Steps for Transforming Nigeria’s Healthcare System
Senior medical professionals have outlined critical steps that Nigeria must take to improve its struggling healthcare system. They emphasize the urgent need to shift from policy rhetoric to effective implementation, aiming for better health outcomes across the country.
The doctors highlighted that beyond just formulating policies, the nation must focus on sustainable financing, improved welfare for health workers, and effective implementation. These measures are essential to drive long-overdue reforms in the sector.
World Health Day is observed every April 7 to raise global awareness about a specific health theme and highlight priorities for the World Health Organisation (WHO). This year’s theme, “Together for health. Stand with science,” underscores the role of science in addressing global health challenges.
Speaking exclusively to PUNCH Healthwise, Dr Benjamin Olowojebutu, the National First Vice-President of the Nigerian Medical Association (NMA), stressed the importance of reassessing Nigeria’s healthcare system. He called on the Federal Government to allocate adequate funding to the health sector, warning that persistent underinvestment continues to undermine healthcare delivery.
“It is important that as Nigerians, we galvanise and look at what we are doing right now. In Nigeria, we should be clear about the indices. Has maternal mortality in Nigeria reduced significantly? Has infant mortality reduced? Is the welfare of doctors and healthcare workers improving adequately? Those are the questions we must ask ourselves clearly,” he said.
According to him, the 2001 budget agenda recommended that healthcare should account for 15 per cent of the total national budget. However, it remains between 4.5 and 5.2 per cent, leading to low healthcare access, especially in rural communities.
While the current government has made efforts to improve infrastructure in teaching hospitals, these efforts remain far from adequate. Budget deficits and poor budget performance have also affected the execution of healthcare projects across the country.
Olowojebutu urged the government to prioritise health in national planning and align budgetary allocations with global recommendations. “There is no match between universal health coverage and the amount of funds available to effectively apply this to the general population in Nigeria.”
He pointed out that Nigeria’s population is increasing by about 3.5 per cent every year, moving towards about 300 million people, while the healthcare budget is not sufficient. Doing things differently requires commitment at all levels of government.
“The government should increase the healthcare budget; that is the baseline. Government should raise the healthcare budget to 15 per cent as agreed in the Abuja Declaration,” Olowojebutu said.
Poor funding has contributed to frequent industrial actions, brain drain among health workers, and limited access to quality care across the country. Olowojebutu warned that without decisive action, longstanding challenges in the health sector would continue to worsen.
“There should also be accountability. There must be proper accountability checks, even in the healthcare sector, to ensure that every allocated budget is properly utilised. There must be performance tracking.”
He explained that performance measurement in Nigeria should not be based on the number of procedures or admissions, but on survival rates and reductions in maternal and infant mortality. “That is what reflects a strong healthcare system and contributes to a good GDP of a nation.”
Olowojebutu also emphasized the importance of stronger public-private partnerships and sustained investment in improving patient outcomes and ensuring equitable access to healthcare.
“Philanthropic billionaires in this country should do more. In celebrating occasions like this, they should try to adopt a teaching hospital or a public hospital, at least one in each geopolitical zone, and make it a model of international standards.”
This will help reduce medical tourism and improve access to healthcare for people in those communities. If one billionaire does that for a particular hospital, it creates a vantage point for how things can be done properly within this country.
Olowojebutu added that governance reforms and patriotism among political leaders are equally important. “If a politician travels outside the country for healthcare using taxpayers’ money, that is not the way to go. If that money is invested in hospitals within Nigeria, and they begin to use these hospitals as a form of patriotism, it will give value to healthcare governance in this country.”
Implementing Existing Policies for Real Change
In an earlier interview with PUNCH Healthwise, Prof Bala Audu, the NMA President, stated that the Federal Government must ensure full implementation of existing health policies to drive meaningful reforms. According to him, policies such as the health workforce retention policy, the National Health Act, and the Presidential Initiative on Health Sector Value Chain Development remain largely unimplemented years after adoption.
“The quality of any policy is meaningless if it is not executed. All the reforms we need already exist within current policies. What is lacking is implementation,” Audu said.
Also speaking, Prof Tanimola Akande, a former National Chairman of the Association of Public Health Physicians of Nigeria, decried the low budget allocation and poor budget performance in the country. “The per capita health expenditure in Nigeria is very low, even when compared with some other African countries. Health budget performance is also poor.”
He added that what is released compared to what is budgeted has been grossly inadequate over the years. “This obviously has a significant effect on the level of progress made towards achieving universal health coverage in Nigeria.”
Akande, a Professor of Public Health at the University of Ilorin, Kwara State, also stressed the need for full implementation of existing policies. “There is a need for a lot more political will to make these policies, schemes, and programmes work well towards achieving UHC. The government must invest more in health and ensure accountability and transparency.”
