Protecting Reproductive Autonomy: Strengthening Inclusive Family-Planning Responses for Women with Disabilities in Nigeria

This evidence-gap review examines the existing evidence on family planning, reproductive decision-making, reproductive autonomy, coercion, and sexual/reproductive violence among women and girls with disabilities in Nigeria. The review was undertaken to determine what is currently known, identify areas in which evidence is limited or fragmented, and inform subsequent quantitative and qualitative investigation. The review focuses specifically on evidence relevant to family planning and reproductive choice, rather than the broader sexual and reproductive health needs of women with disabilities. It considers evidence on family-planning knowledge and information, contraceptive access and utilisation, reproductive decision-making, autonomy, interpersonal influences, coercive or unwanted sexual experiences, sexual/reproductive violence, and barriers within health and social systems. A PCC framework was used. The population comprised women and girls with disabilities in Nigeria, including adolescents where relevant. The concept included family planning, reproductive health, reproductive decision-making and autonomy, coercion, and sexual/reproductive violence. The context included Nigerian community, household, healthcare, health-system and related social settings. Quantitative, qualitative and mixed-methods empirical studies reporting Nigerian findings were considered, including studies with separately extractable findings for the eligible population. The review searched PubMed and Google Scholar for evidence published or publicly available from January 2000 to the final search date. Records were screened against predefined eligibility criteria, and relevant information was extracted using a structured extraction framework covering study characteristics, disability focus, family-planning/reproductive-health focus, decision-making and autonomy, coercion/violence, key findings, barriers and evidence gaps. The synthesis is primarily descriptive and thematic, reflecting the heterogeneous designs, populations, disability groups and outcomes represented in the available literature. Particular attention is given to the distinction between access to or use of family-planning services and the ability to make and act upon reproductive preferences. The findings are expected to provide a structured account of the current Nigerian evidence base and identify gaps concerning the intersection of disability, family-planning access and utilisation, reproductive decision-making, interpersonal influence, autonomy, and coercive experiences. The review forms the evidence-synthesis phase of a broader mixed-methods research programme. Its findings will inform the selection and interpretation of variables for analysis of the 2024 Nigeria Demographic and Health Survey (NDHS) and the domains explored in the subsequent qualitative study. Ultimately, the integrated evidence will contribute to development of an evidence-informed framework for disability-inclusive and autonomy-centred family-planning responses for women with disabilities in Nigeria.