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The Trouble With Nigeria’s Healthcare System

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affordable healthcare services

By Michael Owhoko, Ph.D

The quality of a country’s healthcare system is a mirror image of its leaders’ commitment to citizens’ health.  Countries like Singapore, Japan, South Korea and Switzerland are among the world’s top countries with best healthcare for citizens, driven majorly by robust funding and well-structured policy programme. Leaders in these countries do not go to foreign countries for medical tourism, as they have absolute confidence in the delivery capacity of the healthcare system.

But in Nigeria, the healthcare system is fraught with dysfunctionality, forcing elasticity of reliability southward. Poor health facilities, unprofessionalism, unethical standards, weak regulatory agencies, bad personnel attitude, questionable health insurance schemes, unreliable health management organisations (HMOs), mismanagement, corruption, fake drugs and obsolete equipment are incidental to lack of commitment by Nigerian leaders to efficient and quality healthcare system.

Though, this is a symptom of greater disorders in Nigeria, poor funding and non-utilisation of health facilities by the ruling elites undermine efficiency, quality and delivery capacity of the healthcare system.  Why will leaders not trust and utilize the healthcare system they have built, equipped and made available to the people through funding? When food is served to public by a provider who has no intention of eating, there is high probability that quality and hygiene may be compromised.

In the 2025 federal government budget, only N2.56 trillion was budgeted for the health sector, representing 5.15 percent of the country’s total budget of N49.7 trillion, which is far below the 15 percent recommended by the Abuja Declaration, to which Nigeria is a signatory. Though, the N2.56 trillion is an increase of about 58.53 percent of the 2024 budget of N1.62 trillion, however, when viewed in dollar terms, the amount decreased by 15.45 percent, dropping to $1.7 billion from $2.02 billion.

Since the famous coup speech of late General Sanni Abacha on December 31, 1983 that the country’s health services were in shambles, and hospitals had been reduced to mere consulting clinics without drugs, water and equipment, the health sector has not shown promises of improvement. Even 34 years after, the wife of late President Muhammadu Buhari, Aisha, confirmed this in 2017 when she resorted to use of a private hospital wholly owned and run by foreigners due to dysfunctional x-ray machine and lack of syringes in the Villa Clinic.

Unfortunately, 42 years after these observations were made by the powers that were, the healthcare sector is still defined by lack of government’s commitment.  This is particularly worrisome when viewed against the background of Nigeria’s growing population, currently characterized by low life expectancy, high maternal and child mortality rates.  This means that dependable and quality healthcare provision is not a priority for government, and therefore, a mirage for Nigeria to achieve high quality healthcare in line with World Health Organisation (WHO)’s standard.

Globally, Nigeria is ranked 157th out of 191 countries by WHO in the areas of quality health delivery performance. As the largest oil producer in Africa and 16th largest in the world, it is untenable for Nigeria not to provide robust funding for the health sector, given the country’s huge earnings from crude oil sales.

Even among African countries, Nigeria is rated poorly in healthcare provision.  In a report released by The Legatum Institute, a London-based global healthcare assessment organization, Nigeria was ranked 11th out of 12 African countries with poor healthcare system.  The countries include Central African Republic, South Sudan, Chad, Lesotho, Somalia, Sierra Leone, Swaziland (Eswatini), Liberia, Guinea, Angola, Nigeria and Equatorial Guinea.

Despite this poor performance ranking, no concerted effort is being made by government to improve quality service delivery, as budget allocation to the health sector has been on the downward swing.  Since Nigerian leaders who determine the condition of the sector, do not utilize the facilities due to poor services, it means the Nigerian healthcare system is designed to service the health needs of the poor and common Nigerians, and not Nigerian leaders.

Put differently, the healthcare system in Nigeria is determined and conditioned by the thought process and preferences of those who do not use the services.  For example, the President of the Federal Republic of Nigeria and his cabinet members, including the Minister of Health, together with the Senate President and members of the Legislature, who approve the nation’s tertiary healthcare budget, do not patronize services of Nigerian hospitals.

