FG: Health Sector Performance Not Yet at Optimal Level, Reels Out Statistics

Onyebuchi Ezigbo in Abuja

The federal government has said that Nigeria’s health sector is yet to attain the expected heights, despite recent successes recorded in the effort to rebuild healthcare system.

It said although there is evidence of some improvements over the last few years, “they remain not complimentary enough for a nation of our stature, resources and ambition”.

Minister of State for Health and Social Welfare, Dr. Iziaq Adekunle Salako, who delivered a paper titled: “Strengthening Nigeria’s Health System Resilience for Sustainable and Inclusive Care” at the 2025 Joint Annual Review Meeting (JAR) in Abuja on Thursday said the federal government was fully aware of the challenges and is making concerted efforts to reverse it.

Salako who reeled out statistics and health indices portraying current challenges, said Nigeria still accounts for approximately 14 percent of global maternal deaths and 9 percent of global under-5 deaths, despite representing only 2.6 percent of the world’s population.

Quoting figured from the 2023 Nigeria Demographic and Health Survey (NDHS) preliminary results; Salako said that Nigeria’s maternal mortality ratio stands at 512 deaths per 100,000 live births (down from 576 in 2018).

He said that Under-5 mortality rate stands at 110 deaths per 1,000 live births (a reduction from 132 in 2018), while neonatal mortality is at 41 deaths per 1,000 live births.

Also, the minister said that Skilled Birth Attendance is up from 43 percent in 2023 to 53 percent (up from 43 percent in 2018).

Similarly, the minister said that full immunization coverage which stood at 39 percent is an improvement from 31 percent in 2018 while modern contraceptive prevalence is at 20 percent among currently married women.

He said that government health expenditure rose to 5.2 percent of GDP (2025), but is still far below the 15 percent Abuja Declaration minimum, Per Capita Health Expenditure which is approximately $43 USD from all sources (2024).

Salako further said that though the National Health Insurance Coverage has grown to approximately 10-12 percent of the population, out of pocket expenditure for health remains as high as 71 percent.

He said the country’s external financing dependency stood at 21 percent of total health expenditure. 

“These figures underscore the twin challenges of insufficient investment and catastrophic health expenditure that push millions of Nigerians into poverty annually.

“Our over 30,000 PHCs are still not optimally functional as of the 2023 assessment. Our Doctor-to-Population Ratio is 1:5,000 (against the WHO recommendation of 1:600), while Nurse-to-Population Ratio is as low as 1:2,000 (against the WHO recommendation of 1:300).

“This is further compounded by the inequities in the distribution of health workers, where 75 percent are concentrated in urban areas, serving 45 percent of the population.” 

The minister added that, “while these figures above, shows some improvement over the last few years, they remain not complimentary enough for a nation of our stature, resources and ambition.

 He said the government of President Bola Ahmed Tinubu is fully aware of these challenges and is making concerted efforts in partnership with state and local governments, development partners, and civil society to accelerate progress and deliver a health system that will optimally serve all Nigerians.

“We are fully conscious of the issues at stake and in the last 30 months of this administration, we have implemented a coordinated set of programs and interventions towards attaining a resilient health system for Nigeria in line with the Renewed Hope Agenda.”

The minister also reeled out list of interventions and achievements recorded by the government in the last few years.

He said the Nigerian Health Sector Renewal Investment Initiatives (NSHRII) being driven on the strategic imperative of a Sector Wide Approach (SWAp) sought to ensure efficient, collaborative, synergistic and non-siloed implementation.

According to Salako the initiative is designed to deliver a health system that is prepared for, responds to and recovers from shocks – a resilient Nigerian health system.

“I wish to share with you some of the ongoing coordinated interventions under the NSHRII.

“The Basic Health Care Provision Fund (BHCPF), since its operationalization in 2019, has transformed primary healthcare delivery.

“We have built on this, and the BHCPF represents our most significant domestic investment in Primary Health Care, and I commend the BHCPF Gateways (NPHCDA, NHIA, NCDC) and the MOC secretariat for the better coordination and the improved absorption capacity, rising from 45% in 2019 to 78% in 2023.

“The National Health Insurance Authority (NHIA) Act 2024 marked a paradigm shift toward Universal Health Coverage.

“We have witnessed increased enrollment into the insurance pool of care, and the state insurance schemes have contributed in no small way to improving the number of persons benefiting from pooled insurance care and access at both the National and subnational levels,” he said.

Salako said through the formal sector enrollment, the vulnerable group program, and the BHCPF integration pathways, over 20 million persons have been enrolled into care through insurance mechanisms.

He said that with President Tinubu’s recent Executive Order on mandatory implementation across MDAs including for entities involved in public procurement and the defined beneficiary scheme for retirees, “we foresee a significant acceleration and exceeding of our 2027 target of 20 percent coverage”.

“With respect to disease-specific programs, we have recorded significant milestones and improvements. The HIV/AIDS Control has enrolled 1.78 million persons Living with HIV on treatment with a National ART coverage of approximately 80 percent, 72 percent viral suppression, and Prevention of Mother to child transmission coverage of 96 percent of HIV-positive pregnant women.”

On Tuberculosis Control Program, Salako said the federal and state levels has recorded approximately 80 percent notification of estimated incidence, and greater than 85 percent treatment success rate.