rfhealthЗдравоохранение Российской ФедерацииHealth care of the Russian Federation0044-197X2412-0723Federal Scientific Center of Hygiene named after F.F. Erisman10.47470/0044-197X-2025-69-3-240-245nzbxlzrfhealth-1917Research ArticleОРГАНИЗАЦИЯ ЗДРАВООХРАНЕНИЯHEALTH CARE ORGANIZATIONСовременные организационные особенности системы здравоохранения НигерииModern managerial features of the healthcare system in Nigeriahttps://orcid.org/0009-0000-2109-7903ОгуджубаСоломон НнаэмекаOgujubaSolomon N.

Магистрант базовой каф. эпидемиологии, микробиологии и паразитологии Школы медицины и наук о жизни, ФГАОУ ВО ДВФУ, 690922, Владивосток, Россия

e-mail: nnaemekasolomon@gmail.com

Master’s student of the Basic Department of Epidemiology, Microbiology and Parasitology, School of Medicine and Life Sciences, Far Eastern Federal University, Vladivostok, 690922, Russian Federation

e-mail: nnaemekasolomon@gmail.com

nnaemekasolomon@gmail.comhttps://orcid.org/0000-0003-4002-9521БеллоТайе ОлусолаBelloTaye O.

Магистрант базовой каф. эпидемиологии, микробиологии и паразитологии Школы медицины и наук о жизни, ФГАОУ ВО ДВФУ, 690922, Владивосток, Россия

e-mail: tayebello782@gmail.com

Master’s student, Basic Department of Epidemiology, Microbiology and Parasitology, School of Medicine and Life Sciences, Far Eastern Federal University, Vladivostok, 690922, Russian Federation

e-mail: tayebello782@gmail.com

tayebello782@gmail.comhttps://orcid.org/0000-0003-4507-9229РассказоваВалентина НиколаевнаRasskazovaValentina N.

Канд. мед. наук, доцент Департамента общественного здоровья и профилактической медицины Школы медицины и наук о жизни, ФГАОУ ВО ДВФУ, 690922, Владивосток, Россия

e-mail: rasskazova.vn@dvfu.ru

PhD (Medicine), Associate Professor of the Department of Public Health and Preventive Medicine, School of Medicine and Life Science, Far Eastern Federal University, Vladivostok, 690922, Russian Federation

e-mail: rasskazova.vn@dvfu.ru

rasskazova.vn@dvfu.ruhttps://orcid.org/0000-0002-5580-5442ШмелеваВалерия ДмитриевнаShmelevaValeria D.

Ст. преподаватель Департамента общественного здоровья и профилактической медицины Школы медицины и наук о жизни, ФГАОУ ВО ДВФУ, 690922, Владивосток, Россия

e-mail: shmeleva.vd@dvfu.ru

Senior Lecturer, Department of Public Health and Preventive Medicine, School of Medicine and Life Science, Far Eastern Federal University, Vladivostok, 690922, Russian Federation

e-mail: shmeleva.vd@dvfu.ru

shmeleva.vd@dvfu.ruФГАОУ ВО «Дальневосточный федеральный университет»РоссияFar Eastern Federal UniversityRussian Federation202501082025693240245Copyright © Огуджуба С.Н., Белло Т.О., Рассказова В.Н., Шмелева В.Д., 20252025Огуджуба С.Н., Белло Т.О., Рассказова В.Н., Шмелева В.Д.Ogujuba S.N., Bello T.O., Rasskazova V.N., Shmeleva V.D.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.rfhealth.ru/jour/article/view/1917Введение

Введение. Получение качественных и доступных медицинских услуг населением в Нигерии сталкивается с многочисленными динамичными проблемами, включающими дефицит медицинского персонала и оборудования, низкий доступ к медицинским учреждениям населения отдалённых от центра страны местностей.

Цель исследования — оценить систему здравоохранения в Нигерии на основе различных методов анализа и научного обзора литературы, раскрывая её сильные и слабые стороны и возможности, которыми обладает сектор здравоохранения и предложить рекомендации по улучшению получения качественной и доступной медицинской помощи населением страны.

