Nigeria, the most populous country in Africa, continues to face monumental challenges in its quest to deliver accessible, quality healthcare to its citizens. For decades, the country’s public health infrastructure has battled with chronic underfunding, poor management, and a mass exodus of healthcare professionals. As the burden of disease grows and trust in health institutions wanes, urgent reform has become a national necessity.

At the heart of this ongoing conversation is the question: Can Nigeria transform its public health sector into one that truly serves the people, regardless of wealth or geography?

Tax Reform as a Catalyst for Health Funding

On June 30, during a ministerial oversight committee meeting in Abuja, the Minister of Health and Social Welfare, Dr. Mohammed Pate, announced a significant development. He explained that the recently introduced tax reform initiative, signed into law by President Bola Ahmed Tinubu, aims to boost government revenue. A key portion of these increased funds, according to the minister, will be directed toward essential public services—healthcare being a primary beneficiary.

Pate emphasized that the Federal Government intends to allocate ₦32 billion for healthcare access improvements over a six-month period, equating to roughly ₦140 per citizen. This funding, which covers April through June 2025, is expected to be released by the end of August.

While this initiative marks a commendable step forward, it remains insufficient when weighed against the scale and complexity of Nigeria’s healthcare crisis. For many stakeholders, the question is no longer about pledges—but about execution, accountability, and systemic transformation.

The Financial Drain of Medical Tourism

Adding to the strain on Nigeria’s healthcare system is the outflow of financial resources through medical tourism, primarily by the country’s political and economic elites. Each year, Nigerians reportedly spend between $1.1 billion and $2 billion seeking medical treatment abroad, particularly in countries like India, the UK, and the UAE.

This trend not only drains the national economy but also reflects a lack of confidence in the country’s own medical institutions. Instead of investing in local healthcare facilities, policymakers have opted to seek treatment overseas, leaving the majority of citizens to rely on poorly equipped and understaffed hospitals.

A History of Underfunding and Broken Promises

In 2001, Nigeria committed to allocating 15% of its annual budget to the health sector—a pledge made in line with the Abuja Declaration. More than two decades later, Nigeria consistently falls short of that target. Budgetary allocations remain insufficient to address infrastructure decay, equipment shortages, and the vast disparities in access between rural and urban populations.

This chronic financial neglect has left health facilities unable to deliver essential services. According to the National Primary Health Care Development Agency, only 20% of the 30,000 Primary Health Centres (PHCs) across Nigeria are fully operational. The remaining 80% lack essential personnel, medications, or functioning equipment.

The Brain Drain Crisis: Doctors in Flight

An equally pressing concern is Nigeria’s loss of medical professionals to other countries, often referred to as “brain drain.” Within the past five to seven years, over 16,000 Nigerian doctors have reportedly migrated abroad in search of better working conditions, fairer pay, and professional advancement.

Many cite depressing work environments, delayed or unpaid salaries, and lack of career progression as key motivators. Meanwhile, public hospitals continue to function with critical staff shortages, further burdening the few remaining workers and diminishing the quality of patient care.

The Dark Side of Locum Employment

In an attempt to quickly fill gaps in healthcare staffing, the government introduced a locum (casual or temporary) employment system. Originally intended as a stopgap solution, this practice has since become standard, ensnaring many young doctors in a cycle of precarious employment.

These temporary contracts, often renewed monthly or quarterly, exclude healthcare professionals from pensions, health insurance, maternity or paternity leave, hazard allowances, residency training, and even basic recognition for their work. This system denies professionals the security and stability they need, thereby discouraging long-term service within Nigeria’s healthcare institutions.

Medical graduates have also raised concerns over the monetization of internship slots, with reports suggesting that some hospitals allegedly demand payment or favors in exchange for placement. This corruption discourages capable professionals from entering the public health workforce and undermines the meritocratic foundation of healthcare.

Insecurity, Fragmented Insurance, and Poor Policy Execution

Healthcare access in Nigeria is further complicated by regional insecurity, particularly in the northern regions, where attacks on medical facilities and personnel have become increasingly common. In addition, the nation’s health insurance system remains fragmented, failing to reach the vast majority of citizens—especially those in the informal sector or rural communities.

Policy implementation, when it occurs, is often disconnected from grassroots realities. Initiatives may be well-intentioned but frequently lack follow-through due to poor coordination between federal, state, and local governments.

A Strategic Roadmap for Healthcare Renewal

To change this trajectory, Nigeria must adopt a comprehensive and strategic approach. Piecemeal reforms or short-term funding injections will not suffice. Below are critical measures the government must prioritize:

1. Substantially Increase Health Budget Allocations: Nigeria must move toward meeting the Abuja Declaration benchmark. This would enable better hospital infrastructure, availability of medicines, and equipment maintenance.

2. Formalize Locum Policies: Temporary medical staff deserve structure, fairness, and timely compensation. The Federal Government must draft and implement a clear locum employment policy that protects casual workers and ensures equitable treatment.

3. Revamp and Equip PHCs: Primary Health Centres are the first point of contact for most Nigerians. Government should rehabilitate and equip PHCs, especially in remote and underserved regions, to deliver essential services like maternal care, immunization, and basic surgery.

4. Improve Health Workers’ Welfare: Retaining talent requires competitive wages, access to training, career advancement, and job security. The government must ensure regular salary payments, hazard allowances, and professional development programs.

5. Expand Health Insurance Coverage: Universal Health Coverage (UHC) remains an achievable goal if health insurance schemes are expanded to cover informal workers, low-income earners, and remote communities.

6. Strengthen Oversight and Fight Corruption: Health sector transparency must be improved. Government should establish strict monitoring systems to track how funds are disbursed and used. Whistleblower protection laws should be enforced to combat corruption.

Health Is Wealth: Why Reforms Cannot Wait

Without a robust public health system, Nigeria’s path to sustainable development will remain hindered. A healthy population is a productive population. When people can access affordable care, mortality rates drop, life expectancy increases, and economic output grows.

As Minister Pate emphasized, Nigeria must wean itself off external dependence and take full ownership of its healthcare development. That means implementing homegrown solutions backed by political will, sound policies, and proper execution.

In the end, ensuring that every Nigerian, regardless of class or location, can walk into a health facility and receive quality care isn’t just a dream—it’s a responsibility.