The year 2024 has been transformative for Nigeria's health sector, marked by significant policy reforms, increased investments, strategic partnerships, and notable milestones. These developments underscore a collective commitment to enhancing healthcare delivery and outcomes across the nation.
Policy Landscape
In October 2024, the Federal Government (FG) unveiled the Health Sector Strategic Blueprint 2024-2027, aiming to address systemic challenges such as inadequate infrastructure, workforce shortages, and financing issues. This blueprint emphasises a Sector-Wide Approach (SWAp) to ensure cohesive efforts across all levels of government, donor and development partners.
The National Health Sector Renewal Initiative (NHSRII) was launched to revitalise the healthcare system and improve overall healthcare services by leveraging private-sector partnerships and international collaborations. Key actions include expanding Primary Healthcare (PHC) centres and ensuring each Local Government Area (LGA) has at least one comprehensive emergency obstetric and newborn care facility.
Investments in Health
The 2024 federal budget for health saw a significant increase, with allocations aimed at strengthening primary healthcare, improving infrastructure, and expanding health insurance coverage from 16.7 million to 19.2 million under a year. The government also disbursed ₦37 billion through the Basic Health Care Provision Fund (BHCPF) to designated primary health care facilities, doubling previous allocations.
The Presidential Initiative for Unlocking the Healthcare Value Chain (PVAC) achieved a $5 billion project pipeline, $2 billion in foreign investments, and 74 transformative projects. Partnerships with global leaders like Siemens Health, BHR Biosynex, Vestergaard, GlaxoSmithkline (GSK), Abbott, BASF and Moderna including the integration of clinical trials aims to position Nigeria as a leader in Africa's healthcare as well as within the Research and Development (R & D) ecosystem.
Complementary funding of over $3 billion was mobilised with the help of partners, including $2.1 billion confirmed, supplementing the Federal Government's efforts. Additionally, a $1.57 billion facility from the World Bank was secured under the PHC Provision Strengthening Programme (HOPE-PHC) to strengthen and rehabilitate 17,600 PHCs and equip them with climate-resilient infrastructure.
Additionally, the launch of the Nigeria Sovereign Investment Authority (NSIA) Healthcare Expansion Programme in August 2024 seeks to establish ten world-class healthcare facilities, specializing in oncology and diagnostics across the nation's six geopolitical zones and retain 120,000 frontline health workers.
Partnerships and Collaborations
In August 2024, the World Health Organization (WHO) and the Private Sector Health Alliance of Nigeria (PSHAN) launched the 'Adopt-A-Healthcare Facility Programme (ADHFP)' to establish at least one global-standard PHC in each of the 774 LGAs. This initiative aligns with the Health Sector Renewal Investment Programme and emphasises Public-Private Partnerships (PPP) to accelerate PHC revitalisation.
The introduction of SWAp has streamlined coordination among Federal, State, and Local Governments, fostering a unified strategy towards healthcare delivery. This approach ensures "One Plan, One Budget, One Report, and One Conversation," aligning efforts across all stakeholders to meet shared health priorities.
Efforts to catalyse PPPs have been emphasised at various fora to drive sustainable healthcare innovation, with strategies focusing on legal frameworks and opportunities to enhance healthcare delivery. Furthermore, an Industry Engagement Forum held in Lagos with an aim of increasing health product manufacturing in Africa, aligning with the African Development Bank's Pharmaceutical Action Plan, which invests $100 million annually to bolster pharmaceutical production.
Key Milestones
In November 2024, the Federal Ministry of Health & Social Welfare held the inaugural Nigeria Health Sector-Wide Joint Annual Review (JAR). This event brought together stakeholders to assess key performance indicators and secure political commitment needed to advance Nigeria's health priorities and goals. To address high maternal mortality rates, the government launched the Maternal and Newborn Mortality Reduction Investment Initiative (MAMII) targeting 174 high-burden Local Governments responsible for 50% of maternal deaths. The programme reflects a commitment to ending maternal mortality through focused interventions.
The Future of Health Conference (FHC) 2024 which was held in October 2024 focused on building resilience at the climate-health nexus, convening delegates, speakers, and partners to address challenges and advocate for policy action in the health sector. Additionally, the 8th Nigeria Family Planning Conference brought together key stakeholders to engage in discussions and strategies to meet Nigeria's FP2030 commitments, emphasizing the importance of family planning in national health agendas.
In October 2024, Nigeria launched the R21 Malaria Vaccine Rollout (Oxford R21 malaria vaccine), administering it for free as a significant step in combating malaria, a disease responsible for a substantial number of deaths in the country.
These developments reflect Nigeria's commitment to transforming its health sector through strategic policies, substantial investments, robust partnerships, and significant milestones, aiming to improve healthcare outcomes for its population.
Notable Challenges
The Nigerian health sector continues to face difficulties in spite of progress. Basic Healthcare Provision Funds (BHCPF) disbursement delays impede timely programme implementation; agency-to-agency process misalignment and delayed approvals are major contributing factors.
Despite efforts to bolster the health workforce, challenges persist due to emigration of healthcare professionals seeking better opportunities abroad. This brain drain has strained the healthcare system, particularly in rural areas.
The exit of major pharmaceutical companies like GlaxoSmithKline and Sanofi from the Nigerian market, coupled with economic challenges, led to a significant increase in the cost of essential medicines, impacting accessibility for many Nigerians.
Although progress has been made in strengthening emergency response plans and extending climate-resilient health regulations, professional opinions indicate that more work is still needed in a few crucial areas.
Achieving complete adherence to the 7-1-7 outbreak response strategy is one of the major obstacles. While national outbreaks meet the 7-1-7 timelines, only 25-40% of all outbreaks are detected and managed within the desired time frame. This is in spite of the fact that this model has improved response times for larger outbreaks, but many smaller, localized outbreaks go unnoticed or are underreported, especially at the state level. This disparity emphasizes the necessity of capacity-building initiatives customized for regional and state healthcare systems.
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Another area that needs focus is facility readiness. Health facilities, particularly those in rural regions, still lack the equipment and resources necessary to address health shocks, despite the fact that initiatives like National Emergency Medical Service and Ambulance System (NEMSAS) and Rural Emergency Service and Maternal Transport (RESMAT) have made emergency medical care more accessible.
Lessons Learned
The success of initiatives like SWAp and ADHFP highlights the effectiveness of coordinated efforts among government entities, private sector, and international partners in achieving health sector goals. While increased investments have been beneficial, the reliance on international funding underscores the need for sustainable domestic financing mechanisms to ensure long-term health sector improvements.
Looking Ahead: Hopes for 2025
Continued focus on rehabilitating and equipping primary healthcare centres to ensure they are fully functional and accessible to all Nigerians. Efforts to enhance the National Health Insurance Authority's reach, aiming to provide financial protection and access to quality healthcare for a larger segment of the population. Implementing strategies to retain healthcare professionals within the country, including improved working conditions and competitive remuneration. Nigeria can greatly improve its health outcomes and advance the goal of universal access to healthcare by enhancing public accountability, fostering greater community involvement, and paying close attention to the socioeconomic determinants of health.
