Poor health facilities in Nigeria stem from severe underfunding, leading to inadequate infrastructure, lack of modern equipment, drug shortages, and frequent breakdowns in essential services like electricity and clean water. This underdevelopment disproportionately affects rural areas and primary healthcare centers, where facilities are often dilapidated and staff are insufficient. Combined with a significant shortage and brain drain of medical professionals, this creates an overburdened system that struggles to provide quality care, leading to increased medical tourism and poor patient outcomes. Healthcare access in Nigeria is very limited in all dimensions due to factors within and beyond the health system.
Misconception of primary healthcare and poor leadership have resulted in a stunted health system development, which has failed to align system structures and processes with the goal of achieving universal health access. Improving financial access through compulsory health insurance will not be enough to reverse this situation without a holistic primary healthcare reform to correct the system misconstruction, achieve high-quality healthcare that is efficient, acceptable to the people, and therefore sustainable and capable of driving growth and development for the health system and the country. A primary healthcare movement consisting of health professionals within the country and the diaspora, as well as other stakeholders, is needed to drive this process and overcome the inertia of political leadership in this regard.
In 2014, the National Health Act established the Basic Health Care Provision Fund (BHCPF) to address funding gaps hampering effective primary healthcare delivery across the country. The BHCPF comprises 1% of the Federal Government’s Consolidated Revenue Fund (CRF) and additional contributions from other funding sources. It is designed to support the effective delivery of primary healthcare services, the provision of a Basic Minimum Package of Health Services (BMPHS), and Emergency Medical Treatment (EMT) to all Nigerians.
Despite the provisions of the BHCPF, reports expose the precarious state of healthcare in Nigeria, where access to and utilization of health services continue to be marred by systemic challenges across the states.
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The public health facilities in all 36 states and the FCT are deficient, and the experiences of community members seeking healthcare at public facilities are consistently awful.
Primary Healthcare (PHC) is the foundation of the healthcare system in Nigeria and functions as the level at which non-emergency, preventive health issues are resolved. But sadly, many of the PHC centres in the FCT are poorly equipped and lack well-trained personnel.
Kulo PHC was built with solid infrastructure and equipped with solar panels during a 2019 federal initiative aimed at strengthening primary care in hard-to-reach areas. Today, that promise lies in ruins. The solar panels are now dysfunctional—some stolen, others damaged by harsh weather and lack of maintenance. At night, the clinic plunges into darkness, leaving staff to work by torchlight or cell phones with dying batteries.
Three patients on life support at Aminu Kano Teaching Hospital were reported dead following an interruption to the hospital’s electricity supply by the Kano Electricity Distribution Company.
The basic causes of Nigeria’s deteriorating healthcare system are the country’s weak governance structures and operational inefficiencies.
The Basic Health Care Provision Fund (BHCPF) was poorly implemented in 13 states.
The basic causes of Nigeria’s deteriorating healthcare system are the country’s weak governance structures and operational inefficiencies.
Abdullahi Adamu can be reached via nasabooyoyo@gmail.com
