The Lagos-based group is training 40 women as peer educators to take information on sexual and reproductive health, HIV, family planning, gender-based violence and unsafe abortion into communities and brothels.
By Bunmi Yekini
When Ohotu Diamond Women Initiative discovered that many of the female sex workers it was trying to reach were living beyond the brothels, it changed its strategy.
The Lagos-based organisation began taking its sexual and reproductive health programme into communities, recruiting women and adolescent girls to become peer educators who can take health information directly to their peers.
Forty participants attended a two-day training at the Ifako-Ijaiye Local Government Secretariat, covering sexual and reproductive health, HIV and sexually transmitted infections, family planning, contraception, gender-based violence and safe abortion rights.
The programme, supported by Amplify Change, is an expansion of an earlier project that focused on female sex workers in brothels in Agege and Ifako-Ijaiye, said Margaret Onah-Nnag, project coordinator of Ohotu Diamond Women Initiative.
“We discovered that the sex workers were not just only living in the brothels,” Onah-Nnag said. Some were living in rented accommodation or with their parents.
The organisation therefore began engaging community leaders to encourage women and girls outside the brothels to participate.
The goal is to turn those participants into a network of trusted sources of information.
The trained peer educators will return to their communities and brothels each month to educate their peers on sexual and reproductive health and direct those who need services to appropriate health facilities.
Onah-Nnag said the initiative provides peer educators with manuals, information materials, condoms and referral forms. The organisation also follows up with health centres to determine whether people referred through the programme actually receive care.
“We don’t want them to go off,” she said, explaining that quarterly meetings and periodic retraining would help identify challenges, correct gaps and strengthen the programme.
Tackling unsafe abortion
Unsafe abortion was among the most difficult issues discussed during the training.
Participants were encouraged to examine their personal values while respecting the different beliefs and choices of others, said Abiola Ajani Ariyo, lead of the Biola Ariyo Youth and Women Foundation.
During one exercise, participants debated whether women should be able to walk into a health facility and request an abortion. Their responses varied.
Another scenario involved a young woman who had gained admission to school but became pregnant and considered terminating the pregnancy because she wanted to continue her education.
Ajani Ariyo said such discussions demonstrated the difficult decisions women and girls can face when an unintended pregnancy conflicts with their education, economic circumstances or other life plans.
She warned that restrictions and stigma could push some women towards unsafe alternatives.
“Many people lose their life, lose their womb, in the process of unsafe abortion,” she said.
Ajani Ariyo also urged government to examine policies around abortion and women’s reproductive health, arguing that greater access to information and healthcare could help women make safer decisions.
Learning, unlearning
Richard Benson, a facilitator from Impactful Change Initiative, said the training also covered HIV prevention and gender-based violence, including physical, verbal, emotional and financial abuse.
He said participants were willing to challenge some of the ideas they had previously held.
“They had to unlearn the things they knew, and relearn new things,” Benson said.
One of the most significant changes he observed was participants’ growing understanding of bodily autonomy.
But he stressed that bodily autonomy does not override Nigeria’s existing abortion law.
Benson said the law criminalises abortion except where permitted to protect the life of the mother, and urged women not to seek procedures from unqualified providers.
“Don’t go to quack to endanger your life,” he said.
His message, he added, was also about preventing coercion and ensuring that women understand their rights and available healthcare options.
Putting communities at the centre
Beyond health information, the facilitators identified culture, religion and social norms as factors affecting women’s ability to exercise sexual and reproductive rights.
Benson said interventions would have greater impact if communities were involved in designing and driving them.
“Allow the community to be at the centre of every intervention,” he said.
He also called for policies that would make it easier for women to access healthcare without unnecessary dependence on their partners.
Onah-Nnag said the peer education programme would continue beyond the two-day training.
The first batch of peer educators was trained in April, the current group is the second batch, and another training is planned for around October.
For Ohotu Diamond Women Initiative, the strategy is to move health education closer to the women who need it, from the formal training room into the communities, rented homes and brothels where they live.
The organisers hope that by empowering women to educate their peers, conversations about contraception, HIV, gender-based violence and unsafe abortion can become more informed, accessible and ultimately safer.