Nigeria’s broken health system

Nigeria’s public health system is in a state of systemic breakdown, a slow-burning crisis that now threatens the very survival of millions. What is unfolding in hospitals across the country is not just dysfunction; it is an epidemic of inefficiency, neglect and human suffering of alarming proportions. Recent findings by Daily Trust painted a painful […]

Nigeria’s public health system is in a state of systemic breakdown, a slow-burning crisis that now threatens the very survival of millions. What is unfolding in hospitals across the country is not just dysfunction; it is an epidemic of inefficiency, neglect and human suffering of alarming proportions.

Recent findings by Daily Trust painted a painful picture as patients now spend between five and seven hours, and in some cases, days, waiting to see a doctor in public hospitals. In rural areas, the delays are even more harrowing, with some patients making repeated trips over several days before receiving care. This is not just an inconvenience; it is a collapse of a system that is meant to preserve life.

At the core of this crisis lies a fundamental distortion of Nigeria’s healthcare structure. Primary healthcare centres, which should serve as the first line of defence, have all but failed. Ill-equipped, understaffed and in many cases abandoned, these centres can no longer handle even the most basic ailments. Therefore, general hospitals, federal medical centres and teaching hospitals are now overrun by patients suffering from minor conditions.

A national daily, the Guardian, recently reported that 85 per cent of Nigeria’s Primary Healthcare Centres (PHCs) are in distress and lack doctors, despite N55.44 billion in disbursements between 2022 and early 2025. Key findings, according to the newspaper, show 61 per cent lack nurses/midwives, 38 per cent lack water, and 40 per cent lack functional labs, leaving thousands of Nigerians without basic care.

Facilities that should be focused on specialised and critical care are instead clogged with cases of malaria, infections and routine illnesses. This misplacement of responsibility has overwhelmed the system, leaving those with life-threatening conditions to compete for attention in overcrowded wards.

The crisis is further compounded by an alarming exodus of healthcare professionals. As of 2024–2025, over 50,000 Nigerian-trained doctors are practising abroad, with thousands leaving in just the past year alone. The United Kingdom alone hosts more than 12,000 Nigerian doctors, with many others in Canada, the United States and the Gulf.

This “Japa” phenomenon is not merely about the allure of better opportunities abroad; it is a direct response to the harsh realities at home. Doctors in Nigeria are overworked, underpaid and forced to operate in environments that lack basic infrastructure. The doctor-to-population ratio has fallen drastically below global standards, leaving the few who remain to shoulder an unbearable workload.

In some hospitals, a single doctor attends to dozens of patients daily, often working long hours with little rest. Burnout is inevitable. Fatigue compromises judgement, increases the risk of errors and ultimately endangers patient lives. Yet, despite these conditions, many doctors continue to demonstrate remarkable dedication, often going beyond their duties to assist patients, even contributing personal funds in some cases.

Still, dedication alone cannot sustain a broken system. The crisis in Nigeria’s health sector is, by many measures, as severe as the challenges facing the country’s security architecture, if not worse. Yet, it continues to be downplayed by political leaders, treated with a levity that is both troubling and dangerous. Some states have declared states of emergency in the sector, but such declarations have yielded little tangible improvement.

Evidently, Nigerians are still waiting to see comprehensive data that evaluates the success or impact of the federal government’s subsidy programmes on caesarean sections (C-sections) or kidney dialysis, which have been rolled out several months ago. For now, information on these issues tends to be sporadic, anecdotal, or limited to policy announcements rather than rigorous outcome assessments.

The federal government, through initiatives like the National Health Insurance Scheme (NHIS) and state-level programmes, has aimed to subsidise maternal health services, including C-sections. So far, little is known about accountability on these initiatives.

While the number of hospitals has increased, many were established for political convenience rather than as part of a coherent, sustainable healthcare strategy. Today, many of those facilities cannot even pay their basic bills, let alone provide quality care.

For millions of Nigerians, particularly the poor, healthcare has become an unaffordable luxury. The irony of the phrase “health is wealth” has never been more evident. Those who lack financial means are effectively locked out of the system.

Many breadwinners, faced with the harsh reality of limited income, now forgo hospital visits altogether, choosing instead to use what little they earn to feed their families. Others resort to self-medication or unregulated herbal remedies, including for life-threatening conditions such as diabetes, cancer, and kidney or liver diseases. It is a dangerous gamble, but for many, it is the only option.

Even where some relief exists through health insurance schemes, the coverage remains limited. The reality is that a vast majority of Nigerians operate within the informal sector and pay for healthcare out of pocket. With the cost of drugs skyrocketing, despite repeated pronouncements by the government to address the issue, even basic treatment is now beyond the reach of ordinary citizens.

Meanwhile, those in positions of power continue to insulate themselves from the consequences of a failing system. Public officials and the wealthy routinely seek medical care abroad, often using resources that could have been invested in strengthening local healthcare.

What Nigerians are left with is a system where survival often depends on chance. Public hospitals are overstretched, private clinics are expensive, and alternative options are largely unregulated. Patients are left to navigate this chaotic landscape on their own, often with devastating consequences.

The tragedy is that Nigerians are not asking for the impossible. They are not demanding world-class facilities overnight. They are simply asking for a system that works; a system where a sick child can see a doctor without waiting an entire day; where a pregnant woman does not risk her life because no doctor is available; where illness does not automatically translate into financial ruin.

Reversing this crisis will require more than policy pronouncements. It demands genuine political will, sustained investment and a fundamental shift in priorities. Primary healthcare must be revived. Healthcare workers must be adequately compensated and supported. Drug prices must be regulated, and access to health insurance expanded.

Above all, there must be accountability.