Материалы и методы

Материалы и методы. Проведён анализ распространённости заболеваний и причин смертности населения из баз данных Всемирного банка, сайта Всемирной организации здравоохранения, Министерства здравоохранения Нигерии и другой научной литературы, полученной из интернет-источников. Применяли информационно-аналитический, статистический методы исследования и системный анализ.

Результаты

Результаты. Проведённый обзор выявил увеличение эмиграции специалистов из страны, усиливая дефицит медицинского персонала; недостаточное финансирование и нерациональное распределение имеющихся ресурсов в нигерийской системе здравоохранения; устаревшую материально-техническую базу основных фондов здравоохранения; дефицит медикаментов и расходных материалов; недостаточную оснащённость системы здравоохранения медицинскими информационными и коммуникационными технологиями; низкое влияние правительственных инициатив, таких как Национальная система медицинского страхования на качество и доступность оказания медицинской помощи для всех слоёв населения.

Ограничения исследования

Ограничения исследования. Исследование основано на вторичных официальных данных, которые могут не отражать региональные различия внутри Нигерии.

Вывод

Вывод. Проведённый анализ состояния развития системы здравоохранения Нигерии может служить основой для разработки рекомендаций по реализации программ и политики здравоохранения, направленных на обеспечение доступной, своевременной и качественной медицинской помощи для всех слоёв населения страны.

Соблюдение этических стандартов. Исследование не требует представления в комитет по биомедицинской этике.

Участие авторов

Участие авторов: Огуджуба С.Н. — концепция и дизайн исследования, статистический анализ, написание текста, ответственность за целостность всех частей статьи, утверждение окончательного варианта статьи; Белло Т.О. — сбор и обработка данных, написание текста, составление списка литературы; Рассказова В.Н. — написание текста, редактирование; Шмелева В.Д. — редактирование.

Финансирование

Финансирование. Исследование не имело спонсорской поддержки.

Конфликт интересов

Конфликт интересов. Авторы заявляют об отсутствии конфликта интересов.

Поступила

Поступила: 14.01.2024 / Поступила после доработки: 15.04.2024 / Принята к печати: 30.05.2024 / Опубликована: 30.06.2025

Introduction

Introduction. Access to quality and affordable healthcare services by the people living in Nigeria faces numerous dynamic challenges, including shortages of medical personnel and equipment, and poor access to healthcare facilities by the population in remote areas.

The purpose of the study is to assess the healthcare system in Nigeria based on various methods of analysis and a scientific review of the literature, revealing its strengths, weaknesses, and opportunities that the healthcare sector has, and offer recommendations for improving access to qualitative and affordable healthcare by its citizens.

Materials and methods

Materials and methods. An analysis of the prevalence of diseases and causes of mortality in the population was conducted from the World Bank databases, the website of the World Health Organization, the Ministry of Health of Nigeria and other scientific literature obtained from Internet sources. Information-analytical, statistical research methods, and system analysis were used.

Results

Results. The conducted review revealed an increase in the emigration of specialists from the country, exacerbating the shortage of medical personnel; insufficient funding, and irrational distribution of available resources in the Nigerian healthcare system; outdated material and technical service of basic healthcare funds; shortage of medicines and consumables; insufficient provision of the healthcare system with medical information and communication technologies; low impact of government initiatives including the National Health Insurance Scheme (NHIS) on the quality and accessibility of healthcare for all segments of the population.

Research limitations

Research limitations. The study is based on secondary official data that may not reflect regional differences within Nigeria.

Conclusion

Conclusion. The conducted analysis of the state of development of the healthcare system in Nigeria can serve as a basis for developing recommendations for the implementation of health programs and policies aimed at ensuring accessible, timely and quality healthcare for all segments of the population of the country.

Compliance with ethical standards. The study does not require submission to the biomedical ethics committee.

