The healthcare system in Nigeria is complex and riddled with several challenges including limited resources, severe personnel shortages especially in remote areas, limited opportunities for continuing education and career advancements, limited involvement in policy making, and inadequate leadership. The system is still evolving but with no clear pathway for balancing the increasing demand on the healthcare system with adequate supply. Access to healthcare is primarily through personal funding by the patient, resulting in poor outcomes as individuals do not seek professional care until their health has significantly deteriorated, and other home or herbal remedies they may have tried has failed. This leads to a lot death because conservative management which is often all that is available in most clinics may not be effective in the late stages of a disease process.
For years the government has considered improving access to care through the development of a Universal Health Care (UHC) program that will provide insurance to citizens and improve healthcare access at all levels. However, this vision has not been established, with the government contributing very little to public healthcare, and still no organized form of affordable insurance for the masses. Majority of citizens are therefore left to fund their care, and the initial out of pocket cost can be prohibitive (Uzochukwu et al., 2015). With lack of subsidized healthcare, Nigeria has some of the worst health indicators in the world, and ranked second in neonatal death between the years 2000 and 2010 (Akinyemi, Bamgboye, & Ayeni, 2015). This high rate of neonatal death likely results from poor access to antenatal care, and inability to utilize hospital services due to cost.
In addition, continuing industrialization and westernization of lifestyle and eating habits in Nigeria has resulted in an uptrend in chronic diseases such as hypertension (high blood pressure), diabetes (high blood sugar), hyperlipidemia (high cholesterol), as wells as complications from these diseases including cerebrovascular accident ((CVA) otherwise known as stroke, kidney disease, and cardiovascular diseases etc. In the past, infectious diseases were the most common cause of hospitalization and death, and due to its acute nature, the demand on the system was not as significant. Today, chronic diseases have taken over as the primary cause of morbidity and mortality because these conditions require long-term management and follow-up, and lead to poor outcomes if left untreated.
The healthcare needs of patients with chronic diseases and those at risk should become the primary focus of public health policy and advocacy in Nigeria. The exorbitant cost of long-term management of these diseases including drugs and self-monitoring devices, as well as the cost of managing the complications, should be prime targets for analysis and intervention by the government, public health officials, professional healthcare providers, and all stakeholders. Creating healthcare policies to educate the general public and raising awareness of prevention methods is necessary. In addition, screening and early diagnosis will ensure timely intervention to prevent the long-term complications which are  often costlier, debilitating, and can lead to death.
Written by Dr. Idongesit Udoh