Analysis

Examining Nigeria’s Health System and Preventable Deaths, by Alabidun Shuaib AbdulRahman

Published

8 months ago

February 5, 2026

Examining Nigeria’s Health System and Preventable Deaths, by Alabidun Shuaib AbdulRahman

My last week’s column, ‘The Agony of a Columnist,’ was written from a place I never expected to occupy. It was not an attempt at catharsis, nor was it designed to elicit sympathy. It was simply an account of what happened when a citizen encountered the Nigerian healthcare system at its most critical moment and found it wanting. The death of my eight-month-old daughter occurred within a public hospital that, on paper, appeared functional. What followed exposed a gap between appearance and capacity that deserves closer scrutiny rather than sentiment.

This week’s column is broader. It is about structure, policy, and outcomes. It is about what the data says and what lived experience confirms about the state of healthcare delivery in Nigeria, a system that reflects not only underperformance but failure at its most consequential moments.

Considering another recent case that captured national attention, that of Ifunanya Lucy Nwangene, a 25-year-old Abuja-based singer who was bitten by a cobra in her home. She sought emergency care immediately, moving from one health facility to another, and struggled to obtain antivenom and appropriate treatment before it was too late.

Accounts vary on the specifics, but the tragedy is indisputable. Her death, amid circumstances that could have been preventable, echoes the avoidable loss of my own child and reflects the same systemic weaknesses that place ordinary citizens at risk every day. Reports indicate that approximately half of Nigerian hospitals lack the capacity to manage snakebite cases effectively and that nearly all facilities experience difficulties in administering antivenom, the only treatment recognized by the World Health Organization for venomous bites. Such deficits in treatment capacity, emergency response, essential medicines, and clinical training are not anomalies; they are the predictable outcome of chronic systemic weakness.

Nigeria’s healthcare system is structured across primary, secondary, and tertiary levels. According to the latest facility registry data, there are roughly thirty-eight thousand six hundred forty-five operational health facilities nationwide, a figure that includes both public and private establishments, translating to approximately eleven facilities per one hundred thousand people in a population exceeding two hundred and twenty million. Primary care facilities account for nearly eighty-eight per cent of all facilities, secondary care roughly twelve per cent, and tertiary facilities less than one per cent.

On paper, the distribution seems extensive, but quantity does not equal quality or functionality. The majority of primary healthcare centers, which form the first line of defence, are unable to deliver essential services consistently due to shortages of trained personnel, drugs, water, power, and equipment. Only about twenty per cent of primary facilities are considered fully functional, leaving millions of Nigerians dependent on emergency care that is often delayed or unavailable.

Health outcomes are determined by human resources as much as infrastructure, yet Nigeria’s health workforce is severely strained. The doctor-to-population ratio remains well below the World Health Organization’s recommended threshold of one doctor per six hundred people, with practical estimates ranging from one doctor per four thousand to one per five thousand citizens, and some areas experiencing ratios as low as one per nine thousand eight hundred.

Nurses and midwives are similarly scarce and unevenly distributed, favoring urban centers over rural and peri-urban areas. Absenteeism and burnout are systemic risks exacerbated by poor remuneration, unsafe working conditions, and limited career progression. The migration of trained health professionals abroad not only represents a loss of public investment but reduces the system’s capacity to respond to emergencies, increasing the likelihood that predictable crises result in preventable deaths.

Funding is a primary driver of these gaps. Nigeria is a signatory to the 2001 Abuja Declaration, committing to allocate at least fifteen per cent of annual budgets to health, yet the highest allocation recorded in any year remains below six per cent. By comparison, global benchmarks suggest public health spending should constitute at least five per cent of GDP to achieve basic universal health coverage, while Nigeria currently allocates approximately half a per cent. Per capita health expenditure ranges between ten and fifteen US dollars annually, which is insufficient to ensure functional hospitals, reliable emergency response, or the availability of essential drugs and equipment.

The inadequacy of public funding shifts the burden to households. Out-of-pocket payments account for nearly seventy to seventy-five per cent of total health spending, meaning that patients and families finance care at the point of illness rather than through pooled systems. Less than ten per cent of Nigerians are covered by any functional health insurance, and coverage is largely limited to formal sector employment. As a result, families often delay care, ration treatment, or avoid facilities altogether until conditions deteriorate beyond recovery.

