The healthcare system in Nigeria includes both public and private providers, as well as modern and traditional healthcare practices. This responsibility is shared among three levels of government. The system is structured into three levels. The tertiary level, managed by the Federal Government; the secondary level, managed by state governments; and the primary level, managed by Local Government Areas (LGAs). The Federal Government majors in tertiary healthcare delivery through specialized teaching hospitals, federal medical centres, and research institutes. It also establishes national health policies through the Federal Ministry of Health (FMoH) and spearheads initiatives like the National Malaria Elimination Programme (NMEP).
Primarily responsible for secondary healthcare, state governments manage general hospitals and, in some instances, tertiary care through teaching hospitals they own. They collaborate with (LGAs) through the State Primary Health Care Development Agency (SPHCDA) to implement primary healthcare (PHC) programs. Also, they adapt national health policies and lead programs for prevalent health concerns like AIDS, tuberculosis, and malaria. LGAs focus on strengthening service delivery and Community Engagement within their jurisdictions. They manage ward and village health committees, overseeing both private and traditional medical providers.
Most Nigerians pay for healthcare out-of-pocket.
One of the major challenges plaguing Nigeria’s healthcare system is inadequate funding. Although the Nigerian government provides some funding for medical services, most health care costs are paid out-of-pocket by families and individuals, with limited Insurance options available. According to the World Health Organization (WHO), 74.7% of total health expenditure in Nigeria was out-of-pocket in 2021, while government-funded expenditure was less than 5% in the same year. The Nigerian government allocates a limited budget towards healthcare, which has a domino effect on the entire system.
This lack of funding translates to a shortage of resources in hospitals and clinics across the country. Essential medical supplies, medications, and even basic equipment like beds and linens can be scarce. This financial strain also hinders the proper maintenance of infrastructure. Buildings may be in disrepair, lacking air conditioning or proper Sanitation facilities. Furthermore, it makes it difficult to invest in new technologies and advancements in medicine, leaving medical providers with outdated tools and techniques. Ultimately, these funding shortfalls make it difficult for hospitals and clinics to deliver high-quality care to their patients.
Practitioners are leaving the country in droves for greener pastures.
Often referred to as brain drain, the exodus of qualified practitioners also affects the system. This occurs when skilled doctors, nurses, and specialists leave the country to seek opportunities abroad. For instance, the management of the Lagos State Teaching Hospital (LASUTH) Ikeja revealed in 2023 that 150 nurses resigned in just three years. This loss of expertise has a far-reaching ripple effect. It weakens the system’s capacity and jeopardizes the well-being of millions of Nigerians. Several factors contribute to this exodus. Low wages and limited career development opportunities within Nigeria’s healthcare system create a sense of dissatisfaction among medical professionals. Working conditions can be difficult, with overworked staff and a lack of resources. Many of these workers struggle to make ends meet and see limited prospects for advancement within the system.
In contrast, developed countries often offer higher salaries, better working conditions, and access to advanced technologies. These incentives are highly attractive to Nigerian medical professionals seeking a more stable and rewarding career path. Additionally, some medical workers may be motivated by a desire for greater specialization and access to cutting-edge training opportunities unavailable in Nigeria. As a result, fewer workers translate to a heavier workload for those remaining. Patients may experience longer wait times, limited access to specialists, and potentially a declining care quality. The loss of experienced professionals also prevents the transfer of knowledge and skills to the next generation of medical practitioners.
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To address these challenges, several strategies can be adopted. Increased government funding would allow for better Investment in Infrastructure and equipment. Public-private partnerships could expand service delivery and leverage Private Sector expertise. Strengthening PHC can also provide preventive care and early detection of diseases in communities. Telemedicine and digital health solutions can connect remote patients to specialists and improve data collection. Additionally, public campaigns can empower communities to take charge of their health. Expanding access to affordable insurance can reduce financial barriers to care. Finally, by improving wages and working conditions, Nigeria can retain its skilled medical professionals.