Healthcare Financing in Nigeria: A Policy Review

Abstract

A good health financing system is crucial for the effective performance of a country's health system. Many health systems around the world, especially in lower- and middle-income countries such as Nigeria, grapple with perennial challenges such as chronic underfunding, wastefulness, and lack of accountability rendering these systems inefficient. Nigeria's health system faces additional extraneous challenges such as a huge and rapidly growing population, a stagnant economy, and worsening insecurity of lives and property. Furthermore, recent disease outbreaks such as the Ebola epidemic and the COVID-19 pandemic and an evolving disease demography evidenced by an increasing prevalence of chronic, noncommunicable diseases asphyxiate an already floundering health system. To address these challenges and to bolster its efforts in attaining universal health coverage (UHC) and meeting the targets of the Sustainable Development Goals, the Nigerian government launched a new health policy in 2017. A review of the health financing section of this policy shows a focus on improving funding for health care by all levels of government and guaranteeing affordable and equitable access to health services by all Nigerians, albeit with insufficient clarity on how these will be achieved. A more critical review of the country's health financing system also reveals deep-seated systemic issues. Its out-of-pocket payments for funding health care are among the highest in the world, with abysmally low government contributions to health. Successive governments seem to lack the political will to address these shortfalls. Critical gaps exist in the country's health laws, making it difficult to implement the strategies proposed in the new policy. Nigeria must strengthen its health laws to, among other things, mandate health insurance and provide adequate funding for the health system by the government. It should also formulate a dedicated, more precise health financing policy with specific, measurable aims targeting identified problems to enable it to attain universal health coverage.

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“…Moreover, Nigeria's population structure presents distinct healthcare challenges due to the lack of government funding. 69 Government contributions to the healthcare sector remain significantly inadequate. These challenges have contributed to Nigeria's ranking as a country with one of the worst healthcare systems globally, primarily due to poor funding and resource allocation.…”

“…These challenges have contributed to Nigeria's ranking as a country with one of the worst healthcare systems globally, primarily due to poor funding and resource allocation. 69 As a consequence of this dire situation, successive administrations have demonstrated a lack of resolve in addressing these deficiencies. This persistent underfunding and its associated consequences have exacerbated the existing issue of brain drain within the healthcare system.…”

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“…The authors of the third paper unveil systemic issues plaguing healthcare financing in Nigeria, highlighting alarmingly low government contributions to health as a matter of concern even after the launch of a new health policy in 2017 (“Healthcare Financing in Nigeria: A Policy Review” by Alpha Chiemezie Madu and Katy Osborne). 6…”