Antibiotic Use and Antimicrobial Resistance Across the Reproductive Lifecycle of Women in Nigeria: A Scoping Review Protocol

his scoping review examines how reproductive health across the female lifecycle contributes to antimicrobial resistance among women of reproductive age in Nigeria. The female reproductive system creates recurring, anatomically predictable windows of infection susceptibility from menarche to menopause. These biological vulnerabilities are converted into antibiotic exposure through two key behavioural pathways. The first is patient antibiotic use behaviour, including reuse of antibiotics from previous reproductive infections, purchase from patent medicine vendors without diagnosis, incomplete courses due to cost or perceived recovery, and delayed formal care due to stigma, distance, cost, or spousal permission. The second is healthcare worker prescribing behaviour, including empirical prescribing without culture, digital consultations via WhatsApp or online platforms without physical examination, and home based reproductive health services delivered by healthcare practitioners without diagnostic capacity or sterile conditions. Purpose: The study has four aims. First, to map existing literature on antibiotic use and infection management across the reproductive lifecycle of Nigerian women aged 15 to 49, spanning menstruation related infections, sexually transmitted infections, contraception complications, pregnancy, childbirth, postpartum infections, post abortion care, and gynaecological conditions. Second, to assess the reported frequency, intensity, and pattern of antibiotic exposure at each stage, defined as antimicrobial exposure burden. Third, to develop an integrated three layer interwoven model that explains how biological, patient behavioural, and healthcare worker prescribing factors interact to generate cumulative antimicrobial resistance selection pressure. Fourth, to identify gaps in empirical research and in Nigeria’s National Action Plan on AMR regarding these lifecycle, behavioural, and prescribing dimensions. Expected outcomes: This review will produce four main contributions. First, the first conceptual framework linking sequential reproductive health stages to antimicrobial resistance as an interconnected exposure system. Second, a mapped evidence base showing which lifecycle stages and behavioural pathways are studied versus neglected in Nigeria. Third, an analysis of how patient practices and healthcare worker practices, including emerging digital and home service prescribing, operate as stewardship invisible antimicrobial resistance drivers. Fourth, a policy gap analysis demonstrating the absence of lifecycle and behavioral considerations in current antimicrobial resistance action plans. The findings will inform antimicrobial stewardship strategies, healthcare worker training, patent medicine vendor regulation, and digital health oversight specific to women’s health in Nigeria. No causal claims will be made. Results will be used to develop a policy brief for the Nigeria Centre for Disease Control and Federal Ministry of Health.