By Mary Oluwaseun Ajobo
Some incidents occur in our lifetime, and as we go about our business, they stick with us for life. There was a moment during my time in bedside nursing that I have not been able to forget.
A woman was brought in with severe abdominal pain. She had just been told she had ovarian cysts. But beyond the diagnosis, what was more striking was her confusion. She did not understand what it meant. She did not know how it had happened. She did not know what to expect. The pain was intense, but the fear was deeper.
Her condition had already progressed to a critical stage, the cyst had ruptured, and she required emergency surgery. Yet, in that moment of urgency, another barrier emerged: she could not afford the procedure. Like many healthcare settings, treatment was dependent on payment, and she had none.
As a nurse, I provided reassurance at the time. I told her she would be fine. But even as I said it, I knew that it was not enough. Because the issue was not just her condition, it was everything surrounding it.
She lacked the knowledge to understand her health. She lacked the financial means to access care. And she lacked the system support that could have enabled timely intervention.
And in that moment, something became painfully clear: it is not enough for women to hear about health. They must be equipped to understand it, and supported to act on it.
Across Nigeria today, many women are not entirely unaware of reproductive health conditions. In a recent survey of 67 women, over 70% reported that they had heard of uterine fibroids and polycystic ovary syndrome, while more than 80% had heard of ovarian cysts. On the surface, this suggests progress; however, awareness is not the same as understanding.
Beneath these numbers lies a quieter reality, one where women recognize the names of conditions but cannot identify symptoms, do not fully grasp the risks, and often delay seeking care until complications arise. This gap between knowing and acting is where many lives begin to unravel. It is in this gap that the true meaning of reproductive health literacy emerges.
Reproductive health literacy goes beyond hearing information. It is the ability to obtain, process, and understand health information well enough to make informed decisions. It is what transforms awareness into action.
According to Dr. Bello Zion, a family Physician and clinician with experience in women’s health, low reproductive health literacy is closely linked to poorer outcomes among women, including higher maternal mortality, poor pregnancy outcomes, reduced uptake of family planning services, and limited understanding of critical conditions such as cervical and breast cancer. When women do not fully understand their bodies, they are left navigating serious health conditions in uncertainty. But even knowledge, on its own, is not enough.
Another finding from the survey revealed that only about 33% of respondents had any form of health insurance. This means that the majority of women are left to pay out-of-pocket for healthcare, often at unaffordable costs.
Yet, almost all respondents, over 98%, believe that conditions such as uterine fibroids, polycystic ovary syndrome, and ovarian cysts should be covered by health insurance. The message is clear. Women are willing. Women are aware. But the system is not meeting them halfway.
Universal health coverage exists to ensure that healthcare services are available, accessible, and affordable for all without causing financial hardship. But in reality, access remains uneven, and many women are still left behind.
A physician reflecting on current trends noted that the incidence of reproductive health conditions such as polycystic ovary syndrome, uterine fibroids, and ovarian cysts appears to be increasing, influenced by shifts in lifestyle, environment, and social structures. At the same time, cultural silence, stigma, and limited health education continue to delay care-seeking behavior.
Women are living with pain they do not understand. They are managing symptoms they cannot name. They are delaying care not because they do not care, but because they lack the knowledge, the resources, or both. In many cases, by the time they present in hospitals, the condition has already progressed. This is where the conversation must change.
We cannot continue to speak of Universal Health Coverage only in terms of funding and infrastructure. We must also speak of understanding. Because what is the value of accessible healthcare if a woman does not know when or why to seek it?
Universal health coverage without health literacy leaves women informed, but not empowered.
Health literacy without health coverage leaves women aware but unsupported. We need both.
We need systems that not only make care affordable but also make knowledge accessible, knowledge that is simple, clear, and close to the realities of everyday women. We need communities where conversations about reproductive health are no longer hidden behind silence. We need policies that recognize that women’s health is not a side issue, but a central pillar of national development. This is not just about reducing statistics. It is about restoring dignity.
It is about ensuring that no woman sits in a hospital bed, afraid and confused, hearing a diagnosis she does not understand and facing a treatment she cannot afford. It is about building a system where awareness leads to understanding, understanding leads to action, and action is supported, not hindered, by the structures around her. Because in the end, the goal is not just to inform women. The goal is to empower them. And that is where true health begins.
Ajobo, a nurse, writes from Abuja, Nigeria.