Contribution of authors

Contribution of authors: Ogujuba S.N. — concept and design of the study, statistical analysis, writing the text, responsibility for the integrity of all parts of the article, approval of the final version of the article; Bello T.O. — collection and processing of data, writing the text, compilation of a list of references; Rasskazova V.N. — writing text, editing; Shmeleva V.D. — editing.

Funding

Funding. The study had no sponsorship.

Conflict of interest

Conflict of interest. The authors declare no conflict of interest.

Received

Received: January 14, 2024 / Revised: April 15, 2024 / Accepted: May 30, 2024 / Published: June 30, 2025

система здравоохранения Нигериифинансированиемедицинская помощьмедицинские организациипоказатели здоровья населенияNigerian healthcare systemfinancingmedical caremedical organizationspopulation health indicators organizationsReferencesUzochukwu B.S., Ughasoro M.D., Etiaba E., Okwuosa C., Envuladu E., Onwujekwe O.E. Health care financing in Nigeria: Implications for achieving universal health coverage. Niger. J. Clin. Pract. 2015; 18(4): 437–44. https://doi.org/10.4103/1119-3077.154196Uzochukwu B.S., Ughasoro M.D., Etiaba E., Okwuosa C., Envuladu E., Onwujekwe O.E. Health care financing in Nigeria: Implications for achieving universal health coverage. Niger. J. Clin. Pract. 2015; 18(4): 437–44. https://doi.org/10.4103/1119-3077.154196Jabbari M., Shafiepour Motlagh M., Ashrafi K., Abdoli G. Differentiating countries based on the sustainable development proximities using the SDG indicators. Environ. Dev. Sustain. 2020; 22: 6405–23. https://doi.org/10.1007/s10668-019-00489-zJabbari M., Shafiepour Motlagh M., Ashrafi K., Abdoli G. Differentiating countries based on the sustainable development proximities using the SDG indicators. Environ. Dev. Sustain. 2020; 22: 6405–23. https://doi.org/10.1007/s10668-019-00489-zFullman N., Barber R.M., Abajobir A.A., Abate K.H., Abbafati C., Abbas K.M., et. al. Measuring progress and projecting attainment on the basis of past trends of the health-related Sustainable Development Goals in 188 countries: an analysis from the Global Burden of Disease Study 2016. Lancet. 2017; 390(10100): 1423–59. https://doi.org/10.1016/S0140-6736(17)32336-XFullman N., Barber R.M., Abajobir A.A., Abate K.H., Abbafati C., Abbas K.M., et. al. Measuring progress and projecting attainment on the basis of past trends of the health-related Sustainable Development Goals in 188 countries: an analysis from the Global Burden of Disease Study 2016. Lancet. 2017; 390(10100): 1423–59. https://doi.org/10.1016/S0140-6736(17)32336-XOnoka C.A., Onwujekwe O.E., Hanson K., Uzochukwu B.S. Examining catastrophic health expenditures at variable thresholds using household consumption expenditure diaries. Trop. Med. Int. Health. 2011; 16(10): 1334–41. https://doi.org/10.1111/j.1365-3156.2011.02836.xOnoka C.A., Onwujekwe O.E., Hanson K., Uzochukwu B.S. Examining catastrophic health expenditures at variable thresholds using household consumption expenditure diaries. Trop. Med. Int. Health. 