Nigerians worry about access to medical care amid widespread lack of health insurance
Afrobarometer Dispatch No. 1228 | Caroline Nakayiza and Raphael Mbaegbu
Summary
In recent years, Nigeria has implemented several reforms intended to strengthen primary health care and expand health-insurance coverage. One milestone was the enactment of the National Health Insurance Authority Act in 2022 (Onyekpere, 2025), which strengthened regulation of health insurance as a step toward universal health coverage. Complementary efforts include the establishment or strengthening of key institutions and initiatives, including the Basic Healthcare Provision Fund, the National Primary Health Care Development Agency, the Health Sector Renewal Investment Initiative, the National Emergency Medical Service and Ambulance System, and the National Emergency Management Agency.
The government’s commitment is also reflected in increased budgetary allocations to the health sector, which rose from ₦1.33 trillion in 2024 to ₦2.48 trillion in 2025, though still well below 5% of the national budget (Adejoro, 2025)
Despite recent efforts to strengthen Nigeria’s health system, many citizens continue to face significant barriers to accessing affordable and quality care. Health-insurance coverage remains low (Soaga, 2024), and households bear a heavy financial burden through out-of-pocket payments for health services (Federal Ministry of Finance, 2025).
The country also faces major shortages and uneven distribution of health workers. Government estimates indicate that Nigeria has roughly one doctor for every 5,000 people and one nurse for every 2,000 people (Jimoh, 2026), well below World Health Organization recommendations. Moreover, about 75% of health workers are concentrated in urban areas, leaving many rural communities with limited access to essential health services (Federal Ministry of Finance, 2025; World Health Organization, 2026).
Recent Afrobarometer survey findings show that fewer than one in 10 Nigerians have health insurance, while most say they are not aware of any available insurance scheme or can’t afford insurance.
In striking numbers, Nigerians experience barriers to accessing health care, including high costs, long wait times, shortages of medicines, facilities in poor condition, absent medical personnel, and demands for bribes. The share of citizens who report going without needed care has almost doubled over the past decade, and most Nigerians say they worry about being unable to obtain or afford medical care when they need it.
Public demand for better government performance in health care is high: Most citizens say the government is doing a poor job of improving basic health care services, and a clear majority call for universal health care, even if it requires a tax increase.
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