A newly released Country Health System and Services Profile (CHSSP) by the African Health Observatory Platform on Health Systems and Policies (AHOP) has revealed that Nigeria’s health system is functioning at only 45% of its potential, well below the African regional average of 56%.
The report was compiled by the Nigerian National Centre for AHOP (Health Policy Research Group, University of Nigeria, Nsukka) in collaboration with the Federal Ministry of Health and Social Welfare and WHO-AFRO. Despite years of health sector reforms, the findings indicate that health outcomes in Nigeria continue to lag significantly behind expectations.
While there have been incremental improvements in areas such as access and quality over the past decade, the report notes that progress remains far too slow to meet the Universal Health Coverage (UHC) target by 2030. Key indicators—including service coverage, patient satisfaction, and financial risk protection—all fall below regional benchmarks.
Key Findings:
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Out-of-pocket spending makes up a staggering 75% of total health expenditure, placing Nigeria among the countries with the highest personal health spending burdens globally.
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Only 10% of Nigerians are covered by health insurance or risk-pooling mechanisms, leaving a vast majority vulnerable to catastrophic health costs.
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Government health spending as a share of GDP is among the lowest in the world, underscoring chronic underinvestment in the sector.
The report also underscores severe infrastructure challenges, with an estimated 80% of health facilities classified as dysfunctional. This limits service delivery and fuels an estimated $1 billion annually in outbound medical tourism.
Additionally, while private providers operate only 35% of health facilities, they account for over 70% of service delivery, revealing deep public sector inefficiencies and service coverage gaps. For example, only 51% of childbirths are attended by skilled birth personnel—1.7% below the regional average.
In terms of workforce, Nigeria reports 3.95 doctors per 10,000 population, exceeding the regional average of 1.5. However, the report notes that this potential is underutilized due to poor infrastructure, uneven deployment, and weak health system coordination.
The Way Forward:
The AHOP report identifies sustained underinvestment as the central barrier to achieving UHC in Nigeria. To close the performance gap, it calls for the effective implementation of key legislative frameworks, notably the National Health Insurance Authority Act of 2023 and the Basic Health Care Provision Fund (2014).
The report concludes that without bold policy actions, targeted funding, and institutional accountability, Nigeria will continue to fall short of meeting both national and international health goals.