The human consequences of these systemic failures are evident in national health indicators. Nigeria continues to have one of the highest maternal mortality ratios in the world, exceeding eight hundred deaths per one hundred thousand live births, and accounts for approximately twenty per cent of global maternal deaths despite representing less than three per cent of the world population. Infant and under-five mortality remain high, with recent surveys showing roughly sixty-seven deaths per one thousand live births and one hundred and ten per one thousand respectively. Many of these deaths result not from rare or complex conditions but from the inability of the health system to provide timely, skilled intervention for preventable or manageable illnesses. Malaria, pneumonia, childbirth complications, and neonatal distress often escalate into fatalities that could have been avoided had emergency care been available, adequately staffed, and well-supplied.

Infrastructure alone does not solve the problem. Hospitals are renovated, equipment procured, and wards repainted, but functionality depends on staffing, reliable power, water, supply chains, and governance. Electricity supply is particularly critical, as hospitals depend on continuous power for monitoring, oxygen delivery, laboratory diagnostics, and refrigeration of vaccines and essential medicines. Yet many facilities rely on intermittent generators with uncertain fuel supply, leaving patients exposed to system failures that no renovation or new building can correct.

Primary healthcare centers, despite their numbers, are frequently unable to provide preventive and early intervention services, meaning that conditions that should be addressed at the community level escalate to secondary facilities that themselves are overstretched.

Accountability within the health system is diffuse. Budget allocations are announced, but utilization and outcomes are weakly monitored. Staffing requirements are often unmet, and enforcement is inconsistent. Failures rarely attract consequences proportional to their impact, leaving citizens, including vulnerable infants and young adults, to bear the cost. Hospitals are frequently evaluated on the wrong metrics, such as bed count or physical infrastructure, rather than whether care is actually delivered. Time-sensitive emergencies cannot wait for policy announcements or cosmetic compliance; delays and absenteeism in these circumstances are measured in lives lost.

Both my personal experience and the case of the young singer illustrate these realities. My daughter was taken to Suleja General Hospital where initial symptoms did not appear severe, yet she required urgent intervention. Medical review was delayed, oxygen was administered without a definitive diagnosis or treatment plan, and a requested transfer to another facility was not effected in time. In the singer’s case, urgent antivenom administration was critical to survival, yet the system’s gaps prevented timely care, and the result was fatal. These outcomes are not anomalies; they are predictable expressions of systemic failure.

Nigeria does not lack reform frameworks. Initiatives exist to revitalize primary healthcare, expand health insurance, and improve maternal and child health outcomes. Some interventions have produced measurable gains in targeted areas, but they remain uneven and insufficiently scaled, often undermined by governance failures and weak operational oversight. The result is a system that prioritizes form over function, presenting the appearance of readiness while leaving emergency response and routine care vulnerable to failure. The consequences are borne not by policy-makers or administrators, but by citizens whose lives hang in the balance.

The purpose of revisiting last week’s column is not to relive personal grief but to insist on institutional reflection. Every preventable death, whether of a child in a public hospital or a young adult succumbing to a snakebite or otherwise, represents a failure of policy, funding, and governance. Healthcare is not an area where delays, absenteeism, or cosmetic compliance can be absorbed without consequence. Systems either respond, or they fail. In Nigeria, the record shows repeated, predictable failures. Mortality data, budget analyses, facility assessments, and lived experience all converge to the same conclusion: when the health system is tested, it often cannot deliver.

The crisis is visible, documented, and persistent. Nigeria’s hospitals function intermittently, supply chains are fragile, essential medicines are inconsistently available, and health workers are overstretched. Until outcomes, rather than infrastructure announcements, become the primary measure of success, preventable deaths will continue.

Tragically, the cost is measured not only in statistics but in lives that could have been saved. My daughter’s loss was personal, and the death of Ifunanya Nwangene was public. Both expose the same reality: a healthcare system that cannot guarantee timely, competent response in emergencies is not merely underperforming; it is failing its most fundamental obligation.