State governors and their cabinet members, as well as members of the state houses of assembly responsible for approval of budget for secondary healthcare in the country, also, do not patronize health facilities at this level. Same applies to the various local government chairmen and council members whose jurisdiction cover primary healthcare. They all seek better healthcare outside their domains.

The poor premium placed on the health sector by Nigerian leaders have obviously prevented them from knowing that there is a correlation between robust funding of healthcare system and a healthy workforce, and by extension, robust economy.  A vibrant economy is contingent upon a healthy population and a healthy workforce, as health is a critical contributory factor to economic development.  This is the reason advanced economies invest so much in healthcare services, a contrast to Nigeria’s healthcare sector that is troubled by incapacity, unable to address mounting health challenges in the country.

The healthcare delivery system in Nigeria is executed through public and private facilities.  Unfortunately, the private healthcare providers are also enmeshed in unprofessional conduct driven by pecuniary motive.  Most of them take advantage of the country’s weak systemic policies to deliver poor health services.Regulatory authorities like the National Agency for Food and Drug Administration and Control (NAFDAC), National Health Insurance Authority (NHIA), and The Medical and Dental Council of Nigeria (MDCN) are not doing enough to enforce professionalism and standards in the country’s healthcare system.

I recently lost a friend to prostrate operation in one of the private hospitals in Lagos.  Prior to the operation, he walked into the hospital by himself, looking normal.  But what he took to be a proactive step to avoid future complications, ended his life.  He was admitted under a health insurance cover managed by an HMO on executive plan with full options.  But rapid deterioration of his health in the hospital triggered skepticism on whether quality of treatment was commensurate with subscribed insurance plan.

There are numerous public complaints about HMOs conniving with private hospitals to render inadequate and poor services for financial gains.Most of these hospitals deliberately delay diagnosis and treatment until approval is obtained from HMOs, notwithstanding conditions of patients and category of insurance plans. The NHIA which carries out accreditation of HMOs before approval must look beyond this process to ensure they are continually monitored during operations.

My late friend’s case reminded me of a professional colleague, Mr. Yusuph Olaniyonu, who narrated how God spared his life and given another chance to live again at 58.  His story brought to fore, the ineptitude, inefficiencies, unprofessionalism and lack of commitment and management of patients in Nigerian hospitals.His experience also proved that without connection at the top, patients can die out of share negligence and abandonment without consequence.

After undergoing six major operations and three minor procedures for prostrate, his survival was still on a cliff edge, necessitating the intervention of the Minister of Health through the help of ThisDay Publisher, Nduka Obaigbena and former Senate President, Bukola Saraki.  This intervention notwithstanding, hopes dimmed, leading Saraki to fly him to Egypt where he underwent successful corrective surgical operations.

Olaniyony’s case casts aspersion on the entire medical system in Nigeria, and exposed the agony voiceless Nigerians go through in Nigerian health facilities.  Trust deficit induced by poor services in Nigerian hospitals, has given rise to patronage of unlicensed and quack herbal health practitioners whose activities are damaging vital organs of innocent Nigerians, with concomitant reduction in life expectancy.

It is depressing to know that out of about 34,000 general hospitals, 21,000 primary health centers and 60 teaching hospital and federal medical centers located across the country,only about 41,000 hospitals are functional.

Government must therefore reorder its priorities to make health facilities efficient, affordable and reliable to enable both leaders and poor Nigerians alike to receive treatment in-country, as against resort to medical tourism which cost Nigeria approximately $1.6 billion annually.

Dr Mike Owhoko, Lagos-based public policy analyst, author, and journalist, can be reached at www.mikeowhoko.com, and followed on X {formerly Twitter} @michaelowhoko.

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Investing in Women-Led Enterprises Is a Growth Strategy Nigeria Can’t Afford to Delay

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Women-Led Enterprises Vivian Imoh-Ita

By Vivian Imoh-Ita

Across African banking, the conversation is shifting from “inclusion as intent” to “inclusion as performance.” Margin pressure, recapitalisation conversations, digitisation, and tighter risk expectations are forcing a hard question: where will sustainable, low-volatility growth come from in the next cycle?   One answer is hiding in plain sight: women-led enterprises, underfunded, underserved, and consistently productive.

