Feature/OPED
The Trouble With Nigeria’s Healthcare System
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.
By Isah Kamisu Madachi
The news that the Nigerian businessman, Aliko Dangote, plans to expand his business interest into steel production, electricity generation, and port development as part of his broader ambition to accelerate industrialisation in Africa deserves a quick reflection on the promises it carries for Nigeria. It is coming from Dangote at a time when many African countries, including Nigeria, are still struggling with below-average industrial capacity. This move speaks to something important about how prosperity is actually built.
In their Influential book ‘The Prosperity Paradox: How Innovation Can Lift Nations Out of Poverty,’ Clayton Christensen, Efosa Ojomo, and Karen Dillon argue that countries rarely overcome poverty through aid, policy declarations or resource endowments alone. According to them, the effective engine of prosperity has always been market-creating innovations by private and public enterprises that build new industries, generate jobs, and expand economic opportunities for ordinary people.
Even though their theory focuses largely on creating something new or producing it exceptionally, Dangote’s new industrial ambition seems closer to the latter. It is about producing essential things at a scale and efficiency that the existing system has failed to achieve.
Take, for example, the electricity sector in Nigeria. Since the beginning of the current Fourth Republic, billions of dollars have been allocated to power sector reforms, yet electricity supply remains unstable, and many Nigerians still depend heavily on generators to power their homes and businesses. The situation has continued to deteriorate despite the enormous resources committed to the sector by the coming of every new administration.
This is not surprising. In The Prosperity Paradox, the authors explain how nations and even international organisations sometimes keep investing huge resources in certain activities only to realise much later that they were simply hitting the wrong target. The problem is not always the lack of funding; sometimes it is the absence of a functioning market system capable of producing and distributing essential services efficiently.
Seen from this perspective, Dangote’s move into electricity generation may mean more than just an investment. It could be an attempt to tackle one of the most critically lingering bottlenecks in Nigeria’s economic development. If I were to be asked to decide which sector Dangote should begin with in this new industrial plan, I would unhesitatingly choose electricity. It is the most embattled, deeply corrupted and seemingly jeopardised beyond repair, yet the most important sector for the everyday life of citizens.
Stable electricity has the power to transform productivity across every sector. When power supply becomes reliable, small businesses are created, productivity is boosted across all sectors, and households enjoy a better quality of life. Nigeria’s long-standing energy poverty has been strangulating the productive potential of millions of people for decades. Fixing that problem alone would unlock enormous economic possibilities more than expected.
Beyond the issue of productivity, Dangote’s entry into these sectors could also stimulate competition. Healthy competition is one of the most effective drivers of efficiency in any economy. The example of the refinery project already shows how a large-scale private investment can disrupt long-standing structural weaknesses within a sector. A similar dynamic in the proposed sectors could encourage other investors to participate and expand industrial capacity.
Nigeria, by 2030, is projected to need 30 to 40 million new jobs to absorb its rapidly growing population. The scale of this challenge means that the government alone, especially in the Nigerian context, cannot create the necessary opportunities to fill this gap. Private enterprises will have to play a major role in expanding productive sectors of the economy. If supported by the right policy environment, they could contribute significantly to narrowing Nigeria’s widening job gap.
Of course, no single business initiative can solve all structural challenges in the economy. But bold investments of this nature often serve as catalysts for broader economic transformation. With the right support and healthy competition from other investors, initiatives like these could help push Nigeria closer to the kind of industrial foundation that many developed economies built decades ago.
In the end, the lesson is simple: prosperity rarely emerges from policy debates alone. It often begins with large-scale productive ventures that reshape markets, unlock productivity at both small-scale and large-scale businesses, and create direct and indirect economic opportunities for millions of common men and women.
Isah Kamisu Madachi is a policy analyst and development practitioner. He writes via is***************@***il.com
Weddings have always held a special place in African culture. They are more than ceremonies; they are declarations of love, family, identity, and tradition. From the vibrant colours of aso-ebi to the rhythmic sounds of live bands and the emotional exchange of vows, weddings represent a moment of cultural heritage.
In recent years, weddings have gone beyond physical venues. What was once an exclusive gathering for family and friends has transformed into a shared experience for wider audiences. Social media first opened the door, allowing guests and admirers to witness love stories in real time through Instagram posts, TikTok highlights, and YouTube recaps.
And now, television platforms are taking this even further, giving weddings a new kind of permanence and reach.
High-profile weddings, like the widely celebrated union of Adeyemi Idowu, popularly known as Yhemolee (Olowo Eko) and his wife Oyindamola, fondly known as ThayourB, captured massive public attention. Moments from their wedding became a live shared experience on television (GOtv & DStv).
From the high fashion statements to the emotional highlights, viewers were able to feel part of something bigger, a reminder that weddings inspire not just both families but entire communities.
This shift reflects a broader reality: weddings today are content. They inspire conversations about fashion, relationships, lifestyle, and aspiration. They preserve memories in ways previous generations could only imagine. For Gen Z couples, their wedding is no longer just a day; it becomes a story that can be revisited, celebrated, and even inspire others planning their own journey to forever.