2011; 16(10): 1334–41. https://doi.org/10.1111/j.1365-3156.2011.02836.xAregbeshola B.S., Khan S.M. Determinants of catastrophic health expenditure in Nigeria. The Eur. J. Health Econ. 2018; 19(4): 521–32. https://doi.org/10.1007/s10198-017-0899-1Aregbeshola B.S., Khan S.M. Determinants of catastrophic health expenditure in Nigeria. The Eur. J. Health Econ. 2018; 19(4): 521–32. https://doi.org/10.1007/s10198-017-0899-1Okafor C. Improving outcomes in the Nigeria healthcare sector through public-private partnership. African Res. Rev. 2016; 10(4): 1–17. https://doi.org/10.4314/afrrev.v10i4.1Okafor C. Improving outcomes in the Nigeria healthcare sector through public-private partnership. African Res. Rev. 2016; 10(4): 1–17. https://doi.org/10.4314/afrrev.v10i4.1Uzochukwu B.S.C., Okeke C., O’Brien N., Ruiz F., Hollingworth I.S.S. Health technology assessment and priority setting for universal health coverage: a qualitative study of stakeholders’ capacity, needs, policy areas of demand and perspectives in Nigeria. Global. Health. 2020; 16(58): 58. https://doi.org/10.1186/s12992-020-00583-2Uzochukwu B.S.C., Okeke C., O’Brien N., Ruiz F., Hollingworth I.S.S. Health technology assessment and priority setting for universal health coverage: a qualitative study of stakeholders’ capacity, needs, policy areas of demand and perspectives in Nigeria. Global. Health. 2020; 16(58): 58. https://doi.org/10.1186/s12992-020-00583-2Uzochukwu B.S.C., Ughasoro M.D., Etiaba E., Okwuosa C., Envuladu E., Onwujekwe O.E. Health care financing in Nigeria: Implications for achieving universal health coverage. Niger. J. Pract. 2015; 18(4): 437–44. https://doi.org/10.4103/1119-3077.154196Uzochukwu B.S.C., Ughasoro M.D., Etiaba E., Okwuosa C., Envuladu E., Onwujekwe O.E. Health care financing in Nigeria: Implications for achieving universal health coverage. Niger. J. Pract. 2015; 18(4): 437–44. https://doi.org/10.4103/1119-3077.154196GBD 2016 Healthcare Access and Quality Collaborators. Measuring performance on the Healthcare Access and Quality Index for 195 countries and territories and selected subnational locations: a systematic analysis from the Global Burden of Disease Study 2016. Lancet. 2018; 391(10136): 2236–71. https://doi.org/10.1016/S0140-6736(18)30994-2GBD 2016 Healthcare Access and Quality Collaborators. Measuring performance on the Healthcare Access and Quality Index for 195 countries and territories and selected subnational locations: a systematic analysis from the Global Burden of Disease Study 2016. Lancet. 2018; 391(10136): 2236–71. https://doi.org/10.1016/S0140-6736(18)30994-2Haakenstad A., Irvine C.M., Knight M., Bintz C., Aravkin A.Y., Zheng P., et. al. Measuring the availability of human resources for health and its relationship to universal health coverage for 204 countries and territories from 1990 to 2019: a systematic analysis for the Global Burden of Disease Study 2019. Lancet. 2022; 399(10341): 2129–54. https://doi.org/10.1016/S0140-6736(22)00532-3Haakenstad A., Irvine C.M., Knight M., Bintz C., Aravkin A.Y., Zheng P., et. al. Measuring the availability of human resources for health and its relationship to universal health coverage for 204 countries and territories from 1990 to 2019: a systematic analysis for the Global Burden of Disease Study 2019. Lancet. 2022; 399(10341): 2129–54. https://doi.org/10.1016/S0140-6736(22)00532-3Ntoimo L.F., Brian I., Ekwo C., Yaya S., Imongan W., Okonofua F.E. Building community ownership of maternal and child health interventions in rural Nigeria: A community-based participatory approach. Afr. J. Reprod. Health. 2021; 25(3s): 43–54.Ntoimo L.F., Brian I., Ekwo C., Yaya S., Imongan W., Okonofua F.E. Building community ownership of maternal and child health interventions in rural Nigeria: A community-based participatory approach. Afr. J. Reprod. Health. 