Sex Trafficking as a Public Health Crisis: Health System Responses and Gaps for Survivors in Nigeria

The World Health Organization (WHO) recognizes human trafficking as a public health issue, yet this perspective has rarely been adopted in Africa, especially in Nigeria. Our research investigates healthcare for sex-trafficking survivors within Nigeria’s health system, focusing on identifying specific illnesses they face and the interactions between them and the healthcare system. This study involved 26 respondents, representing sex trafficking survivors, health providers, policymakers, civil society groups, and the anti-trafficking task force. Using phenomenological inquiry and critical realism, we examined survivors’ lived experiences and agency in managing their health needs within the broader public health context. Survivors reported various communicable and non-communicable health issues resulting from trafficking and poor living conditions. They experienced unmet mental health needs, including suicidal ideation. Some accessed limited insured care through non-government organizations and faith-based groups. Overall, the public health system failed to address most of the barriers faced by the survivors, leading some to abandon formal health services and face severe outcomes, including death. Substance misuse was not only a mental health issue but a coping mechanism for difficulties in obtaining quality healthcare. Survivors with children faced even greater vulnerability. Implementing a survivor-centered, trauma-informed approach within primary healthcare can help combat modern slavery and support Sustainable Development Goals (SDGs) toward good health and wellbeing and an inclusive society.