Nigeria spends less on health as a share of GDP than nearly every other country in the world
Although it has spent billions on its health system and embarked on reforms, Nigeria’s health system is operating at less than half its potential, according to a new report that paints a bleak picture of the nation’s healthcare landscape.
The African Health Observatory Platform on Health Systems and Policies (AHOP), in partnership with the University of Nigeria’s Health Policy Research Group, has released a detailed profile indicating that Nigeria’s health system is operating at just 45% capacity, significantly below the African regional average of 56%.
This revelation, part of the Country Health System and Services Profiles (CHSSPs), is the first of its kind for Nigeria, developed with support from the Federal Ministry of Health and Social Welfare, as well as the World Health Organisation‘s African regional office.
Poor State of Health Infrastructure
The report, scheduled for public release on October 8, highlights a troubling disconnect between policy efforts and actual health outcomes.
Despite improvements in access and quality over the past decade, Nigeria remains off track to fulfil its aspiration in meeting universal health coverage by 2030.
Findings, among others, revealed a frightening state of the country’s health infrastructure.
According to the report, almost 80% of facilities are described as debilitating, a condition that not only undermines service delivery but also fuels outbound medical tourism, costing the country an estimated $1 billion annually.
Private Sector Outshines Public Sector
Private providers now deliver 70% of all health services, despite representing only 35% of the total number of health facilities.
This imbalance underscores the growing reliance on private care, often at a substantial personal expense.
Out-of-pocket payments account for 75% of total health spending, leaving millions of Nigerians vulnerable to financial hardship due to the high costs of medical care.
Only 10% of the population has access to any form of health insurance or risk-pooling scheme.
Workforce Shortages, Uneven Distribution of Personnel
Nigeria’s ratio of medical doctors, 3.95 per 10,000 people, is higher than the regional average of 1.5 but still falls short of the global benchmark of 4.45 per 10,000 people.
The report also notes that only 51% of childbirths are attended by skilled professionals, a statistic that reflects both workforce shortages and uneven distribution of personnel.
Underinvestment in Health
The report attributes much of the system’s underperformance to chronic underinvestment.
Nigeria spends less on health as a share of GDP than nearly every other country in the world. This fiscal neglect has left the system reliant on individuals and households to shoulder the burden of care.
Efforts to expand mandatory health insurance are underway, but progressing slowly.
Experts say that bridging the gap will require the full implementation of the National Health Insurance Authority Act of 2023 and the establishment of the Basic Health Care Provision Fund, which was set up in 2014.
Call for Efficient Health System
The findings raise urgent questions about the future of healthcare in Nigeria. With a population exceeding 200 million and growing, the stakes are high.
Without decisive action, the country risks deepening inequality and worsening health outcomes for its most vulnerable citizens.
As the report prepares for its official launch, stakeholders across the health sector are being called to confront the realities laid bare—and to chart a course toward a more equitable, efficient, and resilient health system.