In Nigeria’s informal economy, where cash flow is real but documentation is uneven, the institutions that win will be the ones that price risk with better signals, distribute at scale, and convert trust into long-term financial relationships. Too often, women’s economic participation is framed as a social commitment rather than a commercial imperative.

That framing is expensive: when we fail to design capital, products, and distribution around the realities of women in business, we don’t just exclude customers, we misprice opportunity and leave growth on the table. Women in Nigeria are not waiting to be “empowered” before they build.

They are already trading, employing, and sustaining households at scale. The real constraint is not capability; it is the fit between how finance is structured and how women-owned businesses actually operate: cash-flow patterns, collateral realities, and the need for speed, trust, and advisory alongside capital.

Three practical frictions show up repeatedly: Collateral versus cash-flow: many viable women-run businesses are cash-generative but asset-light, so collateral-heavy underwriting excludes the very segment banks say they want. Information gaps: when transactions happen outside formal rails, banks see “thin files.”

But thin files are not the same as high risk; they are a data problem that better design and alternative signals can solve. Time-to-cash matters: entrepreneurs often need small, fast working-capital decisions, not slow processes built for corporate cycles.

Speed is a risk tool when it is paired with the right controls. Nigeria has roughly 23 million women entrepreneurs in the micro-business segment, one of the highest rates of female entrepreneurship globally.

Women account for 41% of  SME ownership, and SMEs contribute nearly half of the national GDP. Yet access to formal finance remains disproportionately low: women receive only about 10% of loans from financial service providers, and an estimated 98% of women entrepreneurs still lack access to formal credit.

An internal strategy analysis drawing on EFInA/Global Findex/SMEDAN data shows a structural gap: 41% of Nigerian women are financially excluded (vs 33% for men), and while 39% of women borrowed from multiple sources, only 4% accessed a bank loan.

Across Africa, the financing gap for women-led businesses is estimated at $42 billion. This is not a “nice-to-have” agenda. McKinsey Global Institute’s The Power of Parity estimates that advancing women’s equality could add up to $12 trillion to global GDP.

The IMF has estimated that equal participation by women could lift GDP by as much as 40% in some countries. For Nigeria, an analysis cited by the Council on Foreign Relations, drawing on McKinsey’s data, projects that closing the gender gap in economic participation could increase GDP by 23%.

For banks, the implication is straight-forward: women-led enterprises are not a niche; they are a mass-market growth opportunity. Unlocking it requires moving from “product availability” to “product usability”: cash-flow-based lending, simpler onboarding, distribution through digital and agent rails, and trust-by-design (clear pricing, consumer protection, and strong data privacy). Usage is what creates the data to lend responsibly at scale.

There is also a practical reason the returns are outsized: women tend to reinvest more of what they earn into their families and communities, often cited as up to 90%, driving a multiplier effect that shows up in education, health outcomes, and local employment.

For financial institutions, that multiplier is not just a story; it is a durable pathway to deposit growth, transaction volume, credit performance, and long-term customer value. I have seen this play out across Nigeria, in every state and market. The woman selling clothes in Balogun Market employs three other women and sends five children to school.

The general merchandise trader in Onitsha Market is the economic anchor of her extended family. Each of these women is a multiplier, and each of them started with someone, somewhere, giving her a loan, a skill, an opportunity, a chance. That is the “Give to Gain” principle made real. Giving is not a subtraction. It is, as this year’s IWD campaign puts it, intentional multiplication.

At Union Bank, we treat women’s financial inclusion as a core product strategy, not CSR, because the commercial logic is clear. When a woman builds financial capability, she doesn’t just open an account. She saves,  transacts, borrows responsibly, expands her business footprint, and brings others with her.