2021; 25(3s): 43–54.Onwujekwe O., Obi F., Ichoku H., Ezumah N., Okeke C., Ezenwaka U., et al. Assessment of a free maternal and child health program and the prospects for program re-activation and scale-up using a new health fund in Nigeria. Niger. J. Clin. Pract. 2019; 22(11): 1516–29. https://doi.org/10.4103/njcp.njcp_503_18Onwujekwe O., Obi F., Ichoku H., Ezumah N., Okeke C., Ezenwaka U., et al. Assessment of a free maternal and child health program and the prospects for program re-activation and scale-up using a new health fund in Nigeria. Niger. J. Clin. Pract. 2019; 22(11): 1516–29. https://doi.org/10.4103/njcp.njcp_503_18Alawode G.O., Adewole D.A. Assessment of the design and implementation challenges of the National Health Insurance Scheme in Nigeria: a qualitative study among sub-national level actors, healthcare and insurance providers. BMC Public Health. 2021; 21(1): 124. https://doi.org/10.1186/s12889-020-10133-5Alawode G.O., Adewole D.A. Assessment of the design and implementation challenges of the National Health Insurance Scheme in Nigeria: a qualitative study among sub-national level actors, healthcare and insurance providers. BMC Public Health. 2021; 21(1): 124. https://doi.org/10.1186/s12889-020-10133-5Amu H., Dickson K.S., Kumi-Kyereme A., Darteh E.K. Understanding variations in health insurance coverage in Ghana, Kenya, Nigeria, and Tanzania: evidence from demographic and health surveys. PloS One. 2018; 13(8): e0201833. https://doi.org/10.1371/journal.pone.0201833Amu H., Dickson K.S., Kumi-Kyereme A., Darteh E.K. Understanding variations in health insurance coverage in Ghana, Kenya, Nigeria, and Tanzania: evidence from demographic and health surveys. PloS One. 2018; 13(8): e0201833. https://doi.org/10.1371/journal.pone.0201833Awosika L. Health insurance and managed care in Nigeria. Ann. Ib. Postgrad. Med. 2005; 3(2): 40–51.Awosika L. Health insurance and managed care in Nigeria. Ann. Ib. Postgrad. Med. 2005; 3(2): 40–51.Ilesanmi O.S., Ige O.K. Equity of care: A comparison of National Health Insurance Scheme enrollees and fee-paying patients at a private health facility in Ibadan, Nigeria. J. Public Health Epidemiol. 2013; 5: 51–5. https://doi.org/10.5897/JPHE12.047Ilesanmi O.S., Ige O.K. Equity of care: A comparison of National Health Insurance Scheme enrollees and fee-paying patients at a private health facility in Ibadan, Nigeria. J. Public Health Epidemiol. 2013; 5: 51–5. https://doi.org/10.5897/JPHE12.047Abubakar M., Basiru S., Oluyemi J., Abdulateef R., Atolagbe E., Adejoke J., et. al. Medical tourism in Nigeria: Challenges and remedies to health care system development. Int. J. Dev. Manag. Rev. 2018; 13(1): 223–38.Abubakar M., Basiru S., Oluyemi J., Abdulateef R., Atolagbe E., Adejoke J., et. al. Medical tourism in Nigeria: Challenges and remedies to health care system development. Int. J. Dev. Manag. Rev. 2018; 13(1): 223–38.Idowu B.M., Okedere T.A. Diagnostic radiology in Nigeria: a country report. J. Glob. Radiol. 2020; 6(1): 1072. https://doi.org/10.7191/jgr.2020.1072Idowu B.M., Okedere T.A. Diagnostic radiology in Nigeria: a country report. J. Glob. Radiol. 2020; 6(1): 1072. https://doi.org/10.7191/jgr.2020.1072Onoka C.A., Hanson K., Hanefeld J. Towards universal coverage: a policy analysis of the development of the National Health Insurance Scheme in Nigeria. Health Policy Plan. 2015; 30(9): 1105–17. https://doi.org/10.1093/heapol/czu116Onoka C.A., Hanson K., Hanefeld J. Towards universal coverage: a policy analysis of the development of the National Health Insurance Scheme in Nigeria. Health Policy Plan. 2015; 30(9): 1105–17. https://doi.org/10.1093/heapol/czu116Ibrahim M. Medical education in Nigeria. Medical teacher. 