Etuk et al. BMC Women’s Health (2023) 23:3 https://doi.org/10.1186/s12905-022-02146-6 RESEARCH © The Author(s) 2023. Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativeco mmons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data. Open Access Barriers to health in women of reproductive age living with or at risk of non-communicable diseases in Nigeria: a Photovoice study Imo Etuk 1 , Amira Iwuala 1 , Kendra Njoku 1 , Bosoye Olagbegi 1 , Ayoposi Ogboye 1* , Jonas Kofi Akpakli 1 , Ugo Okoli 2 , Kathleen Hill 2 , Oniyire Adetiloye 2 , Donald Imosemi 3 , Victoria Omoera 3 , Folashade Oludara 4 , Iniobong Ekong 4 , Olubunmi Alabi 4 and Nneka Mobisson 1 Abstract Background: Nigeria has one of the highest maternal mortality ratios (MMR) globally with an MMR of 512 (per 100,000 live births) and the proportion of maternal deaths due to non-communicable diseases (NCDs) is increas- ing. While evidence shows that many of these deaths are preventable, limited attention is being paid to the unique vulnerabilities and experiences of women of reproductive age (WRA) with NCDs and their risk factors, as well as the barriers to the screening, diagnosis, and management of these diseases in Nigeria. Methods: This study explored the lives of WRA in Lagos and Federal Capital Territory in Nigeria from May to June 2019 using a community-based participatory research (CBPR) methodology called Photovoice which is aligned with CBPR as it includes procedures such as the identification of important community issues, discussion of photo assign- ments and data analysis. Twenty-four women of reproductive age were provided with digital cameras and trained on how to capture photos that conveyed their current health, healthcare utilization and engagement, and experience journeys. Individual interviews with the women were held for an in-depth exploration of the photographs. The data was then analysed thematically. Results: Six distinct themes were identified across the barriers highlighted by the women: food and nutrition, home and family, neighborhood-built environment, economic instability, religion and spirituality and low prioritization of self- care. These themes captured the challenge of reduced agency, limited contribution and participation, and a complex relationship between visible and invisible illness. Conclusion: The perspectives of WRA in Nigeria obtained through this qualitative research provided a strong substratum for understanding the environmental barriers that predispose WRA to NCDs in Nigeria. The results of the study are useful for the improvement of woman-centred services of prevention, diagnosis, and management of NCD risk factors across the maternal and reproductive health care continuum in Nigeria. Keywords: Non-communicable disease, Photovoice, Women of reproductive age, Maternal mortality, Barriers, Healthcare Introduction Nearly 20% of global maternal deaths occur in Nigeria [1]. Approximately 600, 000 maternal deaths occurred in the country between 2005 and 2015 [1]. A woman liv- ing in Nigeria has a 1 in 22 lifetime risk of dying during *Correspondence: ayoposi.ogboye@mymdoc.com 1 mDoc Healthcare, 1a Hakeem Dickson Drive, Off T.F. Kuboye Street, Lekki Phase 1, Lagos, Nigeria Full list of author information is available at the end of the article