The Nigerian health system is pluralistic, including orthodox, alternative, and traditional systems. Healthcare is administered through three tiers - primary run by local government, secondary by state government, and tertiary by the federal government. Nigeria has a large stock of health workers, but faces many health challenges like malaria, HIV/AIDS, and lacks adequate sanitation and access to clean water. Healthcare is financed through taxes, out-of-pocket payments, donors, and health insurance though coverage of the National Health Insurance Scheme remains low, only covering formal sector employees.

1. HEALTH SYSTEMS IN NIGERIA
Presented by:
WINFRED AKPLAGAH
GLOBAL HEALTH

2. OUTLINE
 Introduction
 Key health indicators
 Health needs
 Healthcare in Nigeria
 Service delivery
 Health financing

3. Introduction – Political
background
 Nigeria is a Federal Republic
composed of 36 States, and a
Capital Territory, with an elected
President and a Bi-cameral
Legislature.
 The Senate President is the
Head of the Federal Legislature.
 There is a National Assembly
made up of the Senate and
House of Representatives.
 At the State level, the Legislature

4. Introduction-Demographics
 Demographic characteristics
Population (millions) UN, 2012, total 166.6
Population annual growth rate (%), 2011 2
Crude death rate, 2011 14
Crude birth rate, 2011 40
Life expectancy, 2011 52
Total fertility rate, 2011 5
Urbanized population (%), 2011 50
Average annual growth rate of urban population (%), 2011 3
Population density (per sq. km), 2010 173.94
Adult literacy rate (%), 2011 61

5. Key Health Indicators
Under-5 mortality rate (U5MR), 2011 124
Probability of dying b/n 15&60 m/f per 1,000 pop. 393/360
Total expenditure on health as % of GDP 5.3
Total expenditure on health per capital (US$) 139
Deaths due to HIV/AIDS, 2012 210,000
HIV prevalence (%), 2011 3.7
Annual no. of under-5 deaths (thousands) 2011 756
GNI per capita (US$) 2011 1200
Life expectancy at birth ( m/f years) 2011 52/53
GNI per capita (PPP US$) 2300

6. Health needs
Malaria
HIV/AIDS
Influenza & Pneumonia
Diarrhoeal diseases
Tuberculosis
Stroke
Coronary Heart Disease

7. Health risks
 Alcohol/drinking
 Tobacco/smoking
 Obesity
 Sanitation
 Access to portable
water

8. Healthcare
 Nigerian health system is pluralistic. It
includes orthodox, alternative and
traditional health care delivery systems
operating alongside each other.
 The Government recognizes and
regulates these three systems.
 A world health report ranked Nigeria 177
out of a total of 191 countries, on its
degree of responsiveness to healthcare

9.  The Nigerian healthcare
administration is
organized in to three (3)
tiered of Government
namely Federal, State
and Local.
 Health care in Nigeria is
administered through
three tiers: primary,
secondary and tertiary
levels.
 The primary level is run
by the local government,
the secondary by the
state, while the tertiary is
run by the federal
government
(FRN/FMOH, 2000).

10. Organizational Pyramid of the Nigerian Health Services
Structure
ADMINISTRATIVE
LEVELS
SERVICE STRUCTURE PERSON IN
CHARGE
Federal
Government
Tertiary Health
Services
Federal Ministry
of Health
Secondary
Health Services
State Ministry of
Health
State
Government
Local
Government
Areas
Primary Health
Services
Private Sector Private Services Private
Providers

11. CABINET
National Advisory Council on Health
Inter Sectoral Collaboration
Federal Ministry of Health
Private sector, NGOs, Traditional/Faith healersTeaching Hospitals, Federal Medical Centres
State Ministry of Health
General Hospitals
Local Government Department for Health
Primary Health Clinics and Health Posts

12. Service delivery
 Nigeria has one of the largest
stocks of health workers in Africa
comparable to Egypt and South
Africa.
 About 60% of the states in Nigeria,
provide rural incentives to health
workers that volunteer to serve in
the rural areas, while others make
rural service a condition for some
critical promotion.
 National Youth Service Corps

13. Total health workers and densities in 2008
Categories Number
Density per 1000
population
Physicians 55 376 0.37
Nurses and midwives 224 943 1.49
Dentists and technicians 3 781 0.02
Pharmacists and technicians 18 682 0.12
Environ, and public health 4 280 0.03
Laboratory technicians 22 683 0.15
Other health workers 2313 0.02
Community health 19 268 0.13
Total 351 326 2.32

14. Health financing
 Health care in Nigeria is financed by a
combination of:
 Tax revenue from the sale of oil and gas
 Out of pocket payments
 Donor funding
 Health insurance (private, public, social and
community).
 The TGHE as % of GDP in 2011 was 5.3
 Per capita GGHE (2012) was US$ 29.2
 Per capita THE (PPP int. $) was 139.3
 NHIS in Nigeria covers only the formal sector
employees (mandatory). 90% coverage has been

15.  NHIS contribution represent 15% of basic
salary
 The employer pays 10% and the employee
pays 5%
 The package covers the contributor, a spouse,
and four (4) biological children below age 18.
 Services under the NHIS are:
Out-patient care including necessary consumables.
Prescribed drugs.
Maternity care up to four (4) live births.
 preventive care.
Hospital care up to 15 days per year.
Consultations with specialists
Eye examinations
A range of prostheses (limited to artificial limbs
produced in Nigeria)

16. Thank you