Nigeria’s health care system has gone from being comparable to the rest of the world in the 70s and early 80s, to one of the world’s most underfunded and least robust. 

As the most populous Black nation in the world and Africa’s biggest economy, the state of affairs in Nigeria often reflects issues that exist across the continent. 

Across many indices, health care in Nigeria falls short and the COVID-19 pandemic has exacerbated those problems, signifying a turning point for action in the country. 

Here are five facts about health care in Nigeria that every Nigerian should know about:

1. Nigeria has a shortage of doctors. 

Although Chris Ngige, a medical doctor and Nigeria’s minister of labour, claimed in a TV interview on April 24 that Nigeria has “more than enough” doctors, the country in reality only has 3.8 doctors per 10,000 people — or 0.38 doctors per 1,000 people. 

According to the recommendations of the Global Goals, a series of targets set by the United Nations in 2015, countries should aim for a minimum of 1 doctor per 1,000 people. 

This would mean that Nigeria would need at least 200,000 doctors to sufficiently cater for its 200 million people. 

2. Health care in Nigeria is severely underfunded.

Despite a 2001 declaration by African heads of state — known as the Abuja Declaration — to allocate at least 15% of their national budgets to health care, successive Nigerian governments since then have consistently allocated under 10% of their budgets to health care. 

In 2019, Nigeria was responsible for 20% of all maternal mortality globally and only has about 24,000 hospitals.

In 2018, the Nigeria Center for Disease Control (NCDC) struggled on a government budget that was less than $4 million. In comparison, the US CDC’s budget in the same year was $11 billion. The math comes to less than 0.02 cents per Nigerian per year, compared with the CDC’s $33 per American.

3. Health care workers in Nigeria are grossly underpaid.

Since the COVID-19 pandemic hit, Nigerian health workers have gone on strike at least twice with another strike announced for Sept. 14. 

Some of the grievances the doctors have include unclear information around the hazard allowance (50% of basic salary) announced by the Nigerian Minister of Health, Dr. Osagie Ehanire, to support those working in dangerous conditions; and non-implementation of any of the promised welfare packages to health care workers.

“It was stated [that health care workers would be paid an additional] 50% of basic salary plus an extra 20% for frontline workers. But a specific amount of money was not stated in the news by the health minister and nothing has been implemented,” Segun Adediji, a pharmacist at a public hospital in Lagos, told Global Citizen in June.

Furthermore, over 1,000 Nigerian doctors emigrated to the United Kingdom between 2018 and 2019 seeking better pay for their skills — an issue that also contributes to the low ratio of working doctors to Nigeria’s population. 

4. Over 70% of health care spending in Nigeria is out-of-pocket.

Of health care spend in Nigeria, 77% is out-of-pocket, according to the World Health Organisation’s (WHO) latest data, from 2017. This means that most Nigerians do not have health insurance of any kind and the poorest Nigerians have extremely limited access to quality health care. 

According to a January 2020 publication of the Journal of Public Health, “Policy makers and political actors need to stop the high reliance on out-of-pocket health care spending as a means of financing the Nigerian health system by increasing public health expenditure.”

Meanwhile only 52 Health Management Organisations (HMOs) were listed on the National Health Insurance Scheme’s (NHIS) website in 2018, highlighting a dearth of health insurance options and coverage for Nigerians. 

5. Data collection and record keeping is poor.

Nigeria doesn’t have a comprehensive social register and nearly all of the Nigerian health care industry still relies on analogue record keeping and data collection methods. Most of the data compiled on Nigeria’s health care system are done by global organisations like UNICEF, international nonprofits, and the WHO.

This makes everything harder to track within the system. There are often disparities in numbers published by government and institutional bodies, and there is no known central or holistic database of Nigeria’s health indicators. 

Patient data often gets lost, misdiagnosis is common, and a lot of record keeping is usually repeated. There are also no comprehensive medical equipment registries and blood bank data is limited. While there are startups like Helium Health and LifeBank attempting to use technology to change this situation, adoption and scale is quite slow. 

You can take action to help strengthen Nigeria’s health care systems and reduce the impact of COVID-19 on the country’s most vulnerable by supporting the Nigeria Solidarity Support Fund (NSSF), a fund for Nigerians by Nigerians. The result of a partnership between Global Citizen and the Nigeria Sovereign Investment Authority (NSIA), you can learn more about the Fund here.