We also understand that distribution is a strategy. Union Bank’s UnionDirect agency banking network operates over 58,000 agents across rural and underserved communities, extending access to deposits, withdrawals, and micro-lending where branches cannot cover the economics.

We have also disbursed over  N50 billion in micro-lending to smallholder farmers, market women, and informal entrepreneurs, because inclusion only becomes real when it is usable, frequent, and local.

In a market where a large share of working women operates in the informal sector, bringing women into the formal financial system through savings, digital banking, micro-lending, and insurance is a material growth frontier. Multiple studies across emerging markets also show women often have lower default rates than men, reinforcing what many banks observe in practice: disciplined cash management and strong repayment culture when products are designed around real operating conditions.

That is why we created alpher, Union Bank’s women’s banking proposition launched in 2020 and aligned with SDG5 on Gender Equality. Alpher is designed for the Nigerian woman, whether she is an entrepreneur, a working professional, or managing household finances. For women in business, alpher combines tailored loans and savings plans with capacity-building, mentorship, and practical masterclasses, because capital without capability yields fragile outcomes. alpher is built around a simple promise: practical financial solutions, support systems, savings and investment options,   discounted loans,   personal and professional development,  mentorship/coaching/networking, discounted healthcare plans,  and lifestyle/business discounts.

Operationally, we segment customers into individuals (professionals and entrepreneurs), women-led organisations, and organisations that support women in their workforce and supply chains. Hence, the service is relevant, not generic.

Practically, that has meant designing access to credit with reduced collateral requirements, recognising that traditional collateral models were not built around women’s asset ownership patterns.

It has also meant investing deliberately in skills, entrepreneurship, bookkeeping, pricing, digital commerce, and personal finance, so that funding translates into resilience, not just activity.

One initiative I am particularly proud of is the alpher Fair. In this marketplace concept, we open our premises (and those of partners) to women entrepreneurs to sell directly to customers, employees, and partner networks.

It creates immediate market access, strengthens visibility, and proves a simple point: scaling women-owned businesses is often about building pipelines of customers, information, and trust, not just issuing loans. Beyond our own programmes, we partner to scale outcomes.

In May 2025, through alpher, Union Bank sponsored the Nigerian British Chamber of Commerce (NBCC) Women and Youth Entrepreneurship Development Centre (WYEDC) Cohort 2 Programme, which graduated 125 entrepreneurs who benefited from entrepreneurship training and business grants.  At the graduation, we hosted a pitch segment that awarded funding to standout entrepreneurs. This is the point: capability building is not “soft.”

It is pipeline development for stronger businesses and better credit outcomes. Importantly, alpher sits within Union Bank’s broader retail and SME ecosystem, loan products, business advisory, digital payment infrastructure, and growth workshops, so customers can access funding, learn how to deploy it, connect to mentors and peers, and gain visibility for their businesses.

The objective is straightforward: build businesses that last. The next phase of banking growth in Nigeria will favour institutions that translate insight into design products that reflect customer reality, distribution that meets customers where they are, and risk models that recognise performance beyond legacy collateral. Backing women-led enterprise is not a campaign; it is a competitive advantage.

The forward-looking question is whether we will build the rails, capital, capability, digital trust, and market access fast enough to earn the growth already waiting in plain sight. If we are serious about inclusive growth, we should be equally serious about inclusive balance sheets and about building the underwriting, data, and distribution models that make inclusion commercially sustainable.

Vivian Imoh-Ita is Head, Retail & SME Business at Union Bank of Nigeria, with a focus on building retail and SME propositions that drive inclusion, growth, and long-term customer value

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Why the Camera is the Nigerian Marketer’s Biggest Untapped Asset

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Olumide Balogun Most Searched Questions on AI

By Olumide Balogun

Picture this scenario. You are at a fun party in Lagos. Amidst the sea of colourful jackets and perfectly tailored pants, you spot a guest wearing a pair of striking sneakers that perfectly blend modern streetwear with traditional Aso-Oke fabric. You want to buy a pair immediately. The music is loud, and the guest is across the banquet hall. A few years ago, you would simply have to wonder who made them. Today, you pull out your smartphone, tap the camera icon in your search app, and snap a quick photo. Within seconds, the technology identifies the exact local designer, shows you product reviews, and provides a direct link to their online store.

