SEXUAL AND REPRODUCTIVE HEALTH LITERACY AND ADOLESCENT HEALTH OUTCOMES IN NIGERIA: A NARRATIVE REVIEW OF EVIDENCE AND INTERVENTION STRATEGIES

Abstract

This narrative review considers the contribution of sexual and reproductive health
literacy (SRHL) to adolescent health outcomes in Nigeria in the context of ongoing challenges,
including high rates of unintended pregnancies, sexually transmitted infections (STIs), and poor
access to youth-friendly services. Adolescent sexual and reproductive health literacy (SRHL) is the
capacity to access, comprehend, critically evaluate, and apply sexual and reproductive health
knowledge to make informed decisions. Evidence suggests that poor SRHL contributes to risky
sexual behaviour, low uptake of contraceptives, susceptibility to misinformation, and harmful
socio-cultural norms. In contrast, improved SRHL is associated with reductions in unintended
pregnancies and STIs, including HIV, as well as better mental and emotional well-being.
Adolescents with higher SRHL are more likely to delay sexual debut, practise safer sex, and utilise
health services. However, progress remains hindered by barriers such as gender inequality, weak
school-based sexuality education, and poor parent–child communication. A narrative review was
conducted using a structured search strategy across PubMed, Scopus, Google Scholar, and AJOL.
Studies published in English between 2015 and 2026 were retrieved using relevant keywords and
Boolean operators. Eligible studies focused on adolescents aged 10–24 years, addressed
reproductive health literacy or related concepts, and reported on sexual and reproductive health
outcomes. Data were screened, extracted, and narratively synthesised. Findings indicate that
interventions such as community-based programmes, community health workers, sexuality
education, youth-friendly health services, counselling, mobile health interventions, financial
empowerment programmes, and mass media have positive effects on SRHL. Emerging approaches,
including smartphone-based tools, school-based interventions, game-based learning, and family-
based programmes, also show promise when adapted to socio-cultural contexts. Strengthening
SRHL is therefore critical to improving adolescent reproductive health outcomes in Nigeria,
highlighting the need for context-specific, multi-level interventions and sustained policy attention.