Have you ever had to organize a family meeting because someone needed surgery? Or watched as your neighbours sold their land to pay hospital bills? If you’re like most Nigerians, you know exactly what I’m talking about. The truth is, falling sick in Nigeria isn’t just about fighting disease, it’s about fighting to afford treatment. This isn’t just bad luck or poor planning, it’s the direct result of how healthcare is funded in Nigeria.

 

To understand why Nigerian families struggle so much with medical costs, we need to look at three key measures that shape our healthcare reality: how much of our country’s wealth (GDP) goes to current healthcare expenditure (CHE), what share of our national budget is allocated to health, and, most importantly for ordinary citizens, how much we pay from our own pockets.

How Much Does Our Government Actually Spend?

The numbers tell a stark story. Nigeria’s government currently spends just 0.62% of its GDP on healthcare. To understand how severely inadequate this is, consider that the World Health Organization (WHO) recommends a minimum of 5% for basic healthcare coverage. In simple terms, our government’s contribution is less than one-eighth of what’s considered necessary for basic health services.

Looking at our neighbors shows this doesn’t have to be the case. South Africa invests over 8% of its GDP in healthcare, while Ghana commits about 4%. Even Kenya, facing similar economic challenges to Nigeria, maintains approximately 2.3%. These countries prove that higher healthcare investment is possible even within our regional context.

 

 

The picture doesn’t improve when we look at our national budget. For 2025, ₦2.48 trillion has been allocated to healthcare out of a total budget of ₦47.90 trillion. This 5.18% might seem reasonable until we recall the Abuja Declaration of 2001, where Nigeria joined other African nations in promising to dedicate 15% of the annual budget to healthcare. Two decades later, we’re achieving only about one-third of that commitment.

So Who’s Really Paying for Healthcare?

When government spending falls this short, someone else has to pay the difference. That someone is us – everyday Nigerians. Between 2013 and 2022, Nigerians have consistently paid 70-75% of all healthcare costs directly from their pockets, what economists call “out-of-pocket (OOP) spending.”

The WHO warns that OOP spending shouldn’t exceed 20% if we want to protect families from financial hardship. At 75%, Nigeria’s rate is nearly four times this maximum safe level. This becomes even more troubling when we see how other countries protect their citizens:

 

 

While we struggle with 75% OOP spending, Ghana has reduced their citizens’ burden to 24%, Kenya maintains around 23%, and South Africa has achieved an impressive rate of just 7%. Looking beyond Africa, we see even more possibilities: Canadian citizens pay about 15%, Americans pay 11% despite their system’s reputation for high costs, and the global average sits at about 30%.

 

The Real Cost to Nigerian Families

These aren’t just abstract numbers, they translate into painful daily realities. When government spending is this low (0.62% of GDP) and out-of-pocket costs this high (75%), families face impossible choices. Managing any serious medical condition often means depleting savings, selling assets, taking high-interest loans, or depending on family contributions. Some families must choose between seeking medical care and meeting other basic needs like food or education.

What Are Your Options Today?

While we can’t fix the system’s problems overnight, understanding these numbers helps us make better choices for protecting ourselves and our families. If you work in the formal sector, your employer must now provide health insurance under the National Health Insurance Authority (NHIA). For those in the informal sector, some states offer community health insurance schemes with basic coverage. Primary healthcare centers provide significantly lower costs for regular check-ups and basic medications.

 

The evidence is clear: countries that invest more in healthcare protect their citizens from both illness and financial hardship. Until Nigeria bridges the gap between our current 0.62% GDP spending and the WHO’s recommended 5%, families will need to be strategic about how they access and pay for healthcare. While these individual measures can’t fix a system that fundamentally underfunds healthcare, they provide some protection against devastating medical costs.