CSOs identify stigma, poor facilities as barriers to HIV, TB, malaria treatment in Akwa Ibo

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Civil society organisations and health workers in Akwa Ibom State have identified stigma, cultural restrictions, inadequate health facilities and concerns about confidentiality as barriers limiting access to HIV, tuberculosis (TB) and malaria treatment. They are calling for urgent government action to make healthcare more accessible to women and other vulnerable groups. The stakeholders made the observations on Friday in Uyo at a one-day meeting to evaluate compliance with gender-responsive health policies in the state. They called on the government to improve public awareness of available services, train health workers to treat patients without discrimination and equip primary healthcare centres to encourage service uptake. They also called for consistent data collection to track HIV, TB and malaria cases and assess the implementation of policies designed to address gender-related inequalities in healthcare. The meeting was organised by Lawyers Alert in partnership with Media Health and Rights Initiative of Nigeria (MHR) as part of efforts to strengthen accountability and promote gender-responsive policies in the state’s health sector. Edidiong Enang, programme manager of Vitonia Lead Foundation, said cultural beliefs that discourage women from speaking up, economic hardship and institutional barriers continued to prevent women from accessing healthcare on equal terms. “We have cultural barriers that people believe that women are not supposed to speak up,” she said, adding that women who lacked economic independence often experienced delays in seeking healthcare. Ms Enang said some health facilities were not sufficiently gender-friendly, while stigma could discourage women from seeking services even when they were available. She said the project had strengthened the capacity of participating civil society organisations to engage ministries, departments and agencies, as well as public officials responsible for policy decisions. She called for sustained advocacy to ensure that government institutions addressed the barriers and included women in healthcare interventions. CSOs seek better-equipped health facilities Participants said the government needed to do more than establish policies and build model health facilities, stressing that primary healthcare centres must also be adequately equipped to provide accessible and reliable services. They called on authorities to intensify public sensitisation about available healthcare services and train health workers to be more accommodating and maintain patients’ confidentiality. The organisations also stressed the need for consistent data on HIV, TB and malaria to improve case tracking and measure the effectiveness of interventions. However, health workers from primary healthcare facilities said malaria treatment in the state was free when testing confirmed the infection. They explained that the state’s policy required patients to undergo testing before treatment, noting that not every fever was caused by malaria. Ubong Ekpo, representing the state Ministry of Health, said the government had intensified efforts to identify tuberculosis cases, including through house-to-house testing in rural communities. He also said that the state had three sexual assault referral centres at Ikot Ekpene General Hospital, Iquita Hospital in Oron and Immanuel Hospital in Eket. Mr Ekpo said the Ministry of Health is working closely with the Ministry of Justice on relevant interventions. Akwa Ibom yet to assent to anti-stigma law Enobong Akpan, project manager of the Akwa Ibom State Agency for the Control of AIDS, said the state had domesticated several HIV-related policies but was yet to have the governor’s assent to an anti-stigma law passed by the State House of Assembly. PREMIUM TIMES' investigation had shown how this has caused avoidable deaths and increased infections in Akwa Ibom State. Mr Akpan said the bill had been received by Governor Umo Eno and forwarded to the Ministry of Justice for review before assent. He commended Lawyers Alert for providing technical support to the state, particularly in reviewing its HIV workplace policy. According to him, Akwa Ibom has policies covering HIV prevention, workplace protection, care and treatment, prevention of mother-to-child transmission, and key and vulnerable populations. He said the state reviewed its HIV workplace policy last year with support from Lawyers Alert and was planning to unveil the revised document. On tuberculosis, Mr Akpan said the state had policies on care and treatment, including for multidrug-resistant TB, describing the care and treatment policy as functional. The discussions at the meeting pointed to the gap between having policies in place and ensuring that vulnerable people can access services without discrimination. About the project Lawyers Alert and MHR launched their Gender Equality Fund project in Akwa Ibom in October 2024. The two-and-a-half-year initiative, supported through the Global Fund to Fight AIDS, Tuberculosis and Malaria in partnership with GSK and ViiV Healthcare, is being implemented in Akwa Ibom and Benue states. Tagged “Law, Rights and Community Empowerment for Social Change in TB, HIV and Malaria Response,” the project seeks to strengthen women-led organisations and equip women leaders to demand accountability and advocate policies that address gender-related barriers to healthcare. The Uyo meeting brought together government officials, health workers and civil society organisations to assess the implementation of gender-responsive policies, identify gaps in service delivery and clarify the responsibilities of institutions, health facilities and communities. Participants said the findings should guide advocacy and practical action to make healthcare services more inclusive and accountable.

Civil society groups and health workers in Akwa Ibom say stigma, cultural barriers, poor facilities and confidentiality concerns are keeping vulnerable residents from accessing HIV, TB and malaria services, despite existing government policies.

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