The reality requires less rhetoric and more reform, less emphasis on appearances and more attention to function. Budget allocations must be credible and linked to measurable outcomes, staffing requirements must be enforced, essential medicines and equipment must be reliably supplied, and emergency systems must be consistently operational. Until these conditions are met, Nigeria will continue to produce tragic but predictable stories of lives lost to systemic weakness, and citizens will continue to confront a healthcare system that appears reassuring until it is tested at its most critical moments.

Related Topics:Alabidun Shuaib AbdulRahman Ifunanya Lucy Nwangene

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Analysis

Nigeria’s 2027 Elections and the Unfinished Business of Diaspora Voting, by Boniface Ihiasota

Published

2 days ago

October 14, 2026

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Nigeria’s 2027 Elections and the Unfinished Business of Diaspora Voting, by Boniface Ihiasota

As Nigeria approaches the 2027 general elections, millions of Nigerians living abroad face a familiar democratic dilemma: they remain emotionally, economically and socially connected to their homeland, yet their ability to influence its political leadership through the ballot remains restricted. From London to Washington, Toronto to Johannesburg, and Dubai to other global cities, Nigerians in the diaspora have compelling reasons to prepare for the elections, even as the country continues to grapple with the legal barriers to diaspora voting.

The 2027 elections, scheduled for January 16, according to the Independent National Electoral Commission, will determine the leadership responsible for steering Nigeria through critical economic, security and governance challenges. The decisions made in Abuja and state capitals will affect citizens regardless of whether they live in Nigeria or abroad. These include exchange-rate policies, taxation, education, healthcare, security, investment regulations and the protection of property rights. Nigerians abroad therefore have legitimate reasons to follow the electoral process closely and demand accountability from those seeking public office.

However, preparation must begin with an important distinction: political participation is not the same as having a legally recognised opportunity to cast a ballot from overseas. Nigeria’s electoral framework has historically not provided for out-of-country voting. Although diaspora voting has featured in national debates and legislative proposals, the legal and administrative obstacles have remained significant.

The consequences extend beyond symbolism. Nigeria’s diaspora contributes to the economy through remittances, investment, professional expertise and business networks. The World Bank’s Migration and Development Brief estimated that Nigeria received approximately $20.9bn in personal remittances in 2022. Such financial contributions demonstrate the continuing relationship between Nigerians abroad and households at home. Yet economic contribution does not automatically translate into electoral influence. The challenge is how to ensure that citizens who contribute to national development can participate meaningfully in decisions about the country’s future.

The National Assembly has previously considered constitutional changes intended to enable diaspora voting. In March 2022, however, the proposed constitutional amendment was rejected during the legislative review process. The Nigerians in Diaspora Commission has criticised the setback, arguing that Nigerians abroad should not remain excluded from the democratic process. Subsequent proposals have continued to raise questions about electronic voting, voter verification, cybersecurity, electoral transparency and the practical cost of organising overseas polls. These concerns deserve serious consideration, but they should lead to workable solutions rather than indefinite postponement.

For Nigerians abroad, preparation for 2027 must therefore go beyond waiting for permission to vote. They can monitor INEC announcements, follow legislative developments, examine candidates’ records and scrutinise policy proposals. They can participate in lawful political discussions, support credible civic education initiatives, challenge misinformation and encourage relatives at home to make informed electoral decisions. Diaspora professionals can also contribute expertise in technology, election administration, cybersecurity and public accountability without becoming instruments of partisan manipulation.

Political parties should equally recognise that Nigerians abroad are not merely sources of remittances or occasional audiences for campaign speeches. They are citizens with knowledge of different governance systems, public institutions and economic practices. Their experiences can enrich national debate, provided their contributions are grounded in Nigeria’s realities rather than assumptions that foreign models can be transferred without adaptation.

The question surrounding the 2027 elections is not simply whether Nigerians abroad care about their country. Their sustained economic and personal connections already demonstrate that commitment. The more difficult question is whether Nigeria’s democratic institutions will create a credible, transparent and legally sound framework that allows eligible citizens overseas to exercise their electoral rights.

