Healthcare deficits and the limits of Nigeria’s growth ambitions, by Adaobi Obiabunmuo

In this piece, Dr Obiabunmuo contends that Nigeria’s economic growth ambitions are undermined by weak healthcare systems and poor productivity, arguing that without prioritizing healthcare reform, accountability, and proper investment, Nigeria cannot achieve sustainable growth or improved national productivity.

It is no more news that Nigeria mostly consumes what it does not produce and mostly produces what it does not consume. As the country’s population outpaces the capacity of the economy to provide for everyone, it is important to reverse this trend. The question is how.

At the recent African Business Convention in Lagos on Tuesday, 3 February 2026, Raymond Omachi, the Permanent Secretary of the Federal Ministry of Finance (who represented the Minister of Finance and Co-ordinating Minister of the Economy, Wale Edun), claimed the country was on the path to achieving sustainable growth of at least seven per-cent by 2027/28. He attributed this to structural reforms.

This may sound impressive but even a contingent, annual growth rate of seven per-cent of GDP will be inadequate to match or provide for Nigeria’s population growth rate of 3.2 per-cent. Nor can it be assumed that the benefits of this rate of growth, even if it were to materialize, will accrue in equity to everyone or everywhere in the country.

This fact calls attention to the need for the government to address the financing of essential public goods. Among these, healthcare provision ranks as the most critical. In 2023, the International Labour Organization (ILO) cautioned that health spending has long-run impact on economic growth and productivity.

To improve the health outcome for the population nearly 40 years ago, then Minister of Health, Professor Olikoye Ransome-Kuti, launched the first comprehensive National Health Policy in 1988. Then, less than 35% of Nigeria’s population had access to basic health services.

With its emphasis on Health for All, the World Health Organisation (WHO)’s Alma-Ata Declaration of 1978 identified primary health care as a basic human right and essential anchor for achieving Health for All. Nigeria anchored its National Health Policy on access to basic health as a right not charity. In Nigeria, this right is honoured in breach.

The Primary Health Centre (PHC) is the first level of contact of individuals, the family and community in any national health system. Under the stewardship of Professor Ransome-Kuti as Health Minister in 1992, the country established the National Primary Health Care Development Agency, NPHCDA.

Yet, the suffers a proliferation of non-existent or dilapidated PHC. According to the NPHCDA dashboard, there are 26,711 PHC facilities nation-wide. Katsina State has the highest with 1,724 while Bayelsa State has the least with 221.

Unfortunately, these exist mostly in name only. A 2023 report, for instance, reveals how the lives of residents are at risk from the dilapidated PHCs in Shongom LGA in Gombe State. This is not an isolated case. In 2024, the Guardian highlighted Oyo State, where PHCs gasp for breath. Nigerians die avoidably from pregnancy, violence, Malaria and other preventable diseases because of unavailability of functional PHCs.

According to the WHO, health standards are tools for the achievement of the highest quality of care possible. The WHO assesses national health systems in terms of six building blocks; service delivery, health workforce, health information systems, access to essential medicines, financing, and leadership/governance.

Nigeria scores abysmally in each of these elements. As we enter another election cycle, we must ask: how many politicians will truly prioritize the health of the people or disavow health tourism abroad for themselves and their families? Will healthcare feature at all in their manifestos?

Take service delivery, for instance. It is routine in Nigeria for patients to beg family and friends for medical bills or to resort to crowd-funding through social media. The indignity that comes from this is unspeakable. Quite often, death or disability results while the patients wait to mobilise charity.

Or, consider health financing. The Abuja Declaration, adopted by the Heads of State and Government of the African Union in 2001, set a target of allocating at least 15% of annual budget to the health sector. WHO identifies Nigeria as one of 15 African countries “making insufficient progress” towards realizing this commitment.

In 2025, Nigeria’s federal government appropriated N2.48 trillion for health, about 5.18% of the budget. Unfortunately, the health ministry received only N36 million from the N218 billion capital allocation in the 2025 budget. In 2026, it is down to 5.15% with N3.5 trillion allocated to health sector from a N68.3 trillion budget.

In December 2023, the Tinubu administration launched the National Health Sector Renewal Investment Initiative and was able to secure $2.2B to renovate 17,000 PHCs, train 120,000 frontline health workers, and double national health insurance coverage within three years.

In the second quarter of 2025, the President approved the establishment of 8,800 PHCs but, eleven months thereafter, there is no update on how much progress has been made. During the Ministerial Oversight Committee meeting, Health Minister, Prof. Ali Pate, disclosed that the government approved the disbursement of N32B to health facilities under the Basic Health Care Provision Fund and that the government was on its way to expanding the facilities by an additional 5,000.

Access to essential medicines is no different. The National Bureau of Statistics (NBS) in its 2023 National Health Facility Survey report revealed that only 34.3% of drugs are available in PHCs. This implies that 65.7% of essential medicines are not. With the high cost of medication attributed to the policy reforms by the government and the exit of some multinational pharmaceutical firms, the burden on citizens increased. To cushion the effects of inflation in the health sector, the President, in June 2024, signed an executive order suspending, tariffs, excise duties and Value Added Tax (VAT) on specified pharmaceutical machinery and raw materials. Almost two years after the executive order was signed, progress is unverifiable.

Nigeria’s health workforce and information systems are in disrepair. The problems include corruption, inadequate data for planning, and loss of professionals to trans-national migration. In April 2025, Prof. Ali Pate, disclosed that over 16,000 doctors left Nigeria in the last seven years. Nigeria’s government is unwilling and unable to invest in the retention of expensively trained healthcare professionals.

The state of labour unrest in the sector is a pointer to this fact. The National Association of Resident Doctors (NARD) has been in and out of labour disputes with the federal government, and the Joint Health Sector Unions (JOHESU) only suspended its 84 days strike on 6 February following a conciliation agreement with the federal government.
One of the reasons for the strikes is the failure of government to implement the adjusted Consolidated Health Salary Structure in line with the Consolidated Medical Salary Structure (ConMESS). While health professionals are starved of legitimate remuneration, politicians who should appropriate for their wellbeing profiteer from the patrimony.

Government has a clear and non-negotiable responsibility to improve health outcomes for its people and guarantee access to the safety, health, and overall well-being for all. It is clear that the improvement of Nigeria’s health sector is not a priority for government. With such demonstrable lack of interest in improving national productivity, the likelihood of meeting the national growth targets is low.
Government must ensure that existing health facilities meet stipulated minimum standards and are serviceable. Service conditions for healthcare professionals must be addressed, including adequate remuneration and paid leave. All loopholes in the system must be blocked, and public officials must be held accountable to the people they serve.

Healthcare policy must return to political and policy salience. This alone can guarantee a population healthy enough to power economic growth.

Dr. Obiabunmuo is Programmes Manager at PRIMORG