Caregiver Perspectives on Barriers to Sexual and Reproductive Health Access for People With Mental Illness in Nigeria: A Socio-Ecological Approach.

IntroductionPeople with mental illness (PWMI) in Nigeria encounter internal, cultural, and systemic barriers that limit access to sexual and reproductive health (SRH) services. Despite global focus on mental health, little is known about PWMI's experiences with SRH in Nigeria. This study explores caregivers' views on the challenges restricting PWMI's access to SRH services.MethodsThis research employed a cross-sectional approach based on the socio-ecological model. Structured questionnaires were given to 117 caregivers of people with mental illness (PWMI) in various health facilities and community locations.ResultsEducation and occupation of both PWMI and their caregivers were significantly associated with access to SRH services. Parents are reported as the most common caregivers and play key roles in facilitating access through decision-making and accompanying PWMI, yet the caregiver-PWMI relationship itself was not significantly associated with access. This study also indicates vulnerability, dependency, and gender-related risks that may emerge within caregiving or family structures, particularly in contexts where PWMI depend heavily on others for protection and decision-making.ConclusionCaregivers offer critical insights into SRH access for PWMI. Deeply rooted cultural and systemic barriers persist. Interventions must adopt a caregiver-inclusive, culturally sensitive, and rights-based approach to improve SRH outcomes for PWMI in Nigeria.