Nigeria’s Journey to UHC: Slow progress amid rising challenges, says WHO

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By Abujah Racheal

The World Health Organisation (WHO) says Nigeria has made incremental progress in expanding healthcare services and reducing financial hardship for its citizens.

This is as the 2030 target for achieving Universal Health Coverage (UHC) approaches,

The health organisation, however, said that significant gaps remained threatening the country’s ability to meet global health targets.

Dr. Walter Kazadi Mulombo, Nigeria’s Country Representative for WHO, said this in an interview with the News Agency of Nigeria (NAN) on Saturday in Maiduguri.

According to Mulombo, Nigeria’s UHC Service Coverage Index (SCI) increased from 25 in 2003 to 44 in 2019.

He said that catastrophic health spending had dropped from 23 percent in 2003 to 16 percent in 2018.

However, he said that despite these improvements, out-of-pocket expenses accounted for 75 percent of the nation’s total health expenditure in 2020, a significant rise from 71.5 percent in 2019.

“While progress has been made, the burden of out-of-pocket payments remains a major barrier to achieving equitable healthcare access,” he said.

He revealed that critical service areas like immunisation, antenatal care, tuberculosis treatment, and hypertension management remained below regional and global benchmarks.

“Routine vaccination coverage, for instance, is lower than both global and regional averages, calling for an urgent acceleration in efforts.

“High maternal and under-5 mortality rates were flagged as priority areas. Between 2000 and 2021, under-5 mortality reduced from 182 to 111 deaths per 1,000 live births.

“However, achieving the global SDG target will require a further 66 percent reduction, “he said.

According to him, environmental and behavioural risk factors, including malnutrition, unsafe water and sanitation, air pollution, and rising obesity levels, continue to exacerbate Nigeria’s health challenges.

He called for strong political commitment and the efficient use of public health funding to expand service coverage and limit out-of-pocket payments.

He underscored the need for a “One Health” approach to ensure pandemic preparedness, environmental health, and intersectoral collaboration.

“Achieving UHC is not only a health imperative but a development necessity.

“It requires bold leadership, community engagement, and equitable resource allocation,” he said.

He also expressed concern about the 2023 Global Monitoring Report on UHC, which revealed that billions globally lack access to essential health services, with out-of-pocket spending increasing across countries.

“For Nigeria, achieving UHC by 2030 will require accelerated action across all levels of government and society, particularly in areas such as child immunisation, maternal health, and environmental health,” he said

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