Nigeria’s healthcare sector continues to be weighed down by the burden of rising medical costs and inadequate health insurance coverage. According to the 2024 State of Health of Nigerians Report by the Federal Ministry of Health and Social Welfare, only 19 million Nigerians—roughly 9.5% of the population—are covered by health insurance. This leaves the vast majority to rely on direct out-of-pocket payments, contributing to one of the highest rates of healthcare expenditure in Africa.
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In 2022, Nigeria had the highest out-of-pocket healthcare spending in Africa, accounting for 76% of the total healthcare expenditure, as reported by the World Bank and WHO. This financial strain is compounded by the rising cost of pharmaceuticals, as 70% of medicines are imported, contributing to a staggering $4 billion of the country’s $10 billion healthcare budget spent on drugs alone.
For many Nigerians, medical expenses consume a large portion of their incomes, leaving them with little to spare for other essential needs. High drug prices and hospital bills make it challenging for individuals to access necessary treatments, particularly in the face of chronic illness. “When illness strikes, many Nigerians are deterred from seeking care due to the inability to afford the costs,” said Dr. Sandra Okeke, a public health researcher. “The government must intervene by making healthcare more affordable and accessible.”
Government’s Efforts Fall Short Amid Chronic Underfunding
Despite government initiatives to increase health insurance coverage and reduce pharmaceutical costs, Nigeria’s healthcare budget still falls short of international standards. The 2024 national healthcare allocation saw a 25% increase, reaching ₦1.34 trillion—but this still represents just 5% of the national budget, far from the 15% target set by the Abuja Declaration of 2001.
Prof. Muhammad Ali Pate, the Coordinating Minister of Health & Social Welfare, explained that the government is working on several initiatives to reduce healthcare costs. “We are implementing measures like supporting local medicine production and removing import duties and tariffs on essential drugs. However, we need more financial backing to make these efforts sustainable,” he said.
For over a decade, Nigeria has failed to meet its healthcare budget allocation benchmark. This has contributed to gaps in the country’s ability to deliver adequate healthcare services, leading many Nigerians to seek treatment in the private sector or resort to self-medication.
Rural States Face Greater Healthcare Access Challenges
Healthcare disparities are particularly pronounced between urban and rural regions in Nigeria. While cities like Lagos and Abuja offer relatively better healthcare services, rural states such as Benue, Kano, and Yobe suffer from limited access to medical care.
In Benue, the HIV/AIDS prevalence rate is as high as 4.9%, and the state’s healthcare infrastructure is inadequate to meet the growing demand for medical services. The Central Bank of Nigeria’s Household Expectations Survey in January revealed that Nigerians anticipate spending a larger share of their income on medical expenses over the next six months. This survey highlights the rising financial burden that many Nigerians face when dealing with healthcare costs.
A 2023 Nigerian Healthcare Providers Report found that 80% of Nigerians in rural areas rely on out-of-pocket payments and often resort to self-medication due to a lack of nearby healthcare facilities. Prof. Olumide Okunola, an expert on rural healthcare, explained, “Many Nigerians in rural areas have to travel long distances to access health services, and this distance often deters them from seeking timely care.”
The Need for Increased Health Insurance Enrollment
To tackle these challenges, experts argue that expanding health insurance coverage is essential. Nigeria currently offers different health insurance programs tailored to various income groups. The State Health Insurance Agencies (SHIA) are designed to cover the poor and vulnerable, ensuring they have access to essential healthcare services while reducing out-of-pocket expenses.
However, the enrollment rates for these programs remain low. Dr. Chinonso Uche, a public health expert in Abuja, stressed that the government must focus on making health insurance more inclusive, especially for vulnerable populations. “If we are serious about improving Nigeria’s healthcare system, we need to make health insurance a priority for all income groups. Health insurance is one of the most effective ways to prevent financial ruin due to medical costs,” said Uche.
Initiatives to Reduce Healthcare Costs
Several initiatives have been launched to reduce healthcare costs and improve access to essential medicines. According to Prof. Muhammad Ali Pate, these efforts include supporting local pharmaceutical production, improving distribution networks, and eliminating tariffs on essential medications. These initiatives aim to reduce Nigeria’s reliance on imported medicines and the associated costs.
“The government is committed to reducing the financial burden on Nigerians,” said Prof. Pate. “By strengthening local medicine production, we hope to create more affordable options for the population, particularly those who cannot afford imported drugs.”
Conclusion: A Call for Reform
Nigeria’s healthcare system remains in dire need of reform. With a significant portion of the population still without health insurance and rising medical costs, the government must focus on increasing insurance coverage, improving local drug production, and ensuring that healthcare is affordable and accessible to all Nigerians. Until these issues are addressed, healthcare will continue to be a significant financial burden on the majority of the population.
Dr. Okeke concluded, “The government’s focus should be on policies that ease the financial burden of healthcare. Nigerians should not have to choose between getting treatment and paying for basic necessities.”
With continued reforms and a concerted effort to expand insurance coverage, improve healthcare access, and reduce medical costs, Nigeria can begin to address the significant healthcare challenges facing its people.