2007; 29(9-10): 901–5. https://doi.org/10.1080/01421590701832130Ibrahim M. Medical education in Nigeria. Medical teacher. 2007; 29(9-10): 901–5. https://doi.org/10.1080/01421590701832130Oladipo A.T., Fashola O.T., Agboola E.I., Adisa O.O., Oyekanmi O.D., Akinsete A.M. Challenges with medical education in Nigeria in the COVID-19 era. Pan. Afr. Med. J. 2020; 37: 223. https://doi.org/10.11604/pamj.2020.37.223.26418Oladipo A.T., Fashola O.T., Agboola E.I., Adisa O.O., Oyekanmi O.D., Akinsete A.M. Challenges with medical education in Nigeria in the COVID-19 era. Pan. Afr. Med. J. 2020; 37: 223. https://doi.org/10.11604/pamj.2020.37.223.26418Okereke M., Adekunbi A., Ghazali Y. Why Nigeria must strengthen its local pharmaceutical manufacturing capacity. Innov. Pharm. 2021; 12(4): 10.24926/iip.v12i4.4208. https://doi.org/10.24926/iip.v12i4.4208Okereke M., Adekunbi A., Ghazali Y. Why Nigeria must strengthen its local pharmaceutical manufacturing capacity. Innov. Pharm. 2021; 12(4): 10.24926/iip.v12i4.4208. https://doi.org/10.24926/iip.v12i4.4208Onah C.K., Azuogu B.N., Ochie C.N., Akpa C.O., Okeke K.C., Okpunwa A.O., et al. Physician emigration from Nigeria and the associated factors: the implications to safeguarding the Nigeria health system. Hum. Resour. Health. 2022; 20(1): 85. https://doi.org/10.1186/s12960-022-00788-zOnah C.K., Azuogu B.N., Ochie C.N., Akpa C.O., Okeke K.C., Okpunwa A.O., et al. Physician emigration from Nigeria and the associated factors: the implications to safeguarding the Nigeria health system. Hum. Resour. Health. 2022; 20(1): 85. https://doi.org/10.1186/s12960-022-00788-zAnimasahun B.A., Adekunle M.O., Madise-wobo A.D., Kusimo O.Y. Clinical audit of drug prescriptions in Nigeria: an urgent and vital need. J. Xiangya Med. 2019; 4: 9. https://doi.org/10.21037/jxym.2019.01.05Animasahun B.A., Adekunle M.O., Madise-wobo A.D., Kusimo O.Y. Clinical audit of drug prescriptions in Nigeria: an urgent and vital need. J. Xiangya Med. 2019; 4: 9. https://doi.org/10.21037/jxym.2019.01.05Omotosho A., Ayegba P., Emuoyibofarhe J., Meinel K. Current status of ICT in healthcare in developing countries. Int. J. Online Eng. 2019; 15(8): 91–107.Omotosho A., Ayegba P., Emuoyibofarhe J., Meinel K. Current status of ICT in healthcare in developing countries. Int. J. Online Eng. 2019; 15(8): 91–107.Aririguzoh S., Amodu L., Sobowale I., Ekanem T., Omidiora O., Amoo E.O. Achieving sustainable eHealth through information and communication technologies in rural communities in Nigeria. Cogent Soc. Sci. 2021; 7(1): 1887433. https://doi.org/10.1080/23311886.2021.1887433Aririguzoh S., Amodu L., Sobowale I., Ekanem T., Omidiora O., Amoo E.O. Achieving sustainable eHealth through information and communication technologies in rural communities in Nigeria. Cogent Soc. Sci. 2021; 7(1): 1887433. https://doi.org/10.1080/23311886.2021.1887433Kroll S., Warhold A., Pradhan P. Sustainable Development Goals (SDGs): Are we succeeding in turning trade-offs into synergies? Palgrave Commun. 2019; 5: 140. https://doi.org/10.1057/s41599-019-0335-5Kroll S., Warhold A., Pradhan P. Sustainable Development Goals (SDGs): Are we succeeding in turning trade-offs into synergies? Palgrave Commun. 2019; 5: 140. https://doi.org/10.1057/s41599-019-0335-5

The authors declare that there are no conflicts of interest present.