Until such arrangements are enacted and implemented, Nigerians abroad must remain informed, organised and engaged while respecting the law governing the elections. Democracy should not be reduced to the act of casting a ballot; it also requires informed scrutiny, civic responsibility and sustained demands for accountability. But these activities cannot permanently substitute for the right to vote.

Analysis

Africa’s Resources Must Build Africa, by Alabidun Shuaib AbdulRahman

Published

2 days ago

October 14, 2026

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Africa’s Resources Must Build Africa, by Alabidun Shuaib AbdulRahman

Across Africa lie enormous deposits of oil, gas, uranium, gold, lithium, cobalt, copper, diamonds and other strategic minerals, yet many of the countries sitting on these resources continue to struggle with poverty, unemployment, weak industrialisation and the steady movement of their young people towards Europe, North America and other destinations in search of better opportunities.

For decades, much of Africa’s natural wealth has travelled outward as raw material, while the greater economic value created through processing, refining, manufacturing and technology has accumulated elsewhere. Africa has supplied the resources that feed global industries, but has too often remained at the lower end of the economic chain, buying back finished products at prices far removed from what it earned when those raw materials left its soil.

That contradiction is becoming increasingly difficult to ignore because of what is happening in Niger Republic. Since General Abdourahamane Tiani came to power following the July 26, 2023 coup, his government has increasingly pursued greater control over Niger’s natural resources. What initially appeared to be part of the broader political rupture between Niamey and its former colonial power, France, has gradually developed into a wider policy of resource nationalism.

On June 19, 2025, Niger’s Council of Ministers approved the nationalisation of Société des Mines de l’Aïr, SOMAÏR, the uranium company operating at Arlit in the Agadez region. SOMAÏR was established in 1968 and began uranium production in 1971. Before nationalisation, French nuclear company Orano held 63.4 per cent, while Niger’s state mining company, SOPAMIN, held 36.6 per cent.

Between 1971 and 2024, SOMAÏR produced 81,861 tonnes of uranium, of which 80,518 tonnes were commercialised. Figures presented by the Nigerien government showed that Orano had taken 86.3 per cent of the commercialised production, while SOPAMIN accounted for 9.2 per cent.

In August 2026, the government took another step. It awarded the In Azaoua large-scale uranium mining permit in Arlit to Teloua Safeguarding Uranium Mining Company, TSUMCO, the state company created to replace SOMAÏR and continue operations over the former SOMAÏR perimeter. At its August 21 meeting, the Council of Ministers also approved the reassignment of another uranium permit, Madaouela I, to the state-linked Madaouela Mining Company.

The government has adopted a similar approach in the petroleum sector. On June 12, 2026, Niger’s Petroleum Minister, Hamadou Tini, announced that the government was reviewing the hydrocarbons code and preparing a new production-sharing contract model. He said the reforms were intended to strengthen the state’s negotiating capacity and increase the economic benefits accruing to Niger. He also disclosed plans to review provisions relating to cost recovery by petroleum operators and stressed the importance of training Nigerien professionals capable of negotiating more effectively with international companies.

Niger has also established MAZOUMAWA National Gold Company as part of its attempt to strengthen national control over gold resources and the country’s gold value chain. In January 2026, its Director-General, Abdou Ousseini, said the company intended to contribute to gold exploitation while controlling the valorisation and value chains of gold in Niger. The company had two exploration permits in the Dan Issa area and had collected more than 6,000 samples for analysis.

There is, therefore, something much bigger than the Niger-France dispute at stake. It is the ownership of Africa’s economic future.

For generations, the structure has remained remarkably familiar. Africa digs, pumps, cuts and exports. Someone elsewhere processes, refines, manufactures, finances and markets. The finished product eventually returns to African consumers at a considerably higher price.

That arrangement is not entirely without benefits. Foreign companies bring capital, technology, technical expertise, international markets and, in some cases, infrastructure that many African countries would struggle to provide on their own. The problem begins when that relationship becomes permanent, when Africa remains trapped at the extraction end of the value chain while the greater economic benefits of its resources accumulate elsewhere.

