Nigeria’s Healthcare Spending: Minister’s Statement and Context
On September 2, 2025, Nigeria’s Coordinating Minister of Health and Social Welfare, Prof. Mohammed Ali Pate, stated during the opening of the National Health Financing Dialogue in Abuja that the country currently spends approximately $120 per capita on healthcare, with the government contributing only about $30 per capita. The remaining funding primarily comes from out-of-pocket payments by individuals and households, which accounts for roughly two-thirds of the total expenditure. Less than 10% of the spending is supported by development partners. This revelation highlights significant challenges in Nigeria’s health financing system, where heavy reliance on personal payments exposes vulnerable populations to financial hardship and limits access to quality care.
Key Highlights from the Minister’s Remarks
- Total Per Capita Spending: $120, which is an increase from the $71.96 reported for 2023, reflecting some progress amid economic growth but still far below global benchmarks for low- and middle-income countries aiming for universal health coverage (UHC).
- Government Contribution: Only $30 per capita (about 25% of total spending), underscoring a funding gap that the minister described as “trying to ride a bicycle while comparing ourselves to countries operating on the level of a Rolls Royce.”
- Out-of-Pocket Dominance: Approximately $80 per capita from private sources, mainly direct payments, which the minister warned could lead to catastrophic health expenditures for families, especially the poor.
- Call to Action: Pate emphasized the need for efficient resource mobilization, policy reforms to boost private sector involvement, and making health insurance compulsory for all Nigerians. He noted a recent surge in insurance enrollment (4 million new enrollees in 18 months) but stressed that only about 5% of the population currently has coverage. The dialogue, themed “Reimagining the Future of Health Financing in Nigeria,” aims to build evidence for sustained financing and larger risk pools through the National Health Insurance Authority (NHIA).
The minister’s comments were made in the context of Nigeria’s broader push toward UHC, including the National Health Insurance Authority Bill of 2022, which mandates coverage and targets vulnerable groups. He also highlighted external shocks, such as potential reductions in foreign aid, as reminders that Nigeria must rely more on domestic resources.
Comparison with Regional and Global Peers
To put Nigeria’s figures in perspective, here’s a comparison based on recent data (2023 estimates unless noted):
| Country | Total Per Capita Spending (USD) | Government Share (%) | Out-of-Pocket Share (%) | Notes |
|---|---|---|---|---|
| Nigeria | $120 (2025 est.) | ~25 | ~67 | Heavy OOP reliance; only 5% insured. |
| South Africa | >$500 | 45 | ~15 | Higher funding supports broader coverage. |
| Kenya | $60 | 35 | ~25 | Focus on public insurance expansion. |
| Ghana | $80 | 40 | ~30 | National Health Insurance Scheme covers ~40%. |
| Rwanda | $100 | 50 | ~20 | Community-based insurance model. |
| United States (for reference) | ~$4,000 (2023) | ~45 | ~10 | High overall spending but unequal access. |
Nigeria’s government contribution lags behind the Abuja Declaration’s 15% target for health in national budgets (actual: ~4-5%). As a share of GDP, health spending is about 3-4%, below the WHO’s recommended 5% for UHC progress in low-income countries.
Broader Context and Challenges
- Historical Trends: Nigeria’s per capita health spending has grown from ~$66 in 2018 to $84 in 2021, but volatility in oil revenues and underspending (e.g., 47% budget under-execution in 2021) have hindered progress. Recurrent expenditures dominate, with capital investments (e.g., infrastructure) fluctuating.
- Impact on Health Outcomes: Low public funding contributes to poor indicators, such as an infant mortality rate of 71 per 1,000 live births and life expectancy of ~54 years—worse than many West African neighbors despite higher total spending. Studies show that increased government health expenditure reduces mortality and boosts life expectancy, but out-of-pocket costs exacerbate inequality.
- Reforms and Opportunities: The government is promoting public-private partnerships (e.g., solarizing hospitals, local drug manufacturing) and aiming to cover 83 million vulnerable Nigerians via insurance. Enrollment has risen, but operationalizing a single risk pool remains key. The Basic Health Care Provision Fund (BHCPF) and initiatives like Saving One Million Lives (SOML) target primary care, though delays in disbursements persist.
- Risks: With 97% of Nigerians uninsured (2018 data) and OOP at ~70% of total health spending, the system is prone to impoverishment. The COVID-19 pandemic exposed gaps, with costs like testing (~$105-264) burdening households. External aid cuts (e.g., U.S. funding for HIV/TB/malaria) could affect 28,000 health workers, prompting a shift to domestic financing.
Recommendations from Experts and the Minister
- Increase domestic revenue through taxes (e.g., on mobile/air travel) to raise government spending to at least 5% of GDP.
- Expand insurance via employer mandates and private sector risk pools.
- Invest in infrastructure, workforce retention, and local production to reduce 70% medicine imports.
- Enhance transparency in budgeting to avoid underspending and build donor trust.
This statement by Minister Pate signals urgency for systemic change, aligning with global goals like SDG 3. For the latest updates, monitoring official sources like the Federal Ministry of Health or NHIA is recommended.