Abubakar, Ibrahim; Angell, Blake; Colbourn, Tim; Onwujekwe, Obinna; Abimbola, Seye; (2025) Priorities and Health Packages in Reforming the Nigerian Health System: Experience from the Lancet Nigeria Commission. In: Alwan, Ala and Mirutse, Mizan Kiros and Twea, Pakwanja Desiree and Norheim, Ole F, (eds.) Publication: Disease Control Priorities, Fourth Edition: Volume 1. Country-Led Priority Setting for Health. (pp. 145-162). World Bank: Washington, D.C., USA.

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Abstract

Nigeria is projected to become the third most populous nation globally by 2100, which will place increasing pressure on the nation’s health systems and necessitate widespread reform to ensure Nigerians have widespread access to affordable, quality health care. The Lancet Nigeria Commission built a case for targeted and high-value investment to support that goal and achieve substantial health gains through several highly cost-effective priority areas for health investment based on analyses of the local burden of disease, prevailing measures of cost-effectiveness, and a prioritization process involving key health system stakeholders. Specifically, the Commission undertook an analysis of existing literature, policies, programs, and governance frameworks, and used the OneHealth Tool1 and the Lives Saved Tool2 to project health and cost effects. It identified high–net gain areas including maternal and child health. The Commission’s recommendations on health reform have had significant influence on national legislation to mandate health insurance and to create a Vulnerable Group Fund. Building on those early achievements will require health care system reform that leverages the strengths of the system and works within the realities of the complex, federalized system but still meaningfully and sustainably overcomes the limitations previously restricting population health outcomes and access to care. Significant scope remains for further development through carefully directed investment, particularly in primary care, health promotion, and interventions to improve the social determinants of health.

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