Nigeria health system


Private Health System

  • Formal primary health care (PHC) facilities, secondary, tertiary and informal patent medicine vendors (PMV) and drug sellers

  • Private facilities account for 40% of all registered health facilities

  • Informal private sector consists of about 120,000 PMVs and an unknown number of drug sellers

  • Greater density in urban areas compared to rural areas

    • Except the informal PMVs and drug sellers that are often established in rural areas

Primary Health Care Level

  • General health services: preventive, curative, promotive and rehabilitative

  • Facility types: (1) Health Post (2) Primary Health Clinic and (3) Primary Health Care Centres

  • Serve catchment area populations of 10,000-30,000 people

Access to healthcare 

  • 64% of the population lives within 20km radius from a hospital (urban: 78% vs rural 58%)

  • 71% of households are within 5 km of a PHC facility (urban 80%, 66% rural)

  • 39% households live in communities visited by a community health worker (CHW) at least once a month (43% urban, 38% rural).

  • ACT Watch Nigeria 2015 Outlet Survey:

    • Public sector: Less than a third of facilities had any severe malaria treatment available

Care-seeking habits

  • Pilot study (2016) on proprietary patent medicine vendors (PPMVs) outcomes:

    • Caregivers’ preferences for seeking treatment of childhood illnesses are at PPMV (40%) and at public health facility (23%)
    • PPMV improved their correct treatment and referral practices when presented with signs of severe illness from 16% to 88%


  • Completeness of data: gaps in HMIS data
    • Lack of tools and skills/capacity at sub-national levels
    • Makes planning and resource mobilization efforts difficult
  • Limited availability of health workers, and deployment in the rural health facilities
  • Execution capacity
  • Absorptive capacity and late release of funds
  • Donor coordination
  • Lack of necessary referral linkages between the different levels of health care

  • Quality and coverage of service delivery

    • Periphery: limited package of services due to limited trained health workers

  • Commodity logistics systems (6 separate vertical commodities management systems)

  • Supervision of health services and institutional capacity