Healthcare Inequity in Nigeria: Why Your Location Still Determines Your Life Expectancy

Benson Michael

An interview with public health advocate Akonasu Qudus Hungbo
In Nigeria, a person’s life expectancy can be shaped by something as simple as their address. Despite improvements in healthcare knowledge and services, deep disparities persist, revealing that where you live often determines how long you live. Public health advocate Akonasu Qudus Hungbo shares his insights on why these gaps exist, how they affect millions of Nigerians, and what can be done to change the story.

Why does location still determine life expectancy in Nigeria?

Akonasu Qudus Hungbo: Life expectancy differences in Nigeria are largely driven by social determinants of health, which are non-medical factors that directly affect health outcomes. These include poverty, access to education, availability and quality of healthcare, clean water, electricity, sanitation and overall community infrastructure. In many parts of Nigeria, especially in rural and conflict-affected areas, these conditions are extremely poor. People living in communities with high poverty, limited schools, weak healthcare systems and unsafe environments are more likely to suffer from preventable diseases and die younger.

Can you give examples of how life expectancy varies across Nigeria?

Yes, the differences are striking. States like Borno, Zamfara and Yobe, where poverty, insecurity and poor healthcare are widespread, have some of the lowest life expectancies in the country. Maternal and child mortality rates are also very high there. On the other hand, places like Lagos and Abuja generally have better healthcare services, higher incomes and better education, which translate into longer life expectancies. For example, some communities in Lekki, Lagos, may have people living 10 to 15 years longer than those in parts of Maiduguri or remote villages in Niger or Taraba states.

How have systemic issues contributed to these health gaps?

A long history of underinvestment, poor governance and regional neglect has deepened these disparities. Many northern and rural areas have faced decades of poor infrastructure, insecurity and a lack of public health facilities. Even urban slums, such as Ajegunle in Lagos or Nyanya in Abuja, face serious challenges like overcrowding, poor sanitation and limited clinics or emergency services. These communities have been left behind by development plans and healthcare investments, creating cycles of poor health and poverty.

Are there any recent policy efforts to address these healthcare inequities?

There are some promising efforts. In Lagos, for example, the Lagos Health Insurance Scheme aims to make healthcare more affordable and accessible. Mobile clinics supported by the National Primary Health Care Development Agency and international partners are reaching underserved areas, especially for maternal and child health services. Organisations like mDoc and Wellvis are offering digital health services to improve access in remote regions. However, these initiatives often face funding challenges and do not yet reach enough people to fully close the gap.

How can communities themselves help reduce healthcare inequity?

Community-driven solutions are very important. Community Health Extension Workers provide basic healthcare, maternal services and vaccination programmes in rural areas. Faith-based organisations and NGOs, such as the Society for Family Health, run outreach programmes focused on sexual health, malaria prevention and maternal care. Local advocacy by youth groups and traditional leaders also plays a key role in improving acceptance of services like immunisation and antenatal care.

What else needs to be done to tackle this crisis?

Nigeria needs bold and coordinated action. We must expand national health insurance to include more low-income and rural residents. Infrastructure development is crucial — we need better roads, water supply, sanitation and more health facilities in remote areas. Investing in the healthcare workforce is essential to train and retain more doctors, nurses and midwives, especially in underserved regions. Strengthening security is also critical, as insecurity often forces people to abandon their communities and lose access to healthcare. Lastly, investing in mobile health technologies can help improve access in areas where physical clinics are lacking.

What is the bottom line?

In Nigeria today, your location still largely determines your chances of living a long and healthy life. While there has been some progress, much more needs to be done through strong policies, community action and targeted healthcare reforms. Until then, the gap between where people live and how long they live will remain a serious national crisis.