Over two-thirds of the health facilities in Nigeria lack essential drugs and basic medical equipment necessary to function.
This was detailed in the latest National Health Facility Survey published by the National Bureau of Statistics on Monday, using data from the year 2023.
The report sampled 3,330 health facilities with a nominal sample of 90 facilities in each state and the FCT. It estimated that only 35% of the facilities had essential drugs available and unexpired. The remaining 65% either had expired drugs or did not have the essentials at all.
These included critical medications like paracetamol, aspirin, amoxicillin and oral rehydration salts. The survey reported that secondary health facilities were better stocked, with 50.6% having the necessary drugs. But as for primary health centres, only 34.3% had the essential drugs available or unexpired.
“The availability of essential drugs in primary health facilities ranged from 13.7% in Kebbi to 53.6% in Delta,” the report revealed.
States like Delta, Imo (52.9%) and Ogun (51.2%) ranked highest in drug availability, while Kebbi sat at the bottom with only 13.7% availability. The situation was equally grim with regard to basic medical equipment, such as stethoscopes, thermometers and weighing scales.
The survey found that just 31.4% of health facilities had functional equipment. Secondary health facilities fared better at 68%, but only 29.9% of primary health centres were adequately equipped.
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Geopolitical zones also showed disparities. The South-West led with 47% of primary health facilities equipped, while the North-West recorded just 19.8%. In drug availability however, the North-West led with 57.8% of its sampled facilities stocked with essential medicines.
The gaps in healthcare provision were starkest at the state level. Ogun topped the list of primary facilities with basic equipment at 74.2%, while Katsina trailed with a mere 0.9%.
HEALTH IS UNDERFUNDED IN NIGERIA
In April 2001, the African Union, during a meeting in Abuja, committed to allocating at least 15% of their annual budgets to health. This target, known as the Abuja Declaration, was considered a realistic benchmark to tackle the continent’s health challenges, including malaria, HIV/AIDS and tuberculosis in respective countries.
However, Nigeria has consistently fallen short of this commitment. In December, The Punch reported that the country failed to meet this target in over 15 years since the declaration was signed.
Despite a 2024 budget increase, Nigeria allocated just 5.46% of its total budget to health. This figure includes allocations for the Federal Ministry of Health and other health-related expenditures.
According to the Centre for Social Justice (CSJ), the total health allocation in 2024 amounted to N1.5 trillion out of a budget exceeding N27 trillion.
This translates to a per capita allocation of N6,831 for Nigeria’s population of 220 million. At an exchange rate of N750 to $1, this equates to a mere $9.10 per person.
Healthcare in Nigeria operates on a concurrent legislative list, requiring contributions from both federal and state governments.
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RankStatePercentage1Kano16.46%2Kaduna15.63%3Yobe15.05%4Abia15.04%5Bauchi15.03%6Borno14.42%7Nasarawa13.36%8Kogi13.07%9Ogun11.6%10Sokoto11.26%11Cross River11.11%12Kwara11.01%13Taraba10.55%14Edo9.81%15Oyo9.74%16Niger9.36%17Ondo9.24%18Osun8.97%19Benue8.73%20Katsina8.48%21Jigawa7.8%22Gombe7.52%23Zamfara7.48%24Lagos7.15%25Enugu6.92%26Ekiti6.87%27Kebbi6.75%28Ebonyi6.62%29Delta6.6%30Adamawa5.82%31Bayelsa5.51%32Anambra5.47%33Plateau4.91%34Akwa Ibom3.96%35Imo3.93%Even at the state level, only five states met the 15% Abuja Declaration benchmark in the 2024 fiscal year: Kano, Yobe, Bauchi, Abia, and Kaduna.
Even at the state level, only five states met the 15% Abuja Declaration benchmark in the 2024 fiscal year: Kano, Yobe, Bauchi, Abia, and Kaduna.
Interestingly, Lagos — one of the wealthiest states in the country —allocated just 7.15% of its budget to health, falling far below the target.
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CONSEQUENCES
The implications of this underfunding are visible in Nigeria’s health indicators. For instance, FIJ reported how, in overview, children’s health declined in Nigeria within six years.
In 2018, 37% of children under five were stunted, 22% underweight and 2% overweight.
By 2024, the situation had worsened: 40% of children under five were stunted and 27% underweight.
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