Nigeria’s ongoing health-sector reforms are facing a crucial test as government, civil society organisations and other stakeholders focus on whether new policies and investments are translating into better healthcare for citizens.
The debate formed part of a mid-term review of the country’s health reform programme, where stakeholders assessed progress under the Health Sector Renewal Investment Initiative (NHSRII) and examined the challenges still affecting healthcare delivery.
The Coordinating Minister of Health and Social Welfare, Professor Muhammad Ali Pate, said the Federal and state governments must take greater responsibility for sustaining the reforms rather than depending indefinitely on development partners.
Pate acknowledged that transforming Nigeria’s health system would not happen within a short period, stressing that rebuilding the sector required sustained commitment and coordination between different levels of government.
He said the Federal Government was adopting a more coordinated approach involving federal and state authorities, development partners and civil society, while maintaining government responsibility for health outcomes.
Civil society highlights remaining gaps
Civil society organisations participating in the review said the reforms were progressing but warned that the gains needed to be institutionalised and translated into measurable improvements in people’s access to healthcare.
They identified high out-of-pocket spending, delayed release of health funds, fragmented financing and continued reliance on external funding as some of the challenges requiring attention.
The groups also raised concerns over maternal and child health, immunisation, nutrition and family planning.
They cited data from the 2023–24 Nigeria Demographic and Health Survey showing that while 79 per cent of women received antenatal care from a skilled provider, only 43 per cent had four or more antenatal visits. The survey also indicated that 50 per cent of births were assisted by a skilled provider.
On childhood vaccination, the organisations said only 39 per cent of children aged 12 to 23 months had received all basic vaccines, while 14 per cent had received none.
Focus on primary healthcare
The CSOs called for greater accountability in health financing and urged authorities to ensure that approved funds are released on time and can be tracked through to individual health facilities.
They also said primary healthcare reform should go beyond renovating buildings.
According to the groups, functional facilities need adequate health workers, essential medicines, diagnostic equipment, reliable electricity and water supplies, infection-prevention systems and effective referral arrangements.
They proposed closer alignment between health policies and the National Health Act 2014, including the development of an implementation framework that clearly identifies responsibilities, gaps and timelines.
Government points to ongoing investments
The Federal Government has continued to highlight investments in health infrastructure, workforce development, financing and digital systems as part of the reform programme.
The Ministry of Health and Social Welfare said more than 37,000 health workers had been recruited across federal health institutions since 2023, while more than 70,000 frontline workers had received training.
Government has also reported funding for thousands of primary healthcare centres through the Basic Health Care Provision Fund and efforts to expand health insurance coverage.
The government has further promoted domestic production of medicines and medical supplies through initiatives aimed at strengthening Nigeria’s healthcare value chain.
Digital health is another area of the reform agenda, with the Federal Government promoting an interoperable digital health system intended to improve access to patient information and service delivery.
The key question remains implementation
While government officials point to policies, funding and infrastructure projects as evidence of progress, civil society groups argue that the ultimate measure of reform should be whether Nigerians can access affordable, quality healthcare when they need it.
The mid-term review therefore places renewed emphasis on implementation, accountability and measurable outcomes as Nigeria continues its efforts to reform a health system facing longstanding challenges in financing, workforce availability, infrastructure and access to care.
Stakeholders have called for sustained government commitment to ensure that the reforms translate from policy documents and investments into improvements that are felt directly by patients and communities.
