For most Nigerians, paying for treatment is a daily struggle.
Available data indicates that out-of-pocket expenses account for more than 70 per cent of health costs, pushing families into poverty and leaving the most vulnerable without care.
National spending on health remains below five per cent of GDP, far short of the 15 per cent target set in the 2001 Abuja Declaration.
Primary healthcare centres often lack basic equipment, teaching hospitals are overstretched; and medical professionals continue to leave the country in search of better opportunities abroad.
In the Federal Capital Territory(FCT), a heavily pregnant woman carrying twins tragically lost her babies after being turned away from multiple hospitals.
Told to pay ₦28,000 and provide a referral letter, she walked several kilometres to secure the documents, only to return too late.
Investigations revealed the twins had died in her womb days earlier, likely due to delays in receiving timely medical care.
Similarly, in Akwa Ibom, a mother and her newborn died following a caesarean section at the General Hospital in Ikot Ekpene.
Relatives alleged that hospital staff left the woman unattended for over three hours, and no blood was available during surgery.
The incident prompted Gov. Umo Eno to establish a commission of inquiry.
These heartbreaking stories highlight the financial, infrastructural, and systemic barriers facing millions of Nigerians, particularly women and children.
At the recent National Health Financing Dialogue in Abuja, policymakers, development partners, and stakeholders grappled with a pressing question:
How can Nigeria re-imagine healthcare funding to ensure access, affordability, and quality for all?
Over the past two years, the government has implemented reforms aimed at saving lives, reducing financial hardship, and improving healthcare access.
These reforms include revitalising primary healthcare facilities, equipping them with essential commodities, and retraining more 67,000 frontline health workers.
More than 8,000 facilities now receive regular federal disbursements to ensure continuity of services.
On the demand side, insurance coverage has been expanded to vulnerable populations.
The urgency of the conversation extends far beyond policy documents; it is a conversation about healthcare as a fundamental human right.
Through the Vulnerable Groups Fund and the National Health Insurance Authority (NHIA), pregnant women, children, people with disabilities, Al-Majiri children, and out-of-school children can access essential services without facing catastrophic costs.
Emergency care support has also been strengthened; more than 5,000 women have had caesarean sections reimbursed, and programmes have been established to provide treatment for obstetric fistula at no cost.
As the Coordinating Minister of Health and Social Welfare, Prof. Muhammad Pate, emphasised, health reforms were not just abstract policies; they are tangible and measurable with clear human impact.
“Historically, the Nigerian elite have benefited more from public resources than the poorest.
“We are changing that,” Pate said.
In his submission, Prof. John Ele-Ojo Ataguba, Executive Director of the African Health Economics and Policy Association (AfHEA), said that universal health coverage (UHC) was a journey, not a destination.
Successful countries combine contributory and non-contributory schemes, and Nigeria is now pursuing both.
“The contributory component consists of national and state health insurance schemes, while the non-contributory element is represented by the Basic Health Care Provision Fund, which subsidises care for those unable to pay, particularly in the informal sector.
“Despite these efforts, out-of-pocket spending remains a major challenge.
“Illnesses are unpredictable; families should not have to sell assets to survive a medical emergency,” Ataguba said.
Dr Gafar Alawode, the Chief Executive Officer, DGI Consult, highlighted the importance of optimising resources and coordination.
“Before now, multiple actors, government tiers, the private sector, and donors spent in uncoordinated ways.
“With a sector-wide approach, two plus two can become five or six instead of one or zero,” Alawode explained.
Yet, while politicians and technocrats debate financing models, youth and grassroots women leaders say they remain excluded from decision-making.
Mr Seniye Michael, a youth activist, lamented that leaders often attend high-level meetings briefly, make remarks, and leave, leaving young people dialoguing with themselves.
Michael proposed a Youth Health Access Fund to directly finance medical needs for young people.
Mrs Hauwa Adamu, leader of the Wives of Traditional Rulers Network, echoed this call.
“Policies are often written for us without us; women’s lived experiences must shape advocacy and project design,” Adamu said.
The dialogue highlighted a key principle: health is a unifying force. Universal health coverage strengthens human capital, builds social cohesion, and protects society from preventable diseases.
As Pate explained, ensuring that even rural populations have access to care is in everyone’s enlightened self-interest.
Participants at the dialogue agreed that, private sector partnerships, tax reforms, and public engagement are crucial to sustaining these gains.
Governments at all levels, alongside citizens, must commit to funding, transparency, and accountability.
The road to universal health coverage remains long, but the trajectory is clear.
Stakeholders say Nigeria is building an inclusive health system that prioritises the vulnerable, reduces preventable deaths, and protects citizens from financial catastrophe.
This transformation is about more than policies; it is about saving lives, empowering communities, and ensuring that no one is left behind.
The tragic stories from the FCT and Akwa Ibom remind us why this work matters; behind every statistic is a human life, and policies must protect those lives.
Ensuring healthcare access, affordability, and quality is not a political gesture; it is a moral imperative.
As Nigeria continues its journey towards inclusive healthcare, these reforms and initiatives must be sustained, monitored, and adapted to local realities.
Experts say when healthcare systems function effectively, the impact is profound: maternal and child deaths decline, families are protected from financial ruin, and social trust in institutions strengthens.
Ultimately, the story of Nigeria’s healthcare reform is one of hope and resilience; it reflects the determination of policymakers, healthcare workers, activists, and ordinary citizens to transform a fragmented system into one that is inclusive, equitable, and people-centred.
While challenges remain, including limited funding, workforce shortages, and systemic inefficiencies, the commitment is evident.
With sustained focus and participation from all sectors, Nigeria can achieve a healthcare system where policy meets people, and where access to quality care is not a privilege but a right for every citizen.
Observers say for every Nigerian mother walking miles for a referral letter, for every child denied life-saving care due to financial constraints, the ongoing reforms represent a future where health policies translate into real, tangible benefits for all.
(NAN Features)
