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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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When Leaders THRIVE: Yetunde B. Oni’s Candid Counsel to Lateef Jakande Leadership Academy

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When Leaders THRIVE Yetunde B. Oni

Union Bank’s Managing Director and Chief Executive Officer sat with 30 of Nigeria’s most promising young leaders for a frank conversation on character, relationships and the discipline of growth.

Out of 25,000 applicants, only 30 earned a place. That single figure tells you how rare the room was when Yetunde B. Oni, Managing Director and Chief Executive Officer of Union Bank of Nigeria, recently sat down with a cohort of the Lateef Jakande Leadership Academy.

The Academy, a Lagos State Government initiative established in honour of Alhaji Lateef Kayode Jakande, the state’s first civilian governor, exists to raise a generation of ethical and capable young leaders. Its fellows are drawn from across professions, sectors and ethnicities, and shaped through a fellowship facilitated by the Africa Leadership Initiative, West Africa (ALI WA), whose work on values and principled leadership has become a quiet engine behind some of the country’s most thoughtful emerging talent.

It was into this gathering that Mrs Oni brought not a corporate address, but a conversation. Honest, personal and at times disarming, she spoke about the philosophies that have carried her through a career spanning more than three decades, the setbacks she has had to surmount, and the values that opened doors she never expected to walk through.

She gave them a framework to hold on to. She called it THRIVE.

The six principles

T — Take ownership of your relationships. Leadership, she argued, begins with the deliberate stewardship of the people around you. Relationships are not incidental to a career. They are infrastructure.

H — Honour God. She spoke openly about faith as a steadying force, an anchor that keeps ambition tethered to something larger than the self.

R — Recharge and refresh. Mental and physical health, she insisted, are not luxuries to be deferred until the work is done. Leaders who neglect their well-being eventually have less to give.

I — Invest in your growth. Continuous and heavy investment in personal development is, in her telling, the price of staying relevant. The learning never ends.

V — Value your work. She pressed the fellows on identity and brand. What do you stand for? Do you create value? Who, in truth, are you? The questions were not rhetorical.

E — Embrace setbacks. Failure, she said, is not the opposite of progress but a part of it. The leaders who endure are the ones who learn to metabolise disappointment rather than be defeated by it.

The people behind the leader

If one theme threaded the entire conversation, it was relationships. Mrs Oni was candid that she did not arrive at the top of Nigerian banking alone. She credited the steady support of family, her parents and her husband, alongside the mentors, friends, coaches and sponsors who shaped her at different stages.

She drew a sharp and useful distinction between a mentor and a coach, two roles often conflated and rarely understood, and she traced much of her progress back to a foundation of Nigerian cultural values: hard work, honesty and integrity, courtesy and respect. These, she told the fellows, are not relics. They are the very qualities that have earned her trust and opened doors throughout her journey.

“You need people,” was the message, delivered without sentiment. Relationships, she explained, must be managed and nurtured with the same seriousness one brings to any other discipline. Time must be managed with equal care.

On believing, and risking

Perhaps the most resonant moment came when Mrs Oni spoke about self-belief. She admitted that becoming the MD/CEO of Standard Chartered Bank, Sierra Leone, did not cross her mind – not because she was unqualified, but because she didn’t think she would get it. Encouraged by her husband, she applied anyway, and she got it!

That appointment would later see her make history as the first woman to lead a Standard Chartered Bank operation in her market.

The Union Bank of Nigeria appointment told a similar story. She had not even known the position existed after the CBN’s intervention. It came to her through relationships; through the quiet networks of people who knew her work and recommended her name while she was unaware in faraway Sierra Leone.

The lesson she left with the fellows was unambiguous. Believe in yourself. Take the risk. Put in for the thing you are not yet certain you deserve, because the opportunity you are waiting for may be one you cannot see, reaching you through someone you have not yet met.

Why this matters

Engagements of this kind are easy to underestimate. They produce no headlines about balance sheets and no immediate line on a financial statement. Yet they speak to something Union Bank has long understood: that institutions endure when they invest in people, and that leadership is built one honest conversation at a time.

Credit is due to the Africa Leadership Initiative, West Africa, whose facilitation of the Lateef Jakande Leadership Academy continues to shape young Nigerians of real promise, and to the Academy itself for the rigour of a process that turned 25,000 hopefuls into 30 fellows ready to lead.

For Yetunde B. Oni, the afternoon was less about what she had achieved than about what she was willing to give: her time, her story and her counsel, offered freely to those coming after her. It is, in the end, what the best leaders do. They light the path for the next generation, and they THRIVE.

