A new survey has revealed that only 7 per cent of Nigerians have medical-aid coverage, leaving more than nine in 10 citizens without health insurance and exposing millions of households to the financial burden of paying for healthcare directly.
The findings, contained in a recent Afrobarometer survey, also showed widespread anxiety over access to medical treatment, with 91 per cent of respondents saying they were at least somewhat worried about being unable to obtain or afford healthcare when needed.
Nearly half of those surveyed, representing 47 per cent, said they were “very worried” about the possibility of being unable to access or pay for medical care.
The survey highlights the continuing difficulties faced by Nigerians despite government efforts in recent years to expand health insurance coverage and strengthen the country’s healthcare system.
Cost and awareness hinder insurance uptake
Among Nigerians without health insurance, lack of awareness and affordability emerged as the leading obstacles.
About 43 per cent of uninsured respondents said they were unaware of available health insurance schemes, while 24 per cent identified cost as the main reason they did not have coverage.
The findings suggest that expanding insurance coverage will require not only the creation of more affordable schemes but also stronger public education about how insurance works and how citizens can enrol.
Public hospitals face multiple challenges
The survey also examined Nigerians’ experiences with public healthcare facilities.
Among respondents who visited a public clinic or hospital during the 12 months preceding the survey, only 45 per cent said it was easy to obtain the services they needed.
A significant proportion reported encountering problems at healthcare facilities.
Lack of medicines and medical supplies and long waiting times were each reported by 83 per cent of respondents. Meanwhile, 82 per cent cited unaffordable healthcare, while 79 per cent complained about poor facility conditions.
Another 77 per cent reported encountering situations where medical personnel were unavailable.
The survey further found that 26 per cent of respondents who interacted with public healthcare facilities said they had been required to pay a bribe.
Nigerians increasingly going without treatment
The difficulties extend beyond individual hospital experiences.
The proportion of Nigerians reporting that they or a member of their household went without medicine or medical treatment at least once in the preceding year has risen sharply over the past decade.
According to the survey, the figure increased from 43 per cent in 2015 to 82 per cent, representing an increase of almost twofold.
The development underscores the extent to which healthcare costs, availability of services and weaknesses within the health system continue to affect households.
Majority demand universal healthcare
The survey also found strong public support for greater government intervention.
About 64 per cent of Nigerians said the government should guarantee universal access to healthcare, even if achieving that objective requires higher taxes.
At the same time, 81 per cent of respondents said the government was performing poorly in efforts to improve basic healthcare services.
Public confidence in the Federal Ministry of Health was also relatively low, with only 36 per cent saying they trusted the ministry either “somewhat” or “a lot.”
Reforms yet to close healthcare gaps
Nigeria has introduced several measures aimed at improving healthcare delivery and expanding insurance coverage.
The National Health Insurance Authority Act of 2022 strengthened the regulatory framework for health insurance and was intended to support the country’s pursuit of universal health coverage.
Other initiatives include the Basic Healthcare Provision Fund, the National Primary Health Care Development Agency, the Health Sector Renewal Investment Initiative and efforts to establish stronger emergency medical and ambulance services.
Government spending on healthcare has also increased, rising from N1.33 trillion in 2024 to N2.48 trillion in 2025, although the allocation remained below 5 per cent of the national budget, according to the information cited in the survey report.
Despite these interventions, substantial gaps remain in healthcare infrastructure, financing and human resources.
Health worker shortages worsen access
The country’s healthcare workforce remains another major concern.
Government estimates cited in the report put the ratio at approximately one doctor for every 5,000 Nigerians and one nurse for every 2,000 people, while health professionals are unevenly distributed across the country.
About 75 per cent of health workers are concentrated in urban areas, leaving many rural communities with limited access to essential medical services.
The combination of low insurance coverage, high out-of-pocket spending, inadequate staffing and weak infrastructure continues to place considerable pressure on households.
Strong support for childhood vaccination
On preventive healthcare, the survey found substantial public support for mandatory childhood immunisation.
About 82 per cent of Nigerians said parents should be required to vaccinate their children against infectious diseases such as measles and polio.
Overall, the findings point to a population that wants broader and more affordable access to healthcare but continues to face significant barriers in obtaining it.
For Nigeria, the challenge now extends beyond announcing reforms to ensuring that insurance schemes are affordable and widely understood, public facilities are adequately equipped and staffed, and healthcare services are accessible to citizens regardless of where they live or their ability to pay.
