Healthcare, a reflection of societal advancement, has been a key influencer and influenced by economic, social, and political conditions. From ancient civilizations to modern nations, the development of healthcare systems reflects societal priorities and governance. The ability to deliver healthcare services mirrors a state’s commitment to its citizens’ welfare, fostering national growth by improving human capital and productivity. A nation’s healthcare infrastructure plays a vital role in shaping economic output, as healthier populations contribute effectively to the workforce, innovate, and drive the country’s social and economic engine forward.
Healthcare advancements can serve as a unifying factor, bridging inequality and reinforcing trust in governance. The evolution of healthcare reflects societies striving for better living standards. From rudimentary remedies to sophisticated surgeries and digital solutions, healthcare advancements mirror human resilience. Societies prioritizing health experience political stability, longer life expectancies, and economic growth.
Ancient Egypt exemplifies a society that understood the importance of healthcare. In Deir el-Medina, a village housing tomb workers, organized medical care was provided, highlighting one of the earliest governmental healthcare systems. Egyptian medicine was advanced, incorporating surgical skills, specialization, and formal training. Physicians like Imhotep, the first recorded physician, set foundational medical practices.
Modern parallels include Germany and Japan, whose healthcare systems rank among the best globally. Germany’s universal healthcare dates to the 1880s under Otto von Bismarck and covers over 90% of the population. Services include maternity care, preventive medicine, and mental health support. Japan’s focus on preventive care contributes to a life expectancy of 84.6 years by 2023, attributed to regular check-ups, early disease detection, and emphasis on diet and exercise.
Ancient Egypt’s healthcare advancements reflected societal values, as do modern nations’ healthcare improvements.
Our Past And The March To A New Direction
Healthcare systems today reduce mortality, enhance quality of life, and enable productivity. However, a 2022 Lancet report ranked Nigeria’s health system 142 out of 195 countries, right in the basement. The maternal mortality rate was 512 deaths per 100,000 live births, the third highest globally as of 2023. Only 39% of children were fully immunized, compared to a global average of 85%. High out-of-pocket expenses, limited infrastructure, and medical personnel shortages contributed to these challenges. South Africa’s immunization rate is 82%, and Rwanda’s is 95%, showcasing the potential for improvement through targeted healthcare policies and community engagement.
By the start of 2024, healthcare resurfaced as a national priority in Nigeria, spurred by Professor Muhammad Ali Pate’s appointment as Coordinating Minister of Health and Social Welfare in 2023. Last year witnessed a pivotal change in Nigeria’s health sector . Public intellectuals must objectively critique government policies, highlighting areas of concern while recognizing achievements. Acknowledging progress boosts morale, reinforces trust, and fosters innovation.
Under Professor Pate’s leadership , the Nigeria Health Sector Renewal Investment Initiative (NHSRII) was introduced to overhaul the health sector by addressing systemic issues, and driving sustainable improvements. NHSRII is anchored on four pillars: strengthening leadership, policy development, and accountability; enhancing infrastructure, training, and healthcare delivery; encouraging private sector investment and local manufacturing; and focusing on emergency preparedness and response. NHSRII promotes gender equity and reduces healthcare inequalities.
Implemented through a Sector-Wide Approach (SWAp), NHSRII coordinates government action, aligns donor efforts with national policies, and fosters collaboration. This draws from successful models in Ghana and Tanzania, where SWAp streamlines donor funding and aligns development assistance with healthcare strategies.
Significant Achievements
A significant achievement is the 16.7% reduction in under-five mortality, from 132 per 1,000 live births in 2018 to 110 in 2023. This reduction highlights improvements in prenatal care, nutrition programs, and vaccination campaigns, instilling confidence in the healthcare system.
In 2024, Nigeria achieved an HPV vaccination milestone, vaccinating 12.3 million girls aged 9-14 across all 36 states and the FCT, covering 96% of the target population. This is the highest global HPV vaccination coverage, critical in preventing cervical cancer, a leading cause of cancer deaths among Nigerian women. Community engagement, school-based vaccination, and awareness campaigns played crucial roles in fostering public involvement and responsibility.
In November 2024, Nigeria launched a malaria vaccine pilot in Bayelsa and Kebbi, vaccinating 41,145 children. Malaria accounts for 23% of child mortality in Nigeria. This pilot paves the way for nationwide expansion, potentially saving thousands annually.
Health insurance expansion has progressed. By 2024, all states had functional State Health Insurance Agencies (SSHIAs). Over NGN 12 billion was disbursed, covering 1.7 million lives. The National Health Insurance Authority (NHIA) surpassed its 2024 target, enrolling 2 million Nigerians, representing a 14% increase from 2023. Currently, 19.4 million individuals are insured, marking progress toward universal health coverage and reducing financial burdens.
Healthcare investment is rising, with 74 pipeline companies discussing 22 significant projects. Over $2 billion in funding is deployed by foreign manufacturers to support local manufacturing. Regulatory support and market-shaping strategies are essential to this effort.
Human resources for health have been prioritized. In 2024, 53,732 health workers were retrained across 32 states, improving service delivery. This equips frontline workers with updated maternal and child health skills, disease prevention, and emergency response. The curriculum integrates medical advancements and emphasizes hands-on training, enhancing healthcare outcomes and patient satisfaction.
A significant challenge is workforce migration. Skilled healthcare professionals seek opportunities abroad, straining local facilities. In August 2024, Nigeria introduced the National Policy on Health Workforce Migration to address this. The policy improves working conditions, offers incentives, and provides career development. Salary increments, job security, and welfare packages curb migration. Reintegration programs, competitive salaries, and healthcare entrepreneurship grants encourage diaspora professionals to return.
Constraints To Health Sector Reforms
Despite progress, budgetary constraints threaten reforms. The proposed 2025 budget allocates 5.18% (2.48 trillion naira) to healthcare, below the 15% Abuja Declaration target. Efficient resource use is crucial. SWAp maximizes limited funds by aligning donor contributions with policies, enhancing the impact of spending. Domestic investment, public-private partnerships, and tax revenue expansion are critical for sustaining growth.
Nigeria’s renewed focus on healthcare signals a turning point in the nation’s development . Progress through NHSRII, immunization programs, and workforce retention reflects a commitment to public health. Recognizing achievements energizes the sector. Celebrating milestones and addressing challenges proactively can build a resilient healthcare system, driving societal well-being. Sustained investment, collaboration, and accountability are essential for lasting impact.
