Private Sector as Contributor to National Health Goals

Nigeria’s healthcare system is in dire need of transformation, with nearly one in 25 women facing the risk of dying during childbirth. Despite being one of Africa’s largest economies, the country’s healthcare statistics are alarming, with high maternal mortality rates, underfunded health budgets, and uneven access to quality services. However, in recent years, the private sector has emerged as a vital partner in achieving national health goals. Iyadunni Olubode and Dr Tinuola Akinbolagbe writes

Once viewed as a peripheral player in public health, Nigeria’s private sector is rapidly becoming a central force in advancing national health goals, bridging systemic gaps, and accelerating progress toward Universal Health Coverage (UHC). The sector’s growing role marks a crucial shift in how health care is envisioned, financed, and delivered in the country.

The Health Crisis We Cannot Ignore

Nigeria’s maternal mortality rate stands at 993 deaths per 100,000 live births, according to the World Health Organisation (WHO). This accounts for almost 20 per cent of all maternal deaths globally.

Fertility rates remain high at 5.0, while contraceptive use lingers at just 18 per cent. Even more alarming is that half of all births happen outside of health facilities, with only 40per cent attended by trained health personnel.

Government health spending is insufficient to stem the tide. Nigeria allocates just about 6 per cent of its annual budget to health, well below the 15 per cent benchmark set by the African Union in 2001.

Per capita public health expenditure hovers around $6 to $10 annually. With only four doctors for every 10,000 people, the system is overstretched, and the consequences are devastating.

These figures underscore why Nigeria’s push toward Universal Health Coverage (UHC) by 2030 is not just aspirational, it’s imperative.

A Renewed National Agenda

Recognising the enormity of the task, Nigeria’s federal government has introduced a robust strategy: the Nigeria Health Sector Renewal and Investment Initiative (NHSRII), spearheaded by the Coordinating Minister of Health, Professor Muhammad Ali Pate, under the slogan ‘One Plan, One Voice, One Goal’.

This national strategy rests on four critical pillars: Effective Governance; Efficient, Equitable, and Quality Health System; Unlocking the Health Value Chain; and Health Security.

The implementation framework is the Sector Wide Approach (SWAp), a coordinated effort involving government, civil society, the private sector, and development partners.

What sets this initiative apart is its whole-of-society approach. Government agencies, civil society, development partners, and notably, the private sector, are all called upon to participate actively.

The third pillar, focused on ‘Unlocking the Health Value Chain’, represents a direct invitation for private players to contribute their capabilities to strengthen the health ecosystem.

The National Coordinator of the Presidential Initiative for Unlocking the healthcare value chain, Dr. Abdu Mukhtar, leading this effort, has made tangible strides, particularly in negotiating local production incentives for medical supplies.

Digital technology, another area where the private sector excels, is seen as a cross-cutting tool that will enable smarter, data-driven decision-making and service delivery.

As Prof. Pate emphasised in a 2023 dialogue with the Africa CDC, Nigeria is developing a comprehensive digital health policy to unify efforts and guide all stakeholders, including private innovators.

Financing the Future: Partnerships That Work

In an era of declining international donor funding post-COVID-19, the private sector’s role in financing health care is more vital than ever. According to World Bank data, private providers already account for an estimated 78 per cent of total health expenditure and deliver about 60 per cent of services nationwide, according to the WHO.

A shining example of public-private synergy is the Coalition Against COVID-19 (CACOVID), a private sector-led initiative formed in response to the pandemic.

CACOVID mobilised more than ₦39 billion (approximately $100 million), making it the third-largest private sector health fund globally. The funds established over 100 isolation and treatment centres, added 1,000 ICU beds nationwide, and contributed to a 30 per cent reduction in COVID-19 mortality in hospitals.

This success illustrates how private capital, leadership, and speed can complement public health objectives to deliver transformative impact.

Innovation at the Last Mile

While national-level partnerships draw headlines, some of the most innovative models are unfolding at the community level.

