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Chapter 7 of AHOP's Nigeria Health Systems and Services Profile.
Key messages
- Essential health service coverage is very limited, contributing to Nigeria’s poor performance against health indicators. Primary health care (PHC) is the weakest level of health care delivery, although facilities with the capacity to deliver the basic package of essential health services are lacking at the primary, secondary and tertiary levels.
- The regional distribution of tertiary health care facilities is uneven, with a greater concentration in major urban centres and more developed regions than in rural and less developed areas.
- Emphasis remains on curative care, and challenges persist in prioritizing and funding public health interventions. Limited funding, inadequate infrastructure and health care workforce shortages constrain the effectiveness and reach of existing screening programmes.
- Strong community-level structures exist, but have not translated into the scaled-up delivery of essential health services at the primary health level.
- Specialist and emergency services are insufficient. Specialist services are confined primarily to urban areas and are often dictated by funding sources. Emergency medical care exists, but many communities lack ambulance services and prehospital care, and hospital units are ill-equipped to resuscitate critically ill patients.
- Referral systems are suboptimal, and many patients bypass lower levels of care to access higher levels.
- The coexistence of traditional and contemporary medicine poses possible risks, emphasizing the necessity of regulating and incorporating traditional medicine practices into the health care system.
- Service delivery reforms will improve basic package provision, but implementation challenges remain. Recent reforms to allocate at least 1% of the Consolidated Revenue Fund to the Basic Health Care Provision Fund will improve service delivery, providing for one functional PHC centre per ward and one general hospital per local government area. However, funding limitations, infrastructure constraints, cultural barriers and logistical difficulties continue to constrain implementation.