When Nigeria gained independence in 1960, the vision of its founding leaders included a nation where every citizen could enjoy good health and well-being.
The University College Hospital, Ibadan, quickly became a symbol of medical excellence, drawing patients from across West Africa.
Six and a half decades on, the nation’s health sector tells a story of contrasts.
While there are centres of excellence, revitalised primary health care (PHC) facilities, and life-saving interventions, millions of Nigerians still die from preventable illnesses, families are burdened by medical costs, and many healthcare professionals seek opportunities abroad.
Experts note that Nigeria’s health system has developed in cycles of reform and neglect. In the 1970s and 1980s, teaching hospitals were expanded and regional facilities established, and the 1978 Alma-Ata Declaration guided the country to adopt PHC as the foundation of service delivery. The 2001 Abuja Declaration committed African nations, including Nigeria, to allocate 15 per cent of national budgets to health, yet actual spending remains under six per cent.
Initiatives such as the National Health Insurance Scheme, later transformed into the National Health Insurance Authority (NHIA), and the Basic Health Care Provision Fund (BHCPF) have sought to expand access and financial protection. Despite these efforts, challenges persist: underfunding, weak governance, and a dwindling workforce undermine service delivery.
Dr Muyi Aina, Executive Director of the National Primary Health Care Development Agency (NPHCDA), said 901 PHCs have been fully revitalised, with 2,700 more undergoing upgrades, targeting coverage of all 17,000 wards by 2030. Maternal health has improved in some areas, including a 58 per cent drop in deaths across facilities under Project Aisha in Lagos and Kaduna. National vaccination campaigns, nutrition programs, and expanded nursing training have strengthened preventive care.
Yet health financing remains insufficient. In 2025, only 5.18 per cent of the national budget, approximately N2.48 trillion, was allocated to health, far below the Abuja Declaration’s 15 per cent target. Life expectancy is around 55 years, and maternal mortality remains high, particularly in northern and rural regions. Regional inequalities and lack of resources leave millions reliant on personal savings or loans to access care.
Stakeholders argue that health equity must guide future reforms, targeting northern states, underserved rural areas, conflict zones, and marginalized populations. Digital health innovations, telemedicine, and local pharmaceutical initiatives present opportunities to strengthen coverage and efficiency.
At 65, Nigeria’s health sector reflects both achievements and gaps. Revitalised PHCs, expanded insurance, and selective reductions in maternal deaths show progress, yet systemic weaknesses continue to cost lives and deepen inequalities.
The promise of universal health care remains within reach, but only if reforms are sustained with strong political commitment, adequate funding, and accountability. The coming decade will be decisive in determining whether Nigeria can finally deliver a health system that genuinely meets the needs of its citizens.