When Nigeria gained independence in 1960, its founding fathers envisioned a nation that would stand tall, healthy, and prosperous. At the time, the University College Hospital (UCH), Ibadan, was a beacon of modern medicine on the continent, attracting patients from across West Africa.
Six and a half decades later, that vision has dimmed for many Nigerians. The health sector tells a story of progress and paradox: centres of excellence exist, primary health care facilities have been revitalised, and pioneering projects have saved countless lives. Yet, millions still die from preventable causes, families are impoverished by medical bills, and doctors continue to leave in large numbers for opportunities abroad.
As Nigeria marks 65 years of independence, one question looms large: how is the health sector faring?
A History of Promise and Shortfalls
Experts trace the evolution of Nigeria’s health system through alternating waves of reform and neglect. In the 1970s and 1980s, the Federal Government expanded teaching hospitals and established new facilities across regions. Following the 1978 Alma-Ata Declaration, Primary Health Care (PHC) was adopted as the backbone of service delivery.
In 2001, Nigeria signed the Abuja Declaration alongside other African leaders, pledging to allocate 15 per cent of its national budget to health. More than two decades later, the country still spends less than six per cent.
The launch of the National Health Insurance Scheme in 2005—later transformed into the National Health Insurance Authority (NHIA) in 2022—sought to improve financial access. Similarly, the Basic Health Care Provision Fund (BHCPF), introduced in 2014, gave a lifeline to PHCs.
Despite these initiatives, underfunding, weak governance, and a hemorrhaging workforce remain stubborn obstacles.
Gains Amid Challenges
Dr. Muyi Aina, Executive Director of the National Primary Health Care Development Agency (NPHCDA), reported that 901 PHCs have been fully revitalised, with 2,700 more undergoing upgrades. The goal is to reach all 17,000 wards nationwide by 2030. In many communities, where women once delivered babies by torchlight, skilled attendance at birth and timely referrals are now available.
Dr. Kelechi Ohiri, Director-General of NHIA, said enrolment under the scheme has risen from 16.7 million to about 20 million Nigerians. He noted that special funds, including the Vulnerable Group Fund and the Catastrophic Fund, now provide cover for high-cost treatments such as cancer care and dialysis.
Some programmes have yielded significant results. In Lagos and Kaduna, maternal deaths fell by 58 per cent across 32 facilities under Project Aisha, which combines health worker training, midwifery kits, and free caesarean sections. More than six million pregnant women nationwide have also received essential micronutrient supplements.
Nigeria has expanded vaccination campaigns—rolling out the Measles-Rubella vaccine, introducing HPV vaccines, and piloting malaria vaccines—while averting outbreaks through improved coverage. Training has also surged, with nursing enrolment growing from 28,000 to more than 115,000 in just a few years.
Persistent Gaps
Still, systemic weaknesses persist. Nigeria’s 2025 budget allocates N2.48 trillion to health—just 5.18 per cent of the national budget, far below the Abuja target of 15 per cent.
The consequences are dire:
-
Maternal mortality: An estimated 82,000 women die annually from pregnancy-related causes, accounting for 19 per cent of global maternal deaths.
-
Life expectancy: Nigerians live, on average, to 55 years—far below Ghana (64), Kenya (67), and South Africa (64).
-
Doctor-patient ratio: At 1:5,000, the ratio lags far behind the World Health Organization’s 1:600 benchmark.
-
Spending per capita: Health expenditure hovers around $55 per person, compared to the $86 minimum needed to deliver basic services.
Inequities are glaring. Women in northern Nigeria are more than twice as likely to die in childbirth as those in the South. In rural communities, a single nurse may serve an entire facility, while urban centres offer specialist care. Wealth also determines survival: the insured and affluent access treatment, while poor households often resort to selling assets or borrowing to pay hospital bills.
Voices from the Field
For many Nigerians, the health system remains a gamble. At a PHC in Kwali Area Council, Mrs. Sarah Aso, a mother of three, recounted walking four kilometres with her malnourished child only to find no nurse on duty and drugs out of stock.
At the Federal Medical Centre, Jabi, 32-year-old Blessing Alaba undergoes chemotherapy for breast cancer. Her treatment costs nearly a million naira, but under the Catastrophic Fund, half her bills were subsidised. “Without this support, I would have given up,” she said.
Meanwhile, a young doctor preparing to migrate for better opportunities admitted: “Most of my colleagues have left. We are passionate about serving, but the pay and conditions cannot sustain us.”
Calls for Reform
Stakeholders warn that health financing must move beyond reliance on donors. Civil society leader Mrs. Mercy Adeojo stressed: “Nigeria must commit domestic resources and address inequities head-on. Donor-driven health gains are not sustainable.”
Prof. Muhammad Pate, Coordinating Minister of Health and Social Welfare, insisted reforms were underway. “We are revitalising PHCs, expanding insurance, and strengthening governance. The road is long, but we are determined,” he said.
Others emphasise equity and prevention. Virologist Dr. Solomon Chollom urged government to increase funding, strengthen PHCs, and offer incentives to retain health workers. Health economist Mrs. Maimuna Abdullahi argued that universal insurance coverage and investments in clean water, sanitation, and nutrition would save more lives than treatment alone.
Looking Ahead
Stakeholders also see opportunities in digital health innovations, telemedicine to bridge rural-urban gaps, and Nigeria’s participation in the African Medicines Agency to boost local drug manufacturing.
At 65, Nigeria’s health sector stands at a crossroads. Revitalised PHCs, expanded insurance, and measurable reductions in maternal deaths show progress is possible. Yet systemic weaknesses continue to claim lives and widen inequalities.
The founding vision of “health for all” remains within reach—but only if reforms are matched with political will, adequate funding, and accountability.
As the saying goes: A healthy nation is a wealthy nation. For Nigeria, the next decade will determine whether its health system can truly deliver independence—a system that cares for all its people.
About the Author
Discover more from VOICE OF THE PEOPLE
Subscribe to get the latest posts sent to your email.