In underserved areas, community pharmacies and Proprietary Patent Medicine Vendors (PPMVs) often serve as the first point of contact for health services.

Recognising their potential, the Pharmacy Council of Nigeria (PCN), in partnership with the Society for Family Health and supported by several stakeholders, developed a three-tier accreditation model to train and supervise these providers.

Initially rolled out in Lagos and Kaduna, this model now spans 11 states, including Bauchi, Borno, and Kano. The results are impressive.

According to PCN, with this initiative, over 700,000 women were reached through community pharmacies and PPMVs. There were over 230,000 new acceptors of family planning, over 192,000 couple-years of protection, about 55,000 unintended pregnancies averted, over 400,000 children under five seen by trained providers, over 6,000 presumptive TB cases identified, with over 700 confirmed and receiving care.

These figures highlight the power of community-based, private-sector-supported initiatives in reaching marginalised populations, especially in a country grappling with a shortage of trained health workers.

State-Level Success Stories

Another compelling example of a successful public-private partnership is found in Delta State.

In 2018, the Delta State Contributory Health Commission (DSCHC) partnered with the PharmAccess Foundation and other stakeholders to revitalise 15 non-functional primary health centres (PHCs).

Using a financing model that empowered private providers while guaranteeing payment through state-backed insurance, this partnership achieved remarkable outcomes by December 2021, including, zero maternal deaths in target PHCs (compared to the state average of 188 per 100,000 live births); under-5 mortality rate dropped to 0.7 per 1,000 live births (from 83 per 1,000); over ₦200 million in private investment, and 24/7 service delivery across all target facilities.

The lesson is clear: strategic, well-financed PPPs can transform the delivery and quality of care at the grassroots level.

Scaling for National Impact

Another successful model is the Private Sector Health Alliance’s (PSHAN’s) Adopt-A-Healthcare-Facility-Programme (ADHFP), which seeks to revitalise one PHC in each of Nigeria’s 774 LGAs through private sector support.

So far, 215 PHCs have been adopted and 52 refurbished. In project LGAs, antenatal care attendance rose by 200 per cent, skilled birth attendance by 38 per cent, and immunisation coverage by 55 per cent. Overall facility attendance increased by 300 per cent, improving access and utilisation of healthcare.

To achieve Nigeria’s health goals, including universal health coverage and reduced maternal mortality, public-private collaboration is essential. Health sector leaders have recognised this; the next step is scaling models like the three-tier accreditation model and PPPs.

The Path Forward: Urgency and Opportunity

Despite the progress, achieving Nigeria’s health goals remains an uphill battle. Yet the path forward is clearer than ever. The NHSRII provides a comprehensive blueprint, and the examples above demonstrate that success is not only possible but it is replicable. The next frontier is scale.

That means expanding community-based initiatives like the PCN three-tier model to more states. It means formalising partnerships across sectors to revitalise hundreds more PHCs. It means using digital technologies to ensure that health care data guides decisions at every level. And above all, it means maintaining political will to ensure that health remains a top national priority.

But this isn’t solely a government task. Nigeria’s private sector, pharmaceutical companies, banks, telecom firms, logistics providers, fintech startups, and large corporations must view health as part of their core business strategy, not just corporate social responsibility.

Investing in health is not only a moral obligation; it also makes economic sense. A healthier workforce is a more productive one. A stable health system strengthens national resilience and investor confidence.

Call to Action

A nation’s prosperity is deeply tied to the health of its people, especially the women who give birth to future generations. If Nigeria is to build a society where no woman has to die while giving life, the country must continue to foster a health ecosystem where public and private interests align around common goals.

This is not just about policy; it is about partnerships. Not just about infrastructure, but innovation. And not just about funding, but shared responsibility.

With strong leadership, community-level engagement, and private sector collaboration, Nigeria can make significant strides toward universal health coverage and drastically reduce maternal mortality. Together, we can build a future where every woman, child, and family has access to the care they need and deserve.