Out-of-pocket health spending in Nigeria fell to 58.3% in 2024: Report

Nigeria recorded a modest improvement in health financial risk protection in 2024, as out-of-pocket (OOP) spending fell to 58.3 per cent of total health expenditure, according to the National Health Accounts (NHA) 2023–2024.


The NHA report was made available to journalists on Sunday in Abuja by 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, WHO, and the Centre for Health Economics and Development.


The report is intended to guide policy decisions, resource allocation, and monitoring of Nigeria’s progress towards universal health coverage and improved financial risk protection. The report showed that the 2024 figure represents a marginal drop from 58.8 per cent in 2023 and a significant improvement from over 70 per cent recorded between 2015 and 2021, reflecting gradual progress toward reducing the financial burden of healthcare on households.


“Total health expenditure rose from ₦7.88 trillion in 2023 to ₦10.42 trillion in 2024, driven by increased spending from households, government, and development partners. Despite the decline 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,” it said.


The report indicated that 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.
 It said that donor funding increased significantly, rising 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.


The report also showed that capital expenditure accounted for 10.5 per cent of total health spending in 2024, suggesting continued underinvestment in health infrastructure and long-term system strengthening.


Meanwhile, analysts said that although the decline in OOP 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 advised governments at all levels to expand health insurance coverage, increase public health funding, and prioritise pooled financing mechanisms to further reduce out-of-pocket spending and improve financial risk protection. NAN