Barriers to addiction-related care during pregnancy in Nigeria: a scoping review and health system policy analysis.

Substance-related exposures in pregnancy are documented across Nigeria, but their integration into antenatal care remains unclear. This scoping review and health-system policy analysis mapped empirical evidence on these exposures among pregnant women and examined barriers to perinatal addiction-related care. Addiction-related care is understood here as screening, risk assessment, counselling, documentation, referral, and treatment. Five databases were searched on 6 April 2026; 23 empirical studies were synthesised with national policy documents and clinical guidelines using the WHO health-systems building blocks framework. Alcohol, herbal preparations, kolanut, self-medication with pharmaceuticals, and psychoactive substances including opioids were reported across all six geopolitical zones. No included study described routine screening, standardised documentation, structured referral, or integrated perinatal addiction-care pathways. Barriers included fragmented service delivery, workforce gaps, weak information systems, restricted pharmacotherapy access, financing constraints, stigma, and criminalisation. Non-punitive screening and referral pathways should be integrated into antenatal care to improve maternal and newborn outcomes.