Case study: Nigeria

Overview

Nigeria’s health sector is primarily funded by outof-pocket spending, which accounts for 70% or more of total health expenditure. Development partner funding amounts to 7% and public funding to 16.5% of total health expenditure.¹ Public funding for health is limited at US$ 32 per capita annually.² Total public health spending is 5.3% of total government spending.³ Nigeria’s highly decentralized system of governance gives state and local governments considerable autonomy in setting their own health priorities and allocating resources to health and specific services. Most of the funding from development partners and the government is spent on salaries and tertiary care, or in vertical funds managed by different directorates at different levels of the health system. In addition, the limited funds that are available are not always well managed, resulting in stock-outs, ill equipped health workers and poor quality of care.