In March 2024, when floodwaters from Lake Victoria engulfed Nyamasao village in Kenya, 36-year-old Mary Atieno, a mother of three, was among the 350 families who fled to a nearby primary school on higher ground for safety. “We saw the water levels of the Lake rise, but we never imagined it would swallow our village. It was like a dream,” Mary said from a temporary camp.
By the time the Lake displaced them, Mary was days away from welcoming her fourth child. She eventually give birth in a classroom with the help of an elderly woman. “Our only health facility was destroyed. I cannot access family planning and maternal care,” Mary said. “My worst fear is getting pregnant again [while displaced]”
About 250 miles northwest of Kenya’s capital, Nairobi, Lake Victoria has been spilling over onto surrounding areas such as Budalangi, Homabay, Migori and Baringo. Experts attribute the extreme rainfall to climate change. According to Professor Raphael Kapiyo, an environmental scientist and researcher at Kenya’s Maseno University, “Lake Victoria’s flooding and backflow is a clear indication of changing climate patterns. Lake Victoria is advancing by up to 10 meters a day even during the dry season.”
Impact on Kenya’s healthcare facilities
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In Kenya, one in six girls between the ages of 15 and 19 years is either pregnant or already a mother. Disasters like floods worsen the situation exposing many young girls to assault and exploitation, and resulting in more than 260,000 pregnancies annually.
According to Maurice Anyango, Head of Western Region at the Kenya Red Cross Society, in 2024 alone, more than 45 healthcare facilities were submerged and rendered inaccessible, forcing women and girls to rely on community health promoters (CHPs) for reproductive health services.
Linet Aketch, a 37-year-old displaced woman, explained that they are forced to fundraise to hire a motorboat to bring CHPs from the mainland into the marooned village. “Hiring a motorboat and tipping the CHPs costs every woman 500 [Kenyan shillings],” she said, adding that they are often forced to forgo Sexual and Reproductive Health (SRH) services due to a lack of funds. “We have to rely on alternatives to meet our sanitary and contraceptive needs, and this includes using old clothes as pads,” Aketch noted.
Dr. Judith Obiero, a reproductive health specialist in Kisumu City, explained that with the collapse of the SRH system, women and girls are forced to endure unplanned pregnancies simply because they cannot access emergency contraception. “We are witnessing increased cases of young girls struggling to access post-abortion and post-rape care, and this is exposing them to even more health risks.” However, it not only exposes adolescent girls to risks of unwanted pregnancies but also to sexually transmitted infections and early marriages. “We have young girls who have found themselves in marriages because of pregnancies that could have been prevented” Dr Obiero added.
Kennedy Onyango, a former fisherman turned CHP, stated that affected villages have a shortage of menstrual, maternal care, family planning, and post-gender-based violence services. “The camps are overcrowded and lack privacy. They are breeding grounds for sexual violence and exploitation. We have recorded cases of young girls being asked for sexual favours in exchange for sanitary pads.”
Professor Kapiyo, the environmental specialist, warns that Lake Victoria will keep expanding its boundaries and submerging more villages as climate shocks get worse. “With rainfall patterns getting more erratic, inflow into the Lake will keep increasing, and things will only get worse for [communities] bordering the water body.”
Similar climate challenges in Nigeria
Flooding and desertification are among the most visible effects of climate change in Nigeria. Rising water levels, and flash floods, triggered by changing climate patterns, have submerged health facilities and disrupted essential services.
While internally displaced persons (IDPs) camps are set up to accommodate victims affected by floods in Nigeria. Dr Bieye Briggs, a public health physician and environmental activist, stated that healthcare services in IDP camps are mostly makeshift, which restricts access to essential SRHR services. “It’s double wahala [trouble]. Even if there was funding, climate change on its own makes it difficult for people to access SRHR; now, to compound that, funding is being cut.”
On May 29, 2025, heavy rainfall driven by extreme weather conditions associated with climate change occasioned a devastating flood that killed over 500 people and destroyed houses in Mokwa town in Niger, a state in north central Nigeria.
In the IDP camp set up in Mokwa, healthcare services, especially SRHR for women and girls, are lacking. While local actors such as the Planned Parenthood Federation of Nigeria (PPFN) are trying to respond to the gap by providing IDP camps with free medical consultations, drugs and other SRHR services on an intermittent basis, unmet needs remain high.
Amina Mohammed, a 17-year old displaced woman, also explained that she has to leave the camp to obtain contraceptives and treatment for sexually transmitted infections (STIs) , as these services are not available within the camp.
Family planning funding cuts worsen access
While climate change limits access to family planning, inadequate funding further worsens the challenge, even for those not displaced in Nigeria. This funding gap dates back to the COVID-19 pandemic in 2020, which strained the healthcare system, its workforce and patients. The post pandemic period should have prompted increased funding to revitalise the fatigued healthcare system, yet by 2021, Nigeria still failed to meet the African Union’s benchmark for health funding on the continent.
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This was further accompanied by the termination of funding for the United Nations Population Fund (UNFPA ) and the United States Agency for International Development (USAID), ending much-needed support for several critical SRHR programmes in Nigeria. Additionally, the 2025 Nigerian budget reduced funding for family planning interventions by 97%. This culmination of the international aid freeze and national health budget cuts has put SRHR services for women and girls in a dire state.
The effects of the funding shortfalls are already evident. With only about one-third of women accessing SRHR services, experts forecast that the persistent funding gap could trigger a crisis, as Nigeria’s current national stock of contraceptives is expected to run out later this year.
Prince Azeez, environmental health superintendent at the Federal Capital Territory Administration, noted that the absence of SRHR services will endanger the health of women and girls in Nigeria. “When there is no contraceptive available, there is a high tendency that a breastfeeding mother can get pregnant again within 3 to 6 months.”
