Healthcare in Nigeria is a concurrent responsibility of the three tiers of government in the country. Private providers of healthcare in have a visible role to play in healthcare delivery in Nigeria. The use of traditional medicine (TM) and complementary and alternative medicine (CAM) has increased significantly over the past few years.
Healthcare delivery in Nigeria has experienced progressive deterioration as a result of under-investment by successive governments, to effectively solve several problems that have existed in the sector over many years. This directly impacts the productivity of citizens and Nigeria's economic growth by extension. As of February 2018, the country was ranked 187 out of 191 countries in the world, in assessing the level of compliance with Universal Health Coverage (UHC), as very little of the populace is health insured, whereas even government budget for health services is insignificant. Out-of-pocket payments for health causes households to incur huge expenditures. Private expenditure on health as a percentage of total health expenditure is 74.85%.
The implication of this is that government expenditure for health is only 5.03 percent of all the money spent on health across the nation. Of the percentage spent on health by the citizens (74.85%), about 70% is spent as out-of-pocket expenditure to pay for access to health services in both government and private facilities. Most of the remaining money spent by citizens on their health is spent on procuring 'alternatives'. Low wages and poor workplace culture have forced hundreds of thousands of them to flee to Europe and America. However, considering its size and population, there are fewer health workers per unit population than are required to provide effective health services to the entire nation. The most common reason is the brain drain of health professionals in other countries, especially in Europe and America.
Nigeria's health department operates within a multi tiered structure designed to provide medical services at various levels. The healthcare system is broadly categorized into primary, secondary, and tertiary levels, each serving distinct functions within the country's health sector. The Ministry of Health oversees the coordination and regulation of healthcare services, ensuring accessibility, quality, and efficiency.
Health infrastructure The federal government's role is mostly limited to coordinating the affairs of the university teaching hospitals, Federal Medical Centres (tertiary healthcare) while the state government manages the various general hospitals (secondary healthcare) and the local government focuses on dispensaries (primary healthcare), which are regulated by the federal government through the NPHCDA.
The total expenditure on healthcare as a percentage of GDP is 5.03, while the percentage of federal government expenditure on healthcare is about 1.5%. A long-run indicator of the ability of the country to provide food sustenance and avoid malnutrition is the rate of growth of per capita food production; from 1970 to 1990, the rate for Nigeria was 0.25%.
On December 12, 2023, key health sector stakeholders signed a new health sector renewal compact by all relevant stakeholders, including the federal and state governments, donors, and development partners, also known as the first Sector-wide Approach (SWAp) in the health sector in Nigeria, introduced by the Coordinating Minister for Health and Social Welfare Muhammad Pate.
In 2024, the Nigerian government held its first quarterly dialogue on the performance of the health sector across the country between the federal authorities and sub-national governments, and key stakeholders in the health sector. The dialogue was organised as a part of the nation's commitment to revamping the health system using the Health Sector Renewal Investment Initiative and the Sector-Wide Approach, backed by the National Health Act of 2014.
Primary Healthcare Centres (PHCs) Primary Healthcare Centres (PHCs) serve as the foundation of Nigeria's healthcare system, providing basic medical services and preventive care. They are typically located in rural and semi urban areas to ensure accessibility for underserved populations.
Functions Immunization programs Maternal and child health services Health education and awareness campaigns Treatment of common illnesses and minor injuries Nutrition and family planning services
PHCs are managed by local government authorities with support from the state and federal governments, as well as international health organizations.
Secondary Healthcare Facilities General hospitals fall under the category of secondary healthcare facilities and serve as referral centers for cases that cannot be handled at PHCs. These hospitals are present in urban and semi-urban areas, providing specialized care and advanced medical interventions.
Functions of General Hospitals Source Emergency medical care Diagnostic services such as laboratory tests and imaging Surgical procedures Specialized treatments in fields like pediatrics, gynecology, and internal medicine Outpatient and inpatient services
General hospitals are managed by state governments and often receive federal funding and technical support.
Online databases of healthcare providers The official body that registers doctors and dentists, the Medical and Dental Council of Nigeria, does not have an online register. They provide a service to confirm a doctor's status. The Pharmacists Council of Nigeria allows for searching for verified pharmacists and premises. Medpages: Healthcare providers by category and region. Search allows finding of providers by name or specialty.
Health insurance Historically, health insurance in Nigeria could be applied to a few instances: free health care provided and financed for all citizens, health care provided by the government through a special health insurance scheme for government employees and private firms entering contracts with private health care providers. However, there are few people who fall within the three instances; as of 2015 less than 5% of Nigerians have health insurance coverage.
