How Affordable is Healthcare in Nigeria?

Written by Precious Oyeleke

Nigeria, the most populous country in Africa, faces significant challenges in providing affordable healthcare to its citizens in this day and age. Despite being one of the largest economies in Africa, the country struggles with a healthcare system that is underfunded, inefficient, and inaccessible to many. This article delves into the affordability of healthcare in Nigeria, examining the current state of healthcare costs, government spending, private sector involvement, and the impact on the average Nigerian.

The State of Healthcare in Nigeria

Nigeria’s healthcare system is a mix of public and private providers. Public healthcare is theoretically available to all citizens, but in reality, it suffers from severe underfunding, leading to inadequate facilities,? shortage of medical professionals, and inconsistent service delivery. The private sector, while more reliable in terms of service quality, is often expensive for the majority of the population.

Government Spending on Healthcare

One of the critical factors affecting healthcare affordability in Nigeria is government spending. The African Union recommends that countries allocate at least 15% of their annual budgets to healthcare. However, Nigeria consistently falls short of this target. In recent years, Nigeria's healthcare budget has hovered around 4-5% of the total national budget, far below the recommended threshold.

This underfunding leads to several problems. Public hospitals often lack essential medical supplies, and healthcare workers are poorly paid, resulting in strikes and brain drain as many seek better opportunities abroad. For example, it’s not uncommon to find public hospitals without sufficient health professionals and basic diagnostic equipment or essential medications, forcing patients to travel long distances or purchase these items at inflated prices.

Out-of-Pocket Expenditure

Out-of-pocket expenditure is a major problem in Nigeria. According to the World Bank, over 70% of total health expenditure in Nigeria is out-of-pocket, one of the highest rates in the world. This means that Nigerians pay directly for most of their healthcare needs, which can be financially crippling and also affect their quality of life.

The cost of healthcare services varies widely across the country. In urban areas like Lagos and Abuja, private hospitals offer better services but at a high cost. As of the time of writing this article, a single consultation in a private hospital can range from 10,000 to 50,000 Naira ($7 to $32), a significant sum in a country where the minimum wage is 30,000 Naira ($19) per month and 40% of its population live on less than $1 a day. For specialized care or surgeries, the costs can run into hundreds of thousands or even millions of Naira, pushing many families into debt or forcing them to forego necessary treatment.

?Health Insurance Penetration

Health insurance is a potential solution to the problem of healthcare affordability, but its penetration in Nigeria remains low. The National Health Insurance Scheme(NHIS) which is now the National Health Insurance Authority (NHIA) was introduced in 2005 to improve access to healthcare, but its coverage is limited. Only about 5% of Nigerians are covered by any form of health insurance, primarily those employed in the formal sector. Hence, the vast majority of Nigerians who work in the informal sector have no access to health insurance and pay for their healthcare out-of-pocket.?

Efforts to expand coverage have been introduced severally but this is hampered by a lack of political will, inadequate funding, and logistical challenges. As a result, many Nigerians continue to face catastrophic health expenses when serious illness strikes.

The Role of the Private Sector

The private sector plays a significant role in the Nigerian health system, filling gaps left by the public sector. Private hospitals, clinics, and pharmacies are more prevalent in urban areas and provide higher-quality services. However, this comes at a cost. Private healthcare is often unaffordable for the average Nigerian, particularly for major medical procedures.

Pharmaceutical costs are another burden. Nigeria imports a large proportion of its medications and medical equipment making them expensive. In addition, the inadequate price regulation of these pharmaceuticals means that prices can vary significantly, adding to the financial burden on patients. Recently, the cost of drugs has doubled and in some cases the prices have gone up excessively, for example Ventolin Inhaler was N2,000($1.3) but it is now N8,000($5).

?Impact on the Population

The high cost of healthcare has severe consequences for Nigerians. Many people delay seeking medical care due to the cost, leading to disease complications and higher long-term costs. Maternal and child health is particularly affected. Nigeria has the second highest maternal mortality rate in the world, partly because many women cannot afford proper prenatal and delivery care. Similarly, childhood illnesses that could be easily treated or prevented with vaccinations often go unchecked, leading to high child mortality rates.

?

Way Forward

Addressing the affordability of healthcare in Nigeria requires a multi-faceted approach. Increasing government spending on healthcare is crucial. Allocating more funds to the health sector can improve infrastructure, supply essential medications, and ensure that healthcare workers are adequately compensated.

Expanding health insurance coverage is another vital step. Making health insurance accessible and affordable to the informal sector would help reduce out-of-pocket expenses and improve access to healthcare services. Implementation of the NHIA 2022 Act such as health insurance been mandatory for all both employed, informal workers and every resident of Nigeria. Public awareness campaigns are also necessary to educate the population on the benefits of health insurance.

The private sector also has a role to play. Improving and harnessing private sector participation in the provision of healthcare services will also improve health coverage. Partnerships between the government and private healthcare providers can help improve service delivery and make healthcare more affordable. Local drug manufacturing should also be supported and pharmaceutical companies and importers encouraged to lower drug prices through subsidies or price regulation. For instance, the federal government ban on foreign importation of syringe to promote local production is also a step in the right direction.

?Conclusion

Healthcare affordability in Nigeria is a pressing issue that requires urgent attention. While the challenges are significant, there are also opportunities for improvement. By increasing government investment, expanding health insurance coverage, and leveraging private sector partnerships, Nigeria can make strides toward a more accessible and affordable healthcare system. Ensuring that every Nigerian has access to quality healthcare is not just a moral obligation but also essential for the country's social and economic development.