Service providers’ perspectives on youth sexual and reproductive health services in southern Nigeria: a qualitative interview study

BACKGROUND: Despite global commitments to youth-friendly sexual and reproductive health services (SRHS), service delivery gaps persist in sub-Saharan Africa. In Nigeria, health system limitations interact with sociocultural and gender norms, creating barriers to youth SRHS access. OBJECTIVE: This study explored service providers' perspectives on delivering SRHS to youths aged 10-24 years in southern Nigeria, focusing on their experiences, challenges and adaptive strategies. METHODS: A qualitative descriptive study was conducted using semi-structured Zoom interviews with 19 purposively selected service providers from selected public primary healthcare centres (PHCs). Participants came from community health, nursing, midwifery and other clinical backgrounds. Interviews were audio-recorded, transcribed verbatim and analysed using Braun and Clarke's reflexive thematic analysis. RESULTS: Four themes were identified: 1) Striving for comprehensive youth SRHS amid resource constraints, reflecting provider commitment despite staffing, infrastructure and supply challenges; 2) Navigating socio-cultural norms in youth SRH provision, showing how taboos, religious beliefs and gender norms shaped delivery; 3) Provider resilience and commitment in a challenging context, reflected in personal sacrifices and creative solutions; and 4) Limited integration of social support services, highlighting missed opportunities for holistic youth support. CONCLUSIONS: Providers demonstrated resilience and resourcefulness, but reliance on individual commitment may mask structural deficiencies and cannot substitute for system-level support. Strengthening youth SRHS requires workforce support, improved infrastructure, standardised youth-friendly protocols, provider training and multisectoral collaboration to improve quality and accessibility. Findings are context-specific to one local government area in southern Nigeria but offer insights for service strengthening in similar low-resource settings.