Josiah Blessing Osagumwendia, Enebeli Emmanuel Chukwunwike, Duncan Brontie Albertha, Adejumo Prisca Olabisi, Josiah Chinelo Cleopatra, Anukam Lordsfavour, Shittu Muhammad Baqir, Ncube France, Alimele Kelechi Eric, Emmanuel Mercy, Martins-Ifeanyi Oyinye Prosper, Opeyemi Fawole Israel, Akingbade Oluwadamilare, Adebayo Abosede Peace, Ibraheem Busiroh Mobolape, Ekenekot Ubiebo Ataisi, Edafiejire Mudiaga Sidney, Olukoya Solomon Oluwaseun, Mukoro Ufuomaoghene Jemima, Baghdasarian Siyouneh, Obialor Joy Chioma, Alao Gloria Oluwakorede, Obialor Blessing Onyinye, Otoboyor Ndidi Louis, Josiah Oghosa Gabriel, Okonkwo Joshua, Imoyera Precious Ebinehita, Gbolabo Ajao Adewale, Nganwuchu Blessing Chiamaka, Oladimeji Olukayode Joseph, Olaosebikan Timothy Wale, Kantaris Marios
Institute of Nursing Research, Oshogbo, Nigeria.
IUHS School of Medicine, Basseterre, Saint Kitts and Nevis.
PLOS Glob Public Health. 2025 May 28;5(5):e0004615. doi: 10.1371/journal.pgph.0004615. eCollection 2025.
Nigeria aims to enhance its healthcare quality index score of 84th out of 110 countries and its Sustainable Development Goals Index ranking of 146th out of 166. Due to increased population, disease burden, and patient awareness, healthcare demand is rising, putting pressure on funding and quality assurance. The Nigerian healthcare financing and its impacts are complex; this study gives insights into the trends. This questionnaire-based cross-sectional survey (conducted from June to August 2023) and 2010-2023 health budget analysis examined healthcare finance patterns and user attitudes (utilisation, preference and quality perceptions) in Nigeria. Data from government health budgets and a stratified random sample of 2,212 from nine states, obtained from the socioculturally diverse 237 million population, were analysed with a focus on trends, proportions, frequency distributions, and tests of association. Results show that the average rating of healthcare experiences did not vary significantly over the last decade. Healthcare system quality was rated mainly poor or very poor; structure (74.09%), services (61.66%), and cost (60.89%). While 87.36% used government healthcare facilities, 85.00% paid out-of-pocket, and 72.60% of them were dissatisfied with the value for money. Despite a preference for government facilities (71.43%), respondents cited high costs (62.75%), poor funding (85.65%), inadequate staffing (90.73%), and lack of essential medicines (88.47%) as major challenges. The budget analysis reveals an average government healthcare fund allocation of $7.12 compared with an estimated expenditure of $82.75 per person annually. Nigeria allocates only an average of 0.37% of GDP and 4.61% of the national budget to healthcare, comprising a maximum of 13.56% of total health expenditure. This study emphasises the urgent need for policy reforms and implementations to improve Nigeria's healthcare financing and service quality. Targeted interventions are essential to address systemic challenges and meet population needs while aligning with international health services and best standards.
尼日利亚的目标是提升其在110个国家中排第84位的医疗质量指数得分，以及在166个国家中排第146位的可持续发展目标指数排名。由于人口增长、疾病负担加重以及患者意识提高，医疗需求不断上升，给资金和质量保证带来了压力。尼日利亚的医疗融资及其影响十分复杂；本研究深入探讨了相关趋势。这项基于问卷调查的横断面调查（于2023年6月至8月进行）以及2010 - 2023年卫生预算分析，研究了尼日利亚的医疗融资模式以及用户态度（利用情况、偏好和质量认知）。对来自政府卫生预算的数据以及从2.37亿人口中按社会文化差异分层随机抽取的来自九个州的2212个样本进行了分析，重点关注趋势、比例、频率分布以及关联性检验。结果显示，过去十年间医疗体验的平均评分没有显著变化。医疗系统质量的评级主要为差或非常差；涉及结构（74.09%）、服务（61.66%）和成本（60.89%）。虽然87.36%的人使用政府医疗设施，但85.00%的人自掏腰包付费，其中72.60%的人对性价比不满意。尽管受访者更倾向于政府设施（71.43%），但他们指出高成本（62.75%）、资金不足（85.65%）、人员配备不足（90.73%）以及缺乏基本药物（88.47%）是主要挑战。预算分析显示，政府医疗基金的平均分配额为7.12美元，而估计每人每年的支出为82.75美元。尼日利亚仅将国内生产总值的平均0.37%和国家预算的4.61%分配给医疗保健，占卫生总支出的最高比例为13.56%。本研究强调迫切需要进行政策改革和实施，以改善尼日利亚的医疗融资和服务质量。有针对性的干预措施对于应对系统性挑战、满足民众需求以及符合国际卫生服务和最佳标准至关重要。
