The 2024 State of Health of the Nation Report provides an in-depth analysis of Nigeria’s healthcare system, highlighting significant progress in health insurance coverage, maternal and child health and workforce development.
However, the report also outlines persistent challenges, including low facility-based deliveries, high neonatal mortality rates, gaps in immunisation coverage, and an uneven distribution of healthcare workers.
The report, based on data collected under the Nigeria Health Sector Renewal and Investment Initiative (NHSRII), was made available to journalists on Friday in Abuja. It aims to inform policy decisions and drive improvements in healthcare outcomes across the country. One of the most notable achievements highlighted in the report is the increase in health insurance coverage, reflecting the government’s commitment to achieving Universal Health Coverage (UHC). As of December 2024, an estimated 19.1 million Nigerians were covered by health insurance, a significant rise from 16.8 million in 2023.
Despite this progress, the report emphasised that a large percentage of Nigerians still lack financial protection, leaving many households burdened with out-of-pocket healthcare costs. The report also examined family planning trends, noting a gradual increase in contraceptive use but persistent unmet needs for reproductive health services. It stated that the use of modern contraceptives among married women aged 15 to 49 years increased from 12 percent in 2018 to 15 per cent in 2023/2024. However, the unmet need for family planning remains high at 21 per cent, meaning many women who want to prevent or delay pregnancy still lack access to contraceptive methods.
The report noted that this is largely due to the low availability of family planning commodities in health facilities. Only 18.5 per cent of facilities stocked contraceptive pills, injectables were available in just 19.5 per cent of facilities, and implants and intrauterine devices (IUDs) were found in only 17.8 per cent of facilities. Additionally, facility-based deliveries remain low, with only 43 per cent of women giving birth in a health facility. This suggests that many births still occur at home or in informal settings, increasing the risk of complications and maternal deaths.
The report highlighted a decline in under-five mortality rates, showing an improvement in child survival. It stated that the under-five mortality rate dropped from 132 deaths per 1,000 live births in 2018 to 110 per 1,000 in 2023, marking a significant improvement. However, neonatal deaths, which occur within the first 28 days of life, remain alarmingly high, accounting for 37 per cent of all under-five deaths, with a rate of 41 per 1,000 live births. Only 39 per cent of children aged 12 to 23 months received all recommended vaccines, while 31 per cent of children in this age group did not receive any vaccination at all.
The report called for urgent interventions to strengthen routine immunisation programmes and expand vaccine outreach efforts. Malnutrition continues to be a serious public health challenge in Nigeria, with 40 per cent of children under five suffering from stunting (chronic malnutrition), eight per cent wasted (acute malnutrition) and 27 per cent underweight. While 49 per cent of health facilities provide nutrition-related services, the report noted a significant caregiver knowledge gap on proper infant and child feeding practices, requiring urgent intervention.
On non-communicable diseases, the report revealed limited access to care for conditions like hypertension and diabetes. It stated that 31 percent of Nigerians suffer from hypertension, making it a leading risk factor for heart disease and stroke. It further revealed that 11 per cent of non-communicable disease-related deaths were due to hypertension complications, yet only 12 per cent of health facilities offer hypertension management services, and 14 per cent provide diabetes care. The limited availability of services for non-communicable diseases underscores an urgent need for expanded screening, treatment and awareness programmes.
The doctor-to-population ratio in Nigeria remains critically low, with only 2.9 doctors per 10,000 people, far below the World Health Organisation recommendation of 17 per 10,000. The report identified key workforce challenges, including that 80 per cent of doctors are concentrated in urban areas, leaving rural communities underserved. It also noted that 75 per cent of the health workforce is employed by the public sector, creating reliance on government funding for salaries. Additionally, only 39.4 per cent of public health workers received training on integrated management of childhood illnesses in the past two years.
To address these issues, the Federal Government, in collaboration with the National Primary Health Care Development Agency, has commenced the training of 120,000 frontline health workers to improve service delivery at primary healthcare levels. So far, 53,732 health workers have been trained. The report outlined several policy actions needed to enhance Nigeria’s healthcare system, including increased healthcare funding at federal, state and local government levels, expansion of health insurance coverage to reduce out-of-pocket expenses, and higher allocations to the Basic Health Care Provision Fund to reach more Nigerians. It also recommended ensuring the consistent availability of family planning commodities in all health facilities and expanding community-based interventions to encourage more facility-based deliveries.
The report called for strengthening immunisation programmes to reduce vaccine-preventable diseases and improving nutrition education and intervention programmes to combat child malnutrition. On addressing non-communicable diseases, it highlighted the need to scale up hypertension and diabetes screening and treatment services in primary healthcare centres while promoting awareness campaigns on healthy lifestyles and early detection of non-communicable diseases.
It also recommended implementing incentives to encourage health workers to serve in rural areas and expanding training programmes for healthcare providers, particularly in maternal health, childhood illnesses, and emergency care. The report further emphasised the need to strengthen local production of medicines and vaccines by sustaining the current push for local vaccine production through policy incentives and increased private sector investment.
It also called for improving Nigeria’s health security infrastructure by investing in pandemic preparedness, early warning systems, and emergency response mechanisms. Science Nigeria reports that the 2024 State of Health of the Nation Report presents a mixed picture of Nigeria’s healthcare system. While progress has been made in health insurance coverage, maternal and child health and workforce training, major gaps remain in family planning, immunisation and healthcare worker distribution.
To achieve universal health coverage and meet sustainable development goals, Nigeria must increase healthcare investments, strengthen policies and improve service delivery, particularly at the primary healthcare level. With stronger governance, strategic investments and multi-sectoral collaboration, Nigeria can build a resilient healthcare system that ensures quality, affordable and accessible care for all.
The report provides an opportunity for policymakers, stakeholders and the public to assess Nigeria’s healthcare progress and take action to address the remaining challenges.