As the great Chinua Achebe famously wrote, “The world is like a Mask dancing. If you want to see it well, you do not stand in one place.”

The modern Nigerian consumer has certainly moved. They are actively experiencing the world visually, turning their smartphone cameras into their primary shopping tool. Nigerians are highly optimistic about this technological shift. In fact, 80% of Nigerians are more excited about the possibilities of AI, versus just 20% who are more concerned. This enthusiasm translates directly to commerce and innovation. Currently, 80% of Nigerians are using AI to explore a new business or career change, nearly double the global average of 42%. For Nigerian marketers, understanding this shift is the exact key to unlocking unprecedented business growth.

We are witnessing a massive transformation in how people consume media and discover products. YouTube watch time in Nigeria recently jumped by over 55% year over year. Our incredibly young, digital native population is actively redefining the media landscape by immersing themselves in video and visual content. Consequently, they are moving rapidly toward visual and video-led discovery.

The Rise of Visual Search. The modern Nigerian shopper uses their camera to ask questions. Globally, Lens is used for over 20 billion visual searches every month. Features like Circle to Search and video understanding allow users to interact with their surroundings instantly.

A shopper can now circle a fashion item they spot in a social media video or use their camera to scan a product in real life to find out more. Gen Z consumers are leading this charge. They use visual search to effortlessly discover products they cannot easily describe with words. They see something they love, and they use their camera to find it.

Making the Real World Shoppable. This visual behaviour creates a powerful new reality for retail. Imagine a consumer walking through a busy mall and spotting a stylish backpack in a store window. They simply tap the Lens icon on their phone and snap a photo. Instantly, they see a highly helpful results page showing product reviews, price comparisons across different retailers, and direct links to buy.

Google is integrating Shopping Ads directly into these visual search results. Advertisers can now connect with highly motivated shoppers at the exact moment their interest is piqued. The opportunity for businesses is immense, considering 1 in every 4 visual search queries done using Google Lens has a commercial intent. Your product can appear right alongside the items people are photographing out in the real world, turning everyday inspiration into immediate sales.

Video as the New Storefront. This visual revolution extends directly into online video. With YouTube becoming the primary screen for many Nigerians, video serves as the new digital storefront. Consumers turn to YouTube to discover trends, learn new skills, and make confident purchase decisions based on trusted creator reviews.

Brands must capture customer interest while users are deeply engaged in this video content. Google’s Demand Gen campaigns make this process highly effective. These AI-driven campaigns take your best video and image assets and automatically serve them across YouTube and other visual platforms. The results speak for themselves. Advertisers are more likely to say Google Search and YouTube drive business growth more than any other paid advertising platforms.

Step Into the Frame The language of commerce is increasingly visual. Nigerian consumers are already using their cameras and screens to navigate their shopping journeys. Marketers who embrace this visual commerce revolution will build stronger, more profitable connections with their audiences.

By optimising your visual product assets, leveraging AI tools like Demand Gen, and preparing for ads in visual search, you position your brand right at the heart of the modern shopping experience. The camera is the most powerful tool in your customer’s hand today. It is time for your business to step into the frame.

Olumide Balogun is the Director for Google West Africa

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5 Wealth-Building Strategies for Nigerian Women-led Businesses

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Chinwe Iwobi Wealth-Building Strategies

By Chinwe Iwobi

In Nigeria, women are the backbone of our economy. Data from the National Bureau of Statistics shows that women own approximately 40% of small and medium-sized enterprises across the country (NBS Country Data Overview 2023). Yet despite their outsized contribution to GDP, women-led businesses continue to face systemic barriers to the capital and financial infrastructure needed to scale.

