Faith-based hospitals in Nigeria: Yay or nay?

A few years ago, my childhood friend who lives in Biu was diagnosed with glaucoma. She was referred to ECWA Eye Hospital for further evaluation and treatment. Since then, every six months, like clockwork, she travels from Biu to Kano for her eye check-up. Her destination is not a government hospital or a private for-profit […]

A few years ago, my childhood friend who lives in Biu was diagnosed with glaucoma. She was referred to ECWA Eye Hospital for further evaluation and treatment. Since then, every six months, like clockwork, she travels from Biu to Kano for her eye check-up. Her destination is not a government hospital or a private for-profit clinic, but the ECWA Eye Hospital, a Christian faith-based facility. My friend Hadiza is a Muslim housewife. She has never once been asked about her religion at the hospital. No one has questioned her beliefs, her mode of dressing, or her prayers. What she talks about, instead, is the care she receives:  attentive doctors, courteous nurses, functioning equipment, and the reassurance that her eyes are in safe hands.

That quiet, unremarkable story is worth telling today.

Last week, the United States Embassy in Nigeria announced a five-year, $5.1 billion bilateral health cooperation Memorandum of Understanding with the Federal Government of Nigeria under the America First Global Health Strategy. Of this amount, the United States intends to commit nearly $2.1 billion in health assistance, while Nigeria is expected to invest close to $3 billion in domestic health spending over the same period. It is the largest co-investment signed under the framework so far.

The stated objectives are familiar and largely uncontroversial: strengthening surveillance and outbreak response, improving laboratory systems, supporting frontline health workers, expanding access to HIV, tuberculosis, malaria, polio, and maternal and child health services. Nothing new, Nigeria needs all of this. With one of the highest maternal and child mortality rates in the world and nearly 30 per cent of the global malaria burden, our health system does not have the luxury of rejecting support.

What has generated unease, however, is the explicit emphasis on Christian faith-based healthcare providers. The MOU allocates about $200 million to strengthen Christian hospitals and clinics, recognising their role in delivering care to underserved communities. Nigeria has more than 900 such facilities, reportedly serving over 30 per cent of the population, often in areas where government services are weak or absent.

Ah! As soon as that came out, Nigerian Muslim clerics started to convulse! Hian! Christian-based hospitals? Mogbe! We are finished!

For some, this framing raises understandable concerns. In a country as religiously plural as Nigeria, any policy that appears to privilege one faith over another is bound to be scrutinised. History has taught us to be cautious, especially when foreign assistance intersects with sensitive identity lines.

But healthcare, at its best, has always defied those boundaries.

In Kano, countless Christian patients seek care at Makkah Eye Hospital, an Islamic faith-based institution. Others receive treatment at Ahmadiyya hospitals. These facilities do not ask patients to recite creeds before treatment. They ask about symptoms, not sects. The ethic that guides them is simple: illness does not discriminate, so care should not either. The same way Muslims flock to ECWA Eye Hospital for treatment is the same way Christians troop to Ahmadiyya Hospital; and all patients are seen fairly.

This is the reality on the ground that often gets lost in policy debates.

Faith-based hospitals, both Christian and Muslim, have long filled critical gaps in Nigeria’s health system. They train health workers, provide subsidised services, and remain operational in difficult terrains where public facilities struggle. If some of these hospitals are better equipped, better staffed, and better supported, patients benefit. A functioning operating theatre does not become less lifesaving because it located is within a church compound.

That does not mean concerns should be dismissed. Transparency matters. Equity matters. National ownership matters. If Muslim groups feel excluded by the current structure of the MOU, the response should not be to undermine support for Christian facilities, but to expand the conversation. Nothing prevents Islamic international organisations like the Islamic Development Bank and rich oil-producing countries like Saudi Arabia, Qatar, and others from reinforcing Muslim faith-based health institutions in Nigeria in a complementary way. Health diplomacy does not have to be zero-sum.

What Nigeria should insist on is fairness in outcomes: that investments, regardless of their source, translate into better access, improved quality, and stronger systems for all Nigerians. That services funded under any agreement remain open to all patients, without discrimination. That accountability mechanisms apply uniformly, whether funds flow to public hospitals, Christian facilities, or Islamic ones.

It is also worth noting that this MOU is not a charity. It is a negotiated agreement tied to broader geopolitical interests, including expectations around security and the protection of vulnerable communities. Nigeria must engage it with clear eyes, safeguarding sovereignty while maximising benefit to its people.

At the end of the day, patients do not arrive at hospitals carrying policy documents or diplomatic talking points. They arrive with failing eyesight, labour pains, feverish children, and chronic coughs, and they want relief, dignity and care.

If a Muslim woman from Biu can receive excellent treatment at a Christian hospital without prejudice, and Christians can find healing in Islamic facilities in Kano, then perhaps the lesson is already before us. Health, when done right, can still be one of the few spaces where Nigeria gets pluralism right.

If the hospitals are going to be equipped, then why not? If ECWA hospital receives support to carry out high-falutin retinal surgery and it is accessible to all, then what is the problem?

What matters most is that the doors remain open, the care remains humane, and the outcome is a win for patients above all else.

That, surely, is the cooperation that truly counts.