Renowned obstetricians and gynaecologists have warned that high fertility rates and rapid population growth are contributing to economic frustration, regional instability and vulnerability to violent extremism across West Africa.
The experts called on African governments to increase investment in family planning, girls’ education and youth empowerment, saying uncontrolled population growth was placing additional pressure on already limited resources and opportunities.
They made the call during the 5th Congress of the Association of West African Societies of Obstetrics and Gynaecology (AWASOG) and the West African College of Obstetricians and Gynaecologists (WACOG), held in Lagos from September 2 to 5, 2026.
Delivering a keynote address titled “The Demographic-Security Nexus: Reproductive Health, Population Dynamics and Regional Stability in West Africa,” Professor of Obstetrics and Gynaecology, Emmanuel Otolorin, linked demographic trends, reproductive health and the security challenges confronting the sub-region.
Otolorin said West Africa’s population, estimated at about 477 million in 2026, could exceed one billion by 2100 if current demographic trends persist.
“We have a population explosion in West Africa and limited resources. In 2026, the population of West Africa stands at roughly 477 million, and by 2100, it is estimated to cross one billion,” he said.
He warned that when opportunities fail to keep pace with population growth, the anticipated demographic dividend could instead become a source of frustration, irregular migration, displacement and insecurity.
The expert said the situation was worsened by limited access to reproductive health services, particularly family planning, noting that only about 17 per cent of women across the region use modern contraceptives, while 24 per cent have an unmet need for family planning.
Otolorin said persistent high fertility, a rapidly growing youth population and inadequate economic opportunities could leave more young people vulnerable to poverty, unemployment, irregular migration and recruitment by criminal and extremist groups.
He also linked population pressure to competition over scarce resources such as land and water, as well as farmer-herder clashes, communal conflicts, displacement and migration.
Comparing countries within the sub-region, Otolorin noted that Cape Verde had reduced its fertility rate to 1.8 children per woman, below replacement level, alongside a 52 per cent modern contraceptive prevalence rate.
He said Nigeria remained a major concern, with modern contraceptive use estimated at 15 per cent and fertility at between 4.5 and five children per woman.
“On average, only 17 per cent of women use modern contraceptives across West Africa, leaving an unmet family planning need of 24 per cent. Nigeria sits in the red with a mere 15 per cent contraceptive usage, a fertility rate hovering between 4.5 and 5 children per woman,” Otolorin said.
He urged governments to invest in girls’ education, vocational training, job creation, entrepreneurship and women’s economic empowerment to ensure that the region’s expanding youth population has access to meaningful opportunities.
Otolorin also called for family planning to be integrated into routine reproductive healthcare, urging obstetricians and gynaecologists to provide counselling during antenatal, postnatal and post-abortion care.
“We should be discussing healthy birth spacing and preparing for postpartum contraception. And in postnatal services, we offer the same. There are methods that can be offered immediately,” he said.
He advocated immediate postpartum family planning, task-shifting to trained midwives, nurses and community health workers, and increased access to modern contraceptive methods.
According to him, voluntary access to family planning would not only improve maternal and child health but also reduce demographic pressure and contribute to regional stability.
He further urged reproductive health professionals to help dispel myths surrounding contraception, including misconceptions that family planning causes infertility.
Otolorin proposed that by 2035, all WACOG members should be able to confidently provide the full range of family planning methods, while the region should reduce the unmet need for family planning from 24 per cent to below 15 per cent.
He also called for maternal mortality to be reduced to fewer than 70 deaths per 100,000 live births.
“Reproductive health is a population stabilising policy. We need to invest in family planning, in girls’ education, and create more youth opportunities to meet the youth bulge,” he said.
The Lagos State First Lady, Dr Ibijoke Sanwo-Olu, represented at the congress by Dr Modupe Bowale, said the state government remained committed to initiatives aimed at improving access to quality healthcare and protecting the health and dignity of women and children.
Sanwo-Olu highlighted the Multiple Birth Assistance Programme, which she initiated to support mothers of triplets and higher-order multiple births, particularly those from low-income households.
“The initiative focuses on maternal and child healthcare sensitisation, postnatal support and socio-economic empowerment, with the goal of helping families navigate the challenging aspects of their lives,” she said.
She added: “Behind every statistic is a mother, a child, a family and a life that matters. Our collective responsibility is to ensure that every woman receives the care, dignity and support she deserves regardless of her socio-economic status.”
The Special Adviser on Health to the President, Dr Salma Anas, who addressed the congress virtually, said reproductive health should be viewed not merely as a medical concern but as a human development issue with implications across different sectors.
She described family planning as a critical tool for improving maternal and child health outcomes and cited an example from work in a Nigerian state where uptake of family planning services rose from below 0.5 per cent to above 10 per cent within five years through community empowerment and male involvement.
“Family planning is a game-changer to development. Investment in family planning should be regarded not as simply a health expenditure but as an investment in national development,” Anas said.
She added that the localisation of contraceptive commodities and essential maternal health medicines remained a priority of the current administration.
Chairman of the Local Organising Committee, Dr Joseph Akinde, said the congress provided an opportunity to build new alliances and strengthen regional collaboration in efforts to improve maternal and child health outcomes.
The President of AWASOG and WACOG, Professor Brian Adinma, described the college as an innovation-driven initiative aimed at leaving a lasting impact across the 16 West African countries.
He urged newly inducted fellows to participate actively in the college’s standing committees and contribute to its programmes.
The congress also witnessed the induction of 53 new fellows into the association.
Professor Oladapo Ladipo, a member of the Council and Board of Trustees of AWASOG/WACOG, urged the new generation of obstetricians and gynaecologists to help address Nigeria’s high maternal mortality and reproductive health inequalities.
Ladipo described Nigeria’s maternal mortality rate as deeply embarrassing and urged the newly inducted fellows to contribute to efforts to reverse the situation.
“An MMR of 996 per 100,000 live births is shameful. It will be up to this new generation of inducted fellows to fight this fight,” he said.
He also encouraged citizens to consider family sizes that could be adequately supported by available resources, urging the new fellows to promote what he described as “qualitative reproduction”.
Ladipo called on the Federal Government to increase funding for reproductive health commodities.
Another member of the Council and Board of Trustees, Dr Abu Alasa, urged the newly inducted fellows to uphold professional ethics and serve as credible ambassadors of the college.
He warned that members could lose their membership privileges if found guilty of professional misconduct under relevant laws and regulations.
