Nigeria @ 65: Why health sector needs healing

By Abdul Muhammed

As Nigeria marks 65th Independence Anniversary, sociological appraisal on the nation’s Health sector is both timely and necessary. Health, as the World Health Organization (WHO) Rightly describes, is a state of complete physical, mental, and social well-being and not merely the absence of disease.’’ At 65, Nigeria’s health sector has witnessed significant milestones, but its systemic weaknesses remain glaring, calling for sober assessment.
Nigeria has made progress in reducing maternal mortality over the decades. According to the World Bank (2022), maternal mortality has declined from over 1,200 deaths per 100,000 live births in 1990 to about 512 deaths per 100,000 live births in 2020. This improvement, though still far from global targets, demonstrates the impact of health sector interventions such as increased access to antenatal care and maternal health education.
Data from the National Primary HealthCare Development Agency (NPHCDA, 2022) shows that national coverage for routine immunization improved to 57% in 2021, up from 33% in 2016, following the introduction of the Basic Health Care Provision Fund. This has contributed to reductions in under-five mortality, which fell from 2013 deaths per 1,000 live births in 1990 to 117 in 2021(UNICEF survey, 2022).
President Tinubu’s administration has launched several significant health policy reforms and programs that project hope and progress. In December 2023, the Nigeria Health Sector Renewal Investment Initiative (NHSRII) was unveiled to strengthen the country’s primary healthcare system, with a target to increase the number of functional Primary Healthcare Centers (PHCs) from 8,809 to over 17,600 by 2027. Under this initiative, 120,000 frontline health workers are to be trained over sixteen months, and enrolment capacities of nursing and midwifery institutions are being doubled. As of mid‑2025, more than 40,000 health workers have been trained, with 24 states plus the FCT having completed phase one of the training.
Over two million Nigerians were enrolled in the National Health Insurance Scheme (NHIS) in 2024 alone, raising total enrollees to nearly 19.2 million. Free Caesarean sections for the most vulnerable pregnant women have been provided under the scheme, benefiting thousands. The administration also approved an Executive Order to boost local production of pharmaceuticals by eliminating tariffs, excise duties, and VAT on certain raw materials and equipment, aiming to reduce drug costs.
However, despite these stride and achievements, the sector health space continues to grapple with some fundamental challenges, ranging from chronic underfunding. Health expenditure remains below the 15% Abuja Declaration target, with only 4.6% of the urgent action. Nigeria also faces an acute human resource crisis. The Nigerian Medical Association (2023) estimates that over 5,600 Nigerian doctors have migrated abroad in the past five years, contributing to the doctor-to-patient 0f 1:5,000, far below the WHO recommendation of 1:600.
Infant and child mortality, though reduced, but remains one of the highest globally, with UNICEF (2022) ranking Nigeria as the second largest contributor to under-five deaths worldwide, accounting for 12% of global under-five mortality.
Equity in healthcare access is another pitfall. According to the Nigeria Demographic and health survey (NDHS, 2018), while urban areas enjoy relatively better service, rural populations suffer disproportionately from poor infrastructure and lack of skilled personnel. This urban–rural disparity exacerbates health inequalities, leaving millions behind.
Nigeria’s future in health demands urgent, evidence-based interventions. Firstly, increasing health financing is a non-negotiable starting point. Allocating at least 10% of the national budget to health, even as a gradual step toward the Abuja Declaration, would significantly improve infrastructure, workforce retention, and essential drug availability.
Secondly, the “brain drain” must be addressed through competitive remuneration, better working conditions, and professional development opportunities for health workers.
Thirdly, investment in primary health care remains the most cost-effective strategy. According to WHO, if $1 is invested in primary Health care it has the potential of yielding up to $9 in economic returns, reducing the burden on tertiary hospitals and increasing equity in rural areas.
Finally, the integration of digital health innovations could revolutionize service delivery. Telemedicine, electronic health records, and mobile health platforms offer opportunities to reach underserved population, especially in rural and Conflict-affected areas.
At 65, Nigeria’s health sector reflects both resilience and fragility. The statistics tell a story of modest progress overshadowed by persistent challenge. Yet, the prospects are not depressing. With political will, increased financing, and strategic reforms, Nigeria can turn its health sector into a driver of national development. As we celebrate independence, the ultimate question remains: will Nigeria translate its health aspirations into action, or continue to recycle challenges at the expense of its citizens’ well-being.

Abdul Muhammed is a Public Affairs Analyst.