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Destination Ekiti: Two Elections, One Lesson in Vision

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welcome to Ekiti

By Oludayo Oludee Olorunfemi

A couple of months ago, my principal, Mrs Oyinkansola Badejo-Okusanya (SAN), was scheduled to travel from Lagos to Akure for an interactive meeting as part of her consultation process before contesting for the office of President of the Nigerian Bar Association (NBA). Today, she stands cleared to contest the election; the ban on campaigning has been lifted, with elections scheduled for 20 July 2026. However, this is not the central story. What stays with me from that trip is an unexpected lesson in leadership, vision, and the power of deliberate planning. It is a lesson that has become even more relevant as Ekiti State prepares for its governorship election on 20 June 2026, exactly one month before the NBA election. Two elections. Two different constituencies. Two different ballots. Yet remarkably similar questions before the voters.

Who has the vision? Who has done the work? Who has demonstrated the capacity to build for the future rather than merely campaign for the present? The journey began with a logistical challenge. The available flight from Lagos to Akure was scheduled for later in the day and would not get the team to Ondo State in time for a series of engagements planned across Akure, Owo, and Ondo Town.

During discussions on the best alternative, I suggested that we fly into Ekiti through the newly commissioned Ekiti Agro-Allied International Airport. The plan was simple: arrive early in Ado-Ekiti, make strategic visits to leaders of the Bar within the State, and then proceed by road to Akure for the scheduled meetings. What none of us anticipated was that Ekiti itself would become the story. Our first stop was a courtesy visit to Aare Afe Babalola, SAN, founder of Afe Babalola University, Ado-Ekiti. The purpose was straightforward: seek Baba’s blessings for the journey ahead. As always, a visit to Aare Afe Babalola became a masterclass. Drawing from over ninety years of experience, he spoke about governance, leadership, the legal profession, and nation-building. Listening to him, one could not help but reflect on the legacy. Across the South-West, the Aare Afe Babalola Bar Centres stand as visible reminders that impactful leadership is measured not by promises made but by institutions built.

As we continued our visits across Ekiti, someone suggested we stop by the Ekiti State Bureau of Tourism, headed by the energetic lawyer and tourism advocate, Mr Wale Ojo-Lanre. That unplanned detour became the highlight of the trip. The welcome was unmistakably Ekiti, warm, thoughtful, and rich in culture. Before we entered, we observed the symbolic knocking on the traditional drum suspended at the entrance. Then came the recitation of Mrs Badejo-Okusanya’s oriki as an Egba woman, evidence that our hosts had taken time to learn about their distinguished guest before our arrival. It was a small gesture, but one that reflected a larger truth about Ekiti, a people deeply connected to their culture, history, and identity. What followed was even more enlightening.

Officials of the Bureau took us through the various tourism assets of the state and presented the Ekiti State Tourism Development Master Plan (2025–2035). As a proud daughter of Ekiti, I listened with a sense of pride and optimism. The vision was clear. Tourism was no longer being treated as an afterthought but as a strategic economic pillar. Through public-private partnerships, destination governance, infrastructure development, cultural and eco-tourism innovation, enhanced security, asset development, and community empowerment, the state is seeking to position itself as a destination of choice. What impressed me most was the coherence of the plan. Too often, governments commission projects without building ecosystems. What we saw in Ekiti was different. It was a deliberate attempt to connect infrastructure, policy, investment, culture, and people into a sustainable tourism economy. It was the kind of long-term thinking that separates administration from leadership.

The next day, after completing our engagements in Ondo State, on our way back to catch our return flight, we stopped at Ikogosi Warm Springs Resort. Some places are beautiful. Others are transformative. Ikogosi belongs firmly in the second category. Listening to Madam Ruth, our tour guide, narrate the history of the springs, watching warm and cold waters continuously flow side by side, placing one foot in each stream, and observing the famous intertwined trees thriving together despite their differences, one could not help but marvel at nature’s wisdom. Different streams. One destination. Different identities. Shared purpose. The carefully curated pathways, the serenity of the environment, the chorus of birdsong, and the pristine landscape created a profound sense of peace. By the time we left, the verdict from everyone on the team was unanimous: we will be back. GO SEE IKOGOSI.

Ekiti is sitting on immense tourism potential. Not potential that exists only in policy documents or political speeches, but real, tangible, marketable potential. From Ikogosi to Arinta Waterfalls, to Mount of Clouds, to Olosunta Hills; from cultural festivals to ecotourism sites, from its rich history to its emerging infrastructure, Ekiti possesses many of the ingredients required to become one of Nigeria’s premier tourism destinations. What remains essential is sustained leadership and the courage to pursue a vision beyond electoral cycles. Perhaps that is why the coincidence of the election dates feels significant. On 20 June, the people of Ekiti will evaluate the leadership before them and determine the future direction of their state. One month later, on 20 July, lawyers across Nigeria will make a similar decision about the future of their association. The parallels are difficult to ignore.

