Two non-governmental organisations—the Civil Society Legislative Advocacy Centre (CISLAC) and the Vaccine Network for Disease Control (VNDC), have called for increased and protected health financing, urging federal and state governments to significantly raise health budgetary allocations and ensure the timely release of funds.
The groups also stressed the urgent need to address Nigeria’s acute healthcare workforce shortage, which they said continues to strain the health system, limit access to quality care, and fuel burnout among health workers.
In separate appraisals of the health sector in 2025, the organisations highlighted key achievements and persistent challenges, warning that bold reforms, sustained political commitment, and accountability-driven governance will be critical in 2026.
The Executive Director of CISLAC, Auwal Rafsanjani, told The Guardian that Nigeria’s health sector remains at a critical crossroads. He noted that while there have been policy commitments and modest improvements in health insurance coverage and primary healthcare revitalisation, systemic issues, particularly underfunding, governance gaps, workforce crises, and inequitable access, continue to undermine Nigerians’ right to quality and affordable healthcare.
Rafsanjani observed that yearly health budgets still fall short of the Abuja Declaration target of allocating at least 15 per cent of the national budget to health, adding that inflation, currency depreciation, and rising operational costs further erode available funds. He lamented worsening brain drain, frequent industrial actions, poor welfare conditions, and inadequate staffing in public facilities, which he said leave millions underserved, especially in rural and conflict-affected areas.
According to him, improved remuneration, better working conditions, and clear career progression pathways are essential to curb workforce attrition. He also decried Nigeria’s continued reliance on out-of-pocket payments, noting that it pushes households into poverty and contradicts universal health coverage (UHC) goals. Weak oversight, opaque procurement processes, and allegations of mismanagement, he added, have further undermined public trust.
Rafsanjani pointed to persistent disparities between urban and rural areas and across geopolitical zones, particularly in maternal, child, and mental health outcomes. While acknowledging the launch of the Maternal Mortality Reduction Innovation and Initiatives (MAMII) project, which aims to cut maternal deaths by 30 per cent within three years, he stressed that maternal mortality remains a major challenge.
Highlighting progress recorded in 2025, Rafsanjani cited the Minister of Health’s “Red Letter,” which underscored the severity of Nigeria’s health challenges and called for urgent action. He also noted that the Federal Government allocated N170.01 billion for nutrition interventions in the 2025. budget.
A 746 per cent increase from N6.5 billion in 2023 and a 33.7 per cent rise from N127.24 billion in 2024, targeting malnutrition and food insecurity through 249 new programmes across nine ministries, departments, and agencies.
He added that the implementation of the National Health Insurance Authority (NHIA) Act improved enrolment in some states, particularly among public sector workers and vulnerable groups, while disbursements from the Basic Health Care Provision Fund (BHCPF) supported primary healthcare centres, maternal and child health services, and access to essential medicines in several states.
Rafsanjani commended renewed attention to primary healthcare, noting that investments in PHC infrastructure, digital health tools, immunisation campaigns, disease surveillance, and epidemic preparedness improved community-level access. He also welcomed increased civil society, media, and legislative scrutiny of health budgets and procurement, which he said strengthened transparency.
In 2026, Rafsanjani advocates stronger governance, transparency, and accountability, urging governments to protect health spending from leakages through open contracting and robust oversight. He also stressed the need to fully enforce mandatory health insurance across all states, with special protection for the poor and the informal sector.
For her part, Chika Offor, Chief Executive Officer of VNDC, described the 2025 integrated vaccination campaign, covering measles-rubella, HPV, polio, routine immunisation, and neglected tropical diseases, targeting over 106 million children, as one of the government’s most ambitious health interventions.
However, she identified vaccine co-financing as a major shortcoming, noting that although N231 billion was budgeted for immunisation in 2025, only N68 billion was released in November, leaving a substantial funding gap.
“This means that although immunisation passed through the budget, there was no ring-fenced, dedicated funding for vaccines,” Offor said, explaining that vaccine financing is currently drawn from service-wide votes, where it competes with other government priorities. She welcomed the additional two per cent allocation to the BHCPF, describing it as properly ring-fenced funding.
Offor called on the Federal Government to place vaccine financing on the first-line charge, fully release outstanding allocations for 2025, and address funding shortfalls from 2024, noting that only 25 per cent of the previous year’s allocation was released.
