Nigeria recorded a modest improvement in health financial risk protection in 2024, as out-of-pocket (OOP) spending declined to 58.3 per cent of total health expenditure, according to the National Health Accounts (NHA) 2023–2024 report.
The report was made available to reporters on Sunday in Abuja at the Ministerial Oversight Committee (MOC) meeting of the Basic Health Care Provision Fund (BHCPF).
The NHA is produced by the Federal Ministry of Health and Social Welfare in collaboration with the National Bureau of Statistics, the Federal Ministry of Finance, the Budget Office, the Office of the Accountant-General of the Federation, the World Health Organization (WHO) and the Centre for Health Economics and Development.
The report is intended to guide policy decisions, resource allocation and the monitoring of Nigeria’s progress towards Universal Health Coverage (UHC) and improved financial risk protection.
It showed that the 2024 figure represented a slight decline from 58.8 per cent in 2023 and a significant improvement from over 70 per cent recorded between 2015 and 2021, reflecting gradual progress in reducing the financial burden of healthcare on households.
According to the report, total health expenditure increased from ₦7.88 trillion in 2023 to ₦10.42 trillion in 2024, driven by higher spending from households, government and development partners.
Despite the reduction in OOP spending, households remained the largest source of health financing, accounting for 66 per cent of total health expenditure in 2024, down from 70.3 per cent in 2023.
Government spending on health accounted for 12.4 per cent of total health financing in 2024, while social health insurance contributions stood at five per cent, underscoring the limited role of prepaid and pooled financing mechanisms in the country.
The report also showed that donor funding rose significantly, increasing from 14 per cent in 2023 to 19 per cent in 2024, with most donor resources managed directly by development partners rather than through government systems.
Capital expenditure accounted for 10.5 per cent of total health spending in 2024, indicating continued underinvestment in health infrastructure and long-term system strengthening.
Analysts noted that while the decline in out-of-pocket spending is a positive development, the continued dominance of household payments exposes many Nigerians, particularly women, children and low-income households, to financial hardship when seeking healthcare.
Stakeholders in the health sector have therefore urged governments at all levels to expand health insurance coverage, increase public health funding and prioritize pooled financing mechanisms to further reduce out-of-pocket spending and strengthen financial risk protection.

