Nigeria
The national health system in Nigeria is based on a three-tiered hierarchy of services offered by the federal, state, and local governments. All three levels of government are involved in maintenance, financing, and service delivery. The federal government, specifically the National Ministry of Health, is responsible for developing healthcare policies, maintaining transparency across all levels of government, running tertiary hospitals, and managing national healthcare information. At the state level, state ministries of health maintain secondary hospitals. The local governments are responsible for delivering primary healthcare in Nigeria.
Healthcare Spending
Spending on health-related services, institutions, and resources is low in Nigeria. The World Health Organization (WHO) reports that Nigeria spent 6.1% of the GDP on healthcare in 2012. Nigeria ranks 127th in the world on this measure. In addition, the GDP is low. For instance, in 2012, 6.1% of the GDP amounted to only $161 USD, a figure that is below even the regional average for Africa, which is low in comparison to the rest of the world.
Availability of Care
Given the amount of money spent on healthcare in Nigeria, it should not come as a surprise that there is a deficit of healthcare professionals across the country. There are only 0.41 doctors per one thousand people. That’s a ratio of 1:2,439 and is among the lowest in the world, although it is above the regional average in Africa. Nurses and midwives are also scarce, with only 1.61 nurses and midwives per one thousand people. Although this figure is also higher than the regional average of 1.2 nurses and midwives per one thousand persons across Africa, it is far from enough to adequately serve the population. Hospital beds are also a rarity, with 0.53 beds per one thousand people.
Life Expectancy & Mortality
Life expectancy in Nigeria is among the lowest in the world at 52.62 years. Nigeria ranks 212th in the world on this measure, out of a total of 223 countries. Life expectancies for males and females differ only slightly, with males living 51.63 years on average and females living 53.66 years. Neighboring sub-Saharan African countries make up most of the bottom twenty lowest life expectancies in the world.
Other Issues
While it would seem that Nigeria has a highly organized system, the decentralization of services across three levels of government actually results in a significant amount of redundancy, confusion regarding job roles, and ineffective use of funds within the healthcare sector. Unfortunately, this system has not contributed to the improvement of health conditions in Nigeria in recent years, during which several health crises have occurred. In particular, the regulation of drugs is a significant issue. Fake or tampered drugs have been responsible for hundreds of deaths across the country, many of which were children. Another major issue facing the Nigerian healthcare system has to do with geographic inequalities. The quality of health facilities does not always reflect local need, with healthcare in rural areas especially compromised. Finally, another problem plaguing the Nigerian healthcare system is the lack of trained healthcare professionals. Unfortunately, working conditions are so poor that many doctors choose to leave the country and practice elsewhere.