After Nigeria gained its independence in the 1960s it made some progress to its healthcare systems but progress began to stall after a couple decades. Mostly due to everchanging governments and a lack of resources. For years now Nigeria’s healthcare has been rated among the worst in the world. A study in 2018 ranked it 187th out of 191 countries. Nigeria is also one of the poorest countries in the world with over half of the population living on less than $1.90 a day. The Nigeria health care system faces a few notable challenges like poor healthcare infrastructures, lack of funding, poor policy making and under investment in the healthcare system. Nigeria also suffers from high amounts of communicable diseases like HIV/Aids, tuberculosis, hepatitis B and the flu which puts a large burden on the healthcare system. Healthcare in Nigeria is currently a mixture of public, private, traditional and alternative.
In 1999, the government created the National Health Insurance Scheme (NHIS) which covers government employees and the organized private sector. It also has coverage for children under five, permanently disabled persons and prison inmates. However, it only provides insurance for about 1.5% of the population. The federal government’s role is mostly limited to coordinating the affairs of the university teaching hospitals, Federal Medical Centers (tertiary healthcare) while the state government manages the various general hospitals (secondary healthcare) and the local government focus on dispensaries (primary healthcare). Those who can afford it turn to private insurance.
The extremely wealthy in Nigeria do not seek medical care there, instead they go out of the country for all healthcare. The rest of the upper-class will only go to exclusive local private medical centers for minor ailments and seek international care for more serious illnesses. The middle-classes receive medical care at both private and public hospitals, depending on their income. The lower-classes get their medical care from a mixture of places like general hospitals, drug peddlers on the street, pharmacies and from those who practice traditional medicine. Years of importing prescription drugs of subpar quality have made some weary to trust Western medicine.
The healthcare costs for citizens is very high. Those who qualify for NHIS pay about 7.5% of their premiums. Private healthcare is rathe expensive and only a small portion of the population can afford it. Out-of-pocket payments for health causes households to incur huge debts. Private spending on health as a percentage of total health expenditure is 75%. The implication of this is that government expenditure for health is only 25% of all the money spent on health across the nation. Of the percentage spent on health by the citizens (75 %) about 70% spent is out-of-pocket costs 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 alternative treatments which can be costly.
Nigeria continues to try to improve its public health programs but they still have a way to go. The health infrastructure needs work, especially outside of urban areas. There is also a big difference in care between urban and rural areas. Lowering the high rate of communicable diseases should continue to be a top priority. There has been some initiative to fix these issues. Like with the Emergency Operation Centers (EOCs) across the country, centralized offices made up of health experts from different aid agencies and government health workers. They have made great progress in tracking and treating diseases in communities. Despite some progress, Nigeria still has a rather high maternal and infant mortality rate and a low life expectancy. Even with setbacks, the government is still trying to enact reforms.