In May 1999, the government created the National Health Insurance Scheme, encompassing government employees, the organized private sector and the informal sector. Legislatively the scheme also covers children under five, permanently disabled persons and prison inmates. In 2004, the administration of President Olusegun Obasanjo gave more legislative powers to the scheme with positive amendments to the original 1999 legislative act. 1.5 percent of Nigerians have been covered by the National Health Insurance Scheme since its establishment. In 2017, the House of Representatives Committee on Health Care Services in Abuja, organized a two-day investigative hearing; where the Minister of Health Isaac Folorunsho Adewole said that the sum of N351 billion had been expended on health management organizations so far without commensurate result.
On May 19, 2022, President Muhammadu Buhari signed the National Health Insurance Authority Bill 2022 into law "to ensure coverage of 83 million poor Nigerians who cannot afford to pay premiums as recommended by the Lancet Nigeria Commission". This law "repealed the National Health Insurance Scheme Act, Cap N42, Laws of the Federation of Nigeria 2004". In 2024, the National Health Insurance Authority (NHIA) announced an increase in healthcare costs, introducing a 60% rise in capitation and a 40% adjustment in Fee-For-Service (FFS) fees, reportedly due to healthcare cost inflation and the need to maintain quality of care, even as the adjustment could also impose a financial strain on patients and employers.
There is immense private sector participation in the scheme with HMOs like Health Partners HMO, Total Health Trust, Police HMO, Clearline HMO, Multi Shield Nigeria, Expatcare Health International, Oceanic Health Management and Zuma Health Trust.
In 2024, the Federal Government reportedly disbursed a total of N37billion to relevant health agencies through the Basic Health Care Provision Fund (BHCPF) for designated Primary Health Care (PHC) facilities.
Over one million Nigerians are pushed into poverty every year due to health-related expenses, according to a World Bank Human Capital Public Expenditure Review and Institutional Review.
Bone marrow surgeries A new bone marrow donor program, the second in Africa, opened in 2012. In cooperation with the University of Nigeria, it collects DNA swabs from people who might want to help a person with leukemia, lymphoma, or sickle cell disease to find a compatible donor for a life-saving bone marrow transplant. It hopes to expand to include cord blood donations in the future.
Cancer care
Cancer care in Nigeria is at a critical crossroads, as the country faces a rising tide of cancer related illnesses with limited resources to combat them. About 80,000 Nigerians die of cancer annually and over 100,000 are diagnosed with cancer annually. More people are dying of cancer in Nigeria because cancer and non-communicable diseases are not given priority in the country's health budget. There are only seven cancer radiotherapy centers in Nigeria. The future of cancer care in Nigeria depends on collective action, increased funding, and stronger awareness campaigns to ensure early detection and accessible treatment for all.
Many of the cancer-related deaths in Nigeria can be attributed to a lack of knowledge regarding this family of diseases. For example, women are not provided with sufficient guidance to identify the signs and symptoms of breast cancer, and healthcare providers lack the capability to diagnose breast cancer, even after women have actively sought medical examinations.
Moreover, the absence of sufficient knowledge regarding both the prevention and early detection of cancer, coupled with a societal environment that can promote silence and attaches a negative social stigma to such illnesses, has resulted in over 33% of avoidable cancer fatalities. Research showed that many women with breast cancer had their needs met in less scientific and indirect ways. Some believed that breast cancer could be the fault of evil spirits and many women chose to use a complementary and alternative medicine alongside standard treatment.
Types Cancer is a significant health issue in Nigeria, with breast cancer, cervical cancer, prostate cancer, and liver cancer being the most common types. According to the World Health Organization (WHO), cancer cases in Nigeria have been rising, with thousands of new diagnoses annually. The lack of a comprehensive cancer registry poses a challenge to precise data collection, but estimates indicate that Nigeria bears one of the highest cancer burdens in Africa.
Challenges Limited Healthcare Infrastructure: Nigeria has an insufficient number of specialized cancer treatment centers, with most of them concentrated in major cities such as Lagos, Abuja, and Ibadan. This urban centric distribution makes it extremely difficult for people in rural areas to access timely and adequate cancer care. The lack of well equipped oncology units in general hospitals further worsens the situation, as patients often need to travel long distances for diagnosis and treatment. In some cases, delays in referrals and long waiting times at overburdened centers lead to disease progression before treatment begins.