DOI: https://doi.org/10.36347/sasjm.2025.v11i12.002

Pages: 1135-1142

Maternal mortality in Nigeria remains among the highest globally, with northern regions experiencing particularly severe outcomes despite decades of global and national investments in reproductive health. Evidence shows that access to family planning (FP) could prevent a substantial proportion of maternal deaths; however, FP uptake in northern Nigeria remains persistently low. This paper examines theoretical perspectives on how gender structures contribute to the poor utilisation of FP services in northern Nigeria, drawing on feminist and masculinity theories and the broader framework of gender as a social determinant of health. While cultural, religious, economic and geographic factors influence contraceptive use, gendered power relations emerge as the most significant barrier. In many northern communities, patriarchal norms grant men control over reproductive decisions, household resources and women’s mobility. Studies consistently show that male opposition, whether through explicit disapproval, financial restriction, or social sanctions, significantly reduces women’s ability to access or use FP services. Even highly educated women often internalise gender norms that position men as primary decision-makers in matters of fertility and contraception. These dynamics demonstrate that gendered expectations, rather than knowledge or service availability, frequently determine FP use. Feminist theories highlight how gender inequality is structurally produced, while masculinity theories reveal how dominant forms of male identity reinforce hierarchical power relations and restrict women’s reproductive autonomy. Connell’s relational theory of gender further illustrates how hegemonic masculinity shapes institutional and interpersonal practices that marginalise women’s agency in reproductive health. Together, these perspectives explain why FP interventions that overlook gender norms show limited impact. The paper concludes that addressing poor FP utilisation in northern Nigeri