Broadcast platforms like GOtv are playing a meaningful role in this transformation. By bringing wedding-related content directly into homes, GOtv is helping audiences experience these moments not just through social media snippets but in real time.
One of the most notable offerings is Channel 105, The Wedding Channel, Africa’s first 24-hour wedding channel, available on GOtv. The channel is fully dedicated to African weddings, lifestyle, and bridal fashion, showcasing everything from dream ceremonies to the realities of married life. Programs like Wedding Police and Wedding on a Budget, and shows like 5 Years Later, offer a deeper look into marriage itself, reminding viewers that weddings are just the beginning of a lifelong journey.
GOtv is preserving culture, celebrating love, and inspiring future couples with this channel. It allows viewers to witness traditions from different regions, discover new ideas, and feel connected to moments that might otherwise remain private.
With platforms like GOtv, stories continue to live on screens across Africa, where love, culture, and celebration can be experienced by all.
To upgrade, subscribe, or reconnect, download the MyGOtv App or dial *288#. For catch-up and on-the-go viewing, download the GOtv Stream App and enjoy your favourite shows anytime, anywhere.
Nigeria is entering a timing-sensitive macro set-up as the oil complex reprices disruption risk and the US dollar firms. Brent moved violently this week, settling at $77.74 on 02 March, up 6.68% on the day, after trading as high as $82.37 before settling around $78.07 on 3 March. For Nigeria, the immediate hook is the overlap with domestic policy: the Central Bank of Nigeria (CBN) has just cut its Monetary Policy Rate (MPR) by 50 basis points to 26.50%, whilst headline inflation is still 15.10% year on year in January.
“Investors often talk about Nigeria as an oil story, but the market response is frequently a timing story,” said David Barrett, Chief Executive Officer, EBC Financial Group (UK) Ltd. “When the pass-through clock runs ahead of the policy clock, inflation risk, and United States Dollar (USD) demand can show up before any oil benefit is felt in day-to-day liquidity.”
Policy and Pricing Regime Shift: One Shock, Different Clocks
EBC Financial Group (“EBC”) frames Nigeria’s current set-up as “policy-lag arbitrage”: the same external energy shock can hit domestic costs, FX liquidity, and monetary transmission on different timelines. A risk premium that begins in crude can quickly show up in delivered costs through freight and insurance, and EBC notes that downstream pressure has been visible in refined markets, with jet fuel and diesel cash premiums hitting multi-year highs.
Market Impact: Oil Support is Conditional, Pass-through is Not
EBC points out that higher crude is not automatically supportive of the naira in the short run because “oil buffer” depends on how quickly external receipts translate into market-clearing USD liquidity. Recent price action illustrates the sensitivity: the naira was quoted at 1,344 per dollar on the official market on 19 February, compared with 1,357 a week earlier, whilst street trading was cited around 1,385.
At the same time, Nigeria’s inflation channel can move quickly even during disinflation: headline inflation eased to 15.10% in January from 15.15% in December, and food inflation slowed to 8.89% from 10.84%, but energy-led transport and logistics costs can reintroduce pressure if the risk premium persists. EBC also points to a broader Nigeria-specific reality: the economy grew 4.07% year on year in 4Q25, with the oil sector expanding 6.79% and non-oil 3.99%, whilst average daily oil production slipped to 1.58 million bpd from 1.64 million bpd in 3Q25. That mix supports external-balance potential, but it also underscores why the domestic liquidity benefit can arrive with a lag.
Nigeria’s Buffer Looks Stronger, but It Does Not Eliminate Sequencing Risk
EBC sees that near-term external resilience is improving. The CBN Governor said gross external reserves rose to USD 50.45 billion as of 16 February 2026, equivalent to 9.68 months of import cover for goods and services. Even so, EBC views the market’s focus as pragmatic: in a risk-off tape, investors tend to price the order of transmission, not the eventual balance-of-payments benefit.
In the near term, EBC expects attention to rotate to scheduled energy and policy signposts that can confirm whether the current repricing is a short, violent adjustment or a more durable regime shift, including the U.S. Energy Information Administration (EIA) Short-Term Energy Outlook (10 March 2026), OPEC’s Monthly Oil Market Report (11 March 2026), and the U.S. Federal Reserve meeting (17 to 18 March 2026). On the domestic calendar, the CBN’s published schedule points to the next Monetary Policy Committee meeting on 19 to 20 May 2026.
Risk Frame: The Market Prices the Lag, Not the Headline
EBC cautions that outcomes are asymmetric. A rapid de-escalation could compress the crude risk premium quickly, but once freight, insurance, and hedging behaviour adjust, second-round effects can linger through inflation uncertainty and a more persistent USD bid.
“Oil can act as a shock absorber for Nigeria, but only when the liquidity channel is working,” Barrett added. “If USD conditions tighten first and domestic pass-through accelerates, the market prices the lag, not the headline oil price.”
Brent remains an anchor instrument for tracking this timing risk because it links energy-led inflation expectations, USD liquidity, and emerging-market risk appetite in one market. EBC Commodities offering provides access to Brent Crude Spot (XBRUSD) via its trading platform for following energy-driven macro volatility through a single instrument.
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