Nigeria’s Health System Currently Operating At 45% Capacity

A recent Country Health System and Services Profile (CHSSP) issued by the African Health Observatory Platform on Health Systems and Policies (AHOP) has disclosed that Nigeria’s health system is operating at merely 45% of its full potential, a figure that falls significantly short of the African regional average, which stands at 56%.

The report, developed by the Nigerian National Centre for AHOP (Health Policy Research Group at the University of Nigeria, Nsukka), with assistance from the Federal Ministry of Health and Social Welfare and WHO-AFRO, reveals that despite a series of reforms in the health sector, the outcomes related to health in Nigeria have not met anticipated targets.

It stresses that although there have been some advances in outputs such as quality and access during the past decade, the progress remains inadequate to meet the goal of Universal Health Coverage (UHC) by the year 2030. Key health outcomes—including coverage of services, patient satisfaction, and protection against financial risk—are all lagging behind the regional benchmarks.

A critical discovery is the overwhelming dependence on personal expenditure. Out-of-pocket spending accounts for a staggering 75% of total health expenditure, positioning Nigeria among the countries with the highest rates of personal health spending globally.

This situation is worsened by the fact that only about one in ten Nigerians is covered by health insurance or any form of risk-pooling mechanism, leaving a significant and vulnerable portion of the population exposed to potentially devastating health expenses. Additionally, the government’s health expenditure as a proportion of GDP ranks among the lowest worldwide.

Deficiencies in infrastructure also present a major challenge. Nearly 80% of Nigeria’s health infrastructure is considered nonfunctional, which significantly hinders the provision of healthcare services. This poor condition leads to an estimated annual loss of one billion U.S. dollars due to outbound medical tourism.

Moreover, private healthcare providers, despite managing only 35% of health facilities, are responsible for delivering an outsized 70% of all health services.

This discrepancy underscores vast service delivery gaps, with the absolute coverage of essential services trailing 1.7% behind the African regional average; for example, just 51% of all births are attended by skilled birth attendants.

The report points out that Nigeria’s health workforce density, at 3.95 medical doctors per 10,000 people, is numerically above the regional average of 1.5, yet the inefficient infrastructure and poor workforce engagement severely limit the effective utilization of this human resource.

In conclusion, AHOP highlights that chronic underinvestment remains the chief barrier to achieving Universal Health Coverage. Addressing these gaps in performance will require the vigorous and effective enforcement of critical legislative frameworks, particularly the National Health Insurance Authority Act 2023 and the 2014 Basic Health Care Provision Fund.

A Gentle Reminder: Every obstacle is a stepping stone, every morning; a chance to go again, and those little steps take you closer to your dream.

Nnamdi Okoli