The cost of that gap is not abstract. When these entrepreneurs are held back, the ripple effect runs deep, from household stability to the education of the next generation. But the narrative is shifting. Nigerian women are proving, consistently, that they are not just resilient; they are sophisticated, high-earning innovators building businesses that deserve serious financial strategy.

Here are five foundational strategies every women-led business should be deploying to build lasting, generational wealth.

  1. Separate Business and Personal Finances Without Exception

Mixing personal funds with business cash is one of the most common and most damaging financial habits I see among growing entrepreneurs. It obscures your true profit margins, makes tax planning nearly impossible and, critically, disqualifies you from accessing formal credit when you need it most.

The discipline of separation is not just administrative. It is the first signal you send to the financial system that your business is serious. Open a dedicated business account, maintain clean transaction records, and treat your business finances with the same rigour you would expect from any enterprise operating at scale. Clarity on your numbers is the foundation on which every other strategy here depends.

  1. Build Both an Emergency Fund and an Opportunity Fund

Most financial advice stops at the emergency fund, which is three to six months of operating expenses set aside for lean periods. That is necessary, but insufficient. The entrepreneurs I have watched grow most aggressively also maintain what I call an opportunity fund: accessible liquidity specifically reserved to move fast when a prime supplier deal, an expansion location, or a bulk inventory discount appears.

In an unpredictable market like Nigeria’s, the businesses that scale are rarely the ones with the best products alone. They are the ones with the financial readiness to act decisively. Products like FairMoney’s FairSave are designed precisely for this, keeping your funds accessible while earning competitive daily interest so your idle cash is working even when you are not. Build both buffers, and build them before you think you need them.

  1. Invest Profits Back into Revenue-Generating Assets

Surplus cash sitting in a current account is a slow leak. Inflation erodes it, and opportunity costs compound quietly. The discipline here is to consistently channel profits back into assets that grow your revenue capacity, whether that is new equipment, improved technology, better inventory systems, or staff training.

For capital you do not need immediately, consider locking it into a fixed-term savings product that offers higher interest returns. The psychological benefit is as important as the financial one: ring-fencing that capital removes it from day-to-day spending temptation and ensures it is preserved and grown for a defined purpose. Discipline in capital allocation separates businesses that plateau from those that compound.

  1. Diversify Your Revenue Streams Intentionally

Single-stream businesses are inherently fragile. If your sole revenue source is disrupted by market shifts, a supply chain breakdown, or a change in consumer behaviour, your entire operation is exposed. Resilience is built by design, not by accident.

If you are in retail, consider adding a service-based arm. If you are service-led, explore whether digital products or training offerings could create passive income alongside your core work. Beyond product diversification, consider how you accept payments. Building a verified, diverse transaction history through formal payment channels also quietly strengthens your credit profile, an asset that pays dividends when you approach lenders for growth financing. FairMoney’s Business POS infrastructure, for instance, allows entrepreneurs to expand their payment reach while simultaneously building that financial track record.

  1. Invest Beyond the Business

This is the strategy most women entrepreneurs delay for too long, and it is the one I feel most strongly about. Relying entirely on your business for your net worth is a high-risk position, no matter how well that business is performing. Businesses face cycles; personal wealth should not.

As your business stabilises, begin systematically moving a portion of your profits into personal investment vehicles such as long-term savings accounts, money market funds, or other instruments that sit entirely outside the business cycle. Automate it if you can, so the decision is made once and executed consistently. The goal is to build a personal financial foundation that remains intact regardless of what your business goes through in any given quarter. True wealth is not what your business is worth on paper. It is what you own independently of it.

The Bigger Picture

For female entrepreneurs in Nigeria, wealth-building is not simply a personal ambition; it is an economic argument. When women-led businesses scale, communities stabilise, households invest in education, and local economies deepen. The strategies above are not complicated, but they require consistency and the right financial infrastructure to execute well.

The tools exist. The opportunity is real. What remains is the decision to treat your business, and your personal wealth, with the long-term seriousness both deserve.

Chinwe Iwobi is the Head of Wealth Management at FairMoney Microfinance Bank

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