In Ekiti, Governor Biodun Oyebanji has built a reputation for quiet but purposeful governance. Rather than chasing headlines, his administration appears focused on laying foundations in infrastructure, agriculture, education, and tourism that will yield benefits long after the politics of the moment have passed. In the NBA, Oyinkansola Badejo-Okusanya (SAN) presents a similar proposition. Her aspiration has been defined by consultation, engagement, bridge-building, and a vision of a bar that is inclusive, progressive, and institution-focused. Both represent a leadership philosophy that values preparation over performance. Both understand that sustainable progress requires patience. Both appear committed to building structures and a legacy of service that will outlive them.

As we departed Ekiti that evening, we left with more than memories of a successful consultation trip. We left with a renewed appreciation for what thoughtful leadership can accomplish. We left with fresh ideas. We left inspired by the possibilities that exist when vision is matched with execution. Most importantly, we left convinced that Ekiti’s tourism story is only beginning to be told. Destination Ekiti is more than a slogan. In the month that separates 20 June from 20 July, voters in Ekiti and lawyers across Nigeria will be asked essentially the same question: Do we reward those who merely speak about the future, or those who are deliberately building it? For Ekiti, for the NBA, and for all who believe in the power of institutions, the answer should be a BOLD Yes!

Oludayo Oludee Olorunfemi, a lawyer, writes from Ward 10, Idemo Quarters of Oke Aiyedun Ekiti, Ajoni LCDA.

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Why Most Nigerians Are Losing Money by “Saving” It

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Saving Your Money

By Izekeo Adegoke

Somewhere in Nigeria right now, a diligent, financially responsible person is watching their savings grow, and losing money at the same time. They do not know it. Their bank balance is rising. Their statement looks healthy. But in real terms, their wealth is quietly and consistently shrinking.

This is not a fringe scenario. It describes the financial situation of millions of Nigerians who are doing everything they were taught.

The gap nobody talks about

Here is the arithmetic that changes the conversation.

The average Nigerian savings account yields between 2% and 4% per annum. Nigeria’s inflation rate, as of recent Central Bank data, sits at approximately 15.69%. That means if you have ₦1 million in a savings account today, it will nominally become ₦1,030,000 in a year, but the real purchasing power of that money will have fallen to the equivalent of roughly ₦790,000 in today’s terms. You saved diligently. You lost ₦210,000 in purchasing power.

This is what economists call negative real returns, and it is the financial reality for the majority of Nigerian savers right now. The distinction between keeping money safe and making money grow has never mattered more than it does in this macroeconomic environment.

Why the savings instinct made sense and no longer does

The preference for savings accounts is not irrational. It is inherited. A generation of Nigerians was raised during periods of significant economic volatility, bank failures, currency devaluations, and frozen accounts. Saving in a regulated institution felt like the responsible, conservative choice. The alternative, markets, stocks, and funds, felt speculative and risky.

That instinct made sense in its context. But the financial landscape has changed materially, and the definition of “safe” needs to catch up.

A savings account today is not a low-risk option. It is a guaranteed negative return dressed in conservative language. The risk is not that you will lose your capital in nominal terms. The risk is that your capital will progressively lose its ability to buy things, fund a retirement, educate children, or build the future you are working toward. That is a real loss, even if your statement does not show it.

The behaviour-change that changes everything

The shift from saving to investing is not about abandoning caution. It is about directing caution more effectively. A diversified investment portfolio spread across fixed income instruments, equities, dollar-denominated assets, and alternative holdings does not eliminate risk. It manages it intelligently, and in doing so, gives your money a fighting chance against inflation.

Consider a ₦1 million portfolio invested across a balanced mix of Nigerian equities and fixed income instruments targeting a 15–18% annual return. Over three years, compounding and market participation could bring that to approximately ₦1.5–1.6 million in nominal terms and, depending on portfolio construction, meaningfully above the inflation rate in real terms. The savings account brings you to ₦1.09 million, having lost ground every single year.

The numbers are not subtle. They are decisive.

Coronation Wealth’s answer to the problem

This is precisely the problem Coronation Wealth was built to solve. Our platforms give individuals access to professionally managed, diversified portfolios across multiple asset classes, including dollar-denominated instruments that provide a structural hedge against naira depreciation. These are not products previously available only to institutional clients or high-net-worth individuals. They are accessible, clearly structured, and designed for people who want their money working as hard as they do. Wealth creation, as we understand it, is not about spectacular bets. It is about making consistent, informed decisions over time with the right tools, the right structure, and a partner who understands the environment in which you operate.

The reframe you need

Safety is not a function of where your money sits. It is a function of what your money does.

A savings account feels safe because the number never goes down. But if that number cannot keep pace with the cost of living, the cost of education, the cost of the future, it is not protecting you. It gives you the illusion of security while inflation quietly does its work.

The most dangerous financial decision most Nigerians are making right now is not taking too much risk. It is the decision to play it safe, and that is precisely why it needs to change.

Izekeo Adegoke is the Chief Digital Officer at Coronation Wealth, the digital investment and wealth management subsidiary of the Coronation Group in Nigeria. 

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