Stakeholders in Nigeria’s healthcare sector have called for sustainable financing, stronger public-private partnerships (PPPs) and clearer regulatory frameworks to address persistent gaps in primary healthcare delivery and expand access to affordable services.
‎
They made the call at a pre-summit dialogue convened by the Nigerian Economic Summit Group (NESG), in collaboration with the Federal Ministry of Budget and Economic Planning, where participants identified weak financing structures, fragmented regulation and inadequate accountability as constraints to private-sector investment in primary healthcare.
‎
The virtual dialogue, themed “Powering Health Policy Commission (HPC) to Universal Health Coverage (UHC): Unlocking Private Sector Partnership”, examined ways to strengthen primary healthcare and advance universal health coverage.
‎
Managing Director of Almond Healthcare Services Limited, Dr Ben Nkechika, said private-sector participation should extend beyond viewing private providers as contractors or profit-oriented businesses to include advocacy, health sensitisation, community mobilisation, demand generation, financing, technology and service delivery.
‎
He said private-sector interventions must respond to the core functions and needs of primary healthcare facilities, while emphasising the importance of engaging local governments and communities to ensure ownership and sustainability.
‎
Citing a programme implemented in Delta State, Nkechika said the concession of 15 primary healthcare facilities to private operators, supported by incentives, technology, expertise and collaboration with local governments and communities, demonstrated the potential of structured PPPs.
‎
According to him, the participating facilities recorded zero maternal deaths over five years, alongside improvements in infant health outcomes.
‎
Deputy Director, Health Systems Strengthening and Primary Healthcare at the Gates Foundation, Dr Nkata Chuku, said government ownership from the design stage and sustainable domestic financing were critical to scaling up PPP models.
‎
He said clear purchasing pathways were needed to establish who pays for healthcare services, protect poor and vulnerable populations from high out-of-pocket expenditure and provide private providers with a sustainable means of recovering their investments.
‎
Chuku also identified viability gap funding and other de-risking mechanisms as potential tools for attracting private capital to underserved areas.
‎
He advocated a pragmatic approach that builds on existing healthcare financing structures, including the National Health Insurance Authority (NHIA), Basic Health Care Provision Fund (BHCPF) and state health insurance schemes.
‎
Chief Executive Officer of EHA Clinics, Dr Ifunanya Ilodibe, said sustainable and predictable financing remained a major challenge for primary healthcare providers, particularly those serving underserved communities.
‎
She identified low insurance coverage, heavy reliance on out-of-pocket payments and delayed reimbursements as constraints to sustaining services, noting that even social-impact healthcare providers must operate within financially viable models.
‎
Ilodibe also called for greater accountability between public and private partners, describing the situation as “regulatory asymmetry,” in which private providers face stringent accreditation, regulatory and auditing requirements, while government obligations under PPP agreements may not be enforced with similar rigour.
‎
She advocated clearer contractual commitments covering facility upgrades, patient enrolment, capitation guarantees, payment timelines and penalties for non-compliance.
‎
Ilodibe also called for expanded health insurance coverage among Nigeria’s large informal-sector population, particularly in underserved communities, saying predictable patient volumes and timely payments through the NHIA and state health insurance schemes would provide greater certainty for private providers investing in primary healthcare.
‎
Chairman of the House Committee on Health Care Services/Establishments, Dr Amos Mogaji, identified weak revenue certainty, fragmented regulation, cumbersome government processes and weaknesses in contracting and procurement as barriers to private-sector investment in primary healthcare.
‎
He said investors required greater clarity on risks, responsibilities and expected outcomes, adding that multiple regulatory and reporting requirements could create unnecessary bureaucracy.
‎
Mogaji called for a national primary healthcare PPP framework to define the roles, responsibilities and expectations of government and private-sector participants.
‎
He also proposed a PHC investment and risk-sharing facility to provide greater clarity on investment risks and responsibilities, while stressing the need for policy continuity across administrations to sustain investor confidence.

Earlier, a member of the Steering Committee of the NESG Health Policy Commission, Dr Sade Adebanjo, described primary healthcare as the foundation and critical entry point of Nigeria’s healthcare system.
‎
She said persistent gaps in financing, quality of care, human resources, infrastructure and service delivery continued to limit the ability of primary healthcare facilities to meet the needs of underserved communities.
‎
Adebanjo said the private sector accounts for an estimated 60 to 70 per cent of healthcare service delivery in Nigeria, stressing that leveraging the resources, expertise and capabilities of both public and private stakeholders was essential to expanding access to quality, affordable healthcare.