales from Agege signals something deeper: reproductive health advocacy is no longer confined to NGOs. It is entering traditional institutions.
Taking Services to the Doorstep
For Chinedu Nwangazie, a trained community corps provider in Agege, the work is practical and immediate. He and his team deliver injectable contraceptives like Sayana Press within communities, refer women to facilities when needed, and educate young people about their options.
“So many people shy away from sexual reproductive health,” he said. “They forget that sex is part of our biology.”
By bringing services into hard-to-reach areas, community corps members bridge a trust gap that formal institutions often struggle to close. Peer ambassadors, 18 new ones being trained in this phase, will do the same within brothels and street networks.
“When their peers talk to them, it is easier,” Dr Nnang said. “They are not afraid.”
A Two-Year Window – And a Long Road Ahead
The second phase of the project will run for two years. The roadmap includes:
- Community-wide awareness campaigns
- Training for healthcare providers to reduce stigma
- Brothel mapping to track impact
- Expanded peer ambassador programs
- Continuous stakeholder dialogue, not one-off meetings
But everyone in the room acknowledged that reproductive rights in Lagos exist at the intersection of culture, poverty, religion, misinformation, and policy caution. Behind every statistic, Dr Nnang reminded participants, “is a real woman. A real body. A real life.”
While confronting resistance and admitting that there are still gaps in health care service in the state, Dr Adeleye assured stakeholders that the state is ready to collaborate for better and improved service delivery for residents, including vulnerable groups in the state. If Phase One was an announcement, Phase Two is an immersion. And in brothels, clinics, community palaces, and emergency wards across Agege and Ifako-Ijaiye, the outcome may well determine whether vulnerable women in Lagos face stigma or find support when they need it most.