The practical politics of health financing in Nigeria

Report

Health debates in Nigeria focus on the volume of funds entering the system, new infrastructure and disease-specific vertical funds. Far less attention is paid to health’s background ‘plumbing’ – the complex system turning money into better health outcomes – and overall performance suffers as a result. One consequence is that households cover more than 70% of the country’s current health expenditure ‘out-of-pocket’, paid to both private and public health providers. Shifting focus to plumbing, the out-of-pocket spending crisis and making markets work better could raise health’s political salience and deliver outcomes in line with Nigeria’s economic might.

Authors: Agwu, P; Evans, PE

• Publication status: Published
• Publisher: University of Oxford
• Series: Open PEA Product Series
• Place of publication: Oxford, UK
• Publication date: 2026-07-16
• Paper number: 2
• Language: English
• Keywords: public financial management; political economy analysis; out-of-pocket expenditure; health financing; Nigeria health policy