# Structure of Nigeria's Healthcare System

> Nigeria runs a three-tier healthcare system — primary care under local governments, secondary care under states, and tertiary care under the federal government — governed by the National Health Act 2014. Financing shifted in 2022 when the National Health Insurance Authority (NHIA) replaced the voluntary NHIS, though out-of-pocket spending still covered 58.3% of health costs in 2024 (National Health Accounts, 2025).

**Category:** Health & Healthcare · **Updated:** 2026-07-26 19:36:35 · **Canonical:** https://nigeriastuff.org/a/nigeria-healthcare-system

## Key facts
- **Governing framework:** National Health Act 2014; National Health Policy 2016
- **Structure:** Three tiers — primary (LGA), secondary (state), tertiary (federal)
- **Primary care lead agency:** National Primary Health Care Development Agency (NPHCDA), established 1992
- **Insurance authority:** National Health Insurance Authority (NHIA), established by Act of 19 May 2022, replacing NHIS
- **Out-of-pocket health spending:** 58.3% of ₦10.42 trillion total health expenditure, 2024 (National Health Accounts 2023–2024, published Dec 2025)
- **Doctor-to-patient ratio:** Estimated 1:2,500 to 1:8,000, against a WHO-recommended 1:600 (Nigerian Medical Association, July 2024)
- **As of:** 24 July 2026

## Sources
- Nigeria Health Systems and Services Profile — WHO Africa Health Observatory Platform (AHOP) (https://ahop.aho.afro.who.int/country_profiles/nigeria)
- National Health Insurance Authority — About Us — National Health Insurance Authority (NHIA), Federal Republic of Nigeria (https://www.nhia.gov.ng/about-us/)
- Nigerian doctor-patient ratio worsens by 1,000% against WHO recommendation — NMA — Nairametrics (https://nairametrics.com/2024/07/18/nigerian-doctor-patient-ratio-worsens-by-1000-against-who-recommendation-nma/)
- Out-of-pocket health spending in Nigeria fell to 58.3% in 2024: Report — The Gazette (Nigeria) (https://gazettengr.com/out-of-pocket-health-spending-in-nigeria-fell-to-58-3-in-2024-report/)
- About NPHCDA — National Primary Health Care Development Agency (NPHCDA) (https://www.nphcda.gov.ng)
- About NCDC — Nigeria Centre for Disease Control and Prevention (NCDC) (https://ncdc.gov.ng/about-us)
- 2,125 Primary Health Centres Now Fully Revitalised Across Nigeria — NPHCDA — Premium Times (https://www.premiumtimesng.com/news/top-news/841959-2125-primary-health-centres-now-fully-revitalised-across-nigeria-nphcda.html)

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