The African Union has recognised this problem for years through initiatives such as the African Mining Vision and its commodities strategy. The objective is for Africa to move from being primarily a supplier of raw materials towards greater value addition, stronger local content, higher returns from commodities and meaningful participation in global value chains.

The African Development Bank estimates that Africa possesses about 30 per cent of the world’s mineral reserves and could capture more than 10 per cent of the projected $16tn revenues from key green minerals by 2030. Yet the same institution reported that Africa received about $190.7bn in financial inflows in 2022 while losing approximately $587bn through financial leakages.

The implication is clear: Africa does not necessarily need to chase away foreign investors. It needs to become a better negotiator, a more capable participant and, ultimately, a stronger owner of the industries built around its own resources.

Botswana offers an important illustration. Its diamond industry was not built by simply shutting foreign capital out. Debswana, the company at the centre of Botswana’s diamond production, is jointly owned by the Government of Botswana and De Beers, with each holding 50 per cent. The partnership has become a major contributor to Botswana’s GDP, foreign exchange earnings and government revenue and employs about 5,000 staff and 6,000 contractors.

Tanzania has pursued another route by giving the state a minimum 16 per cent non-dilutable free-carried interest in mining companies, alongside taxation, royalties and other government participation mechanisms. Its local-content framework also seeks to ensure that Tanzanian companies participate in supplying goods and services to the mining industry.

Ghana has moved in a different direction. Rather than nationalising its gold mines, it has sought to increase domestic participation through regulation. Its 2025 local-content framework required surface mining operations to be undertaken by wholly Ghanaian-owned contractors, while underground contract mining requires at least 50 per cent Ghanaian ownership.

Zimbabwe’s lithium policy provides perhaps an even clearer example of beneficiation as a development strategy. After banning exports of unprocessed lithium ore in 2022, Zimbabwe announced in June 2025 that it would prohibit the export of lithium concentrates from January 1, 2027. The objective is to encourage greater domestic processing. Zimbabwe is Africa’s leading lithium producer, while Chinese-owned companies have invested more than $1bn in the country’s lithium sector since 2021.

If lithium is increasingly important to batteries and energy storage, Zimbabwe wants more of the economic activity generated by that demand to take place within Zimbabwe rather than elsewhere. That is precisely the direction Africa needs to consider.

The International Energy Agency reported in October 2025 that Africa captures less than one per cent of the value generated from manufacturing clean-energy technologies and their components, despite supplying around 75 per cent of global manganese, 70 per cent of cobalt and nearly 20 per cent of copper. The IEA estimates that moving into beneficiation, processing and manufacturing could raise the market value of minerals produced in Africa to about $120bn by 2040.

This is why the African Union’s Africa Green Minerals Strategy, adopted in March 2025, is significant. The strategy calls for Africa to move beyond raw mineral exports towards value addition at source, regional industrialisation, local beneficiation, job creation and economic diversification. The AU’s African Forum on Mining subsequently called for stronger continental bargaining power and high-level African critical-minerals diplomacy to ensure that mineral agreements prioritise local value addition rather than simply facilitate the export of raw materials.

Niger, therefore, should not be judged simply by whether its nationalisation policy succeeds or fails. Its experiment should be watched for what it reveals about both the possibilities and dangers of greater resource control.

National ownership does not automatically produce efficient management. A government can own a mine and still mismanage it. It can control petroleum and still import refined products. It can take over gold operations while communities around the mines remain poor. It can remove foreign companies and replace foreign inefficiency with domestic corruption.

Niger itself has already encountered some of these complications. Orano has pursued arbitration over the nationalisation of its interest in SOMAÏR. In September 2025, Reuters reported that about 1,500 tonnes of uranium, valued at roughly $270m, remained stockpiled at the former SOMAÏR mine. Orano had begun arbitration proceedings and warned against the material being transferred or sold without authorisation.

A country seeking greater control over its resources needs competent geologists, engineers, lawyers, accountants, negotiators, regulators and financial institutions. It needs reliable electricity, roads, railways and ports. It needs research institutions capable of developing technology. It needs transparent contracts and systems through which citizens can know what governments receive from their natural resources and how those revenues are spent.

Without these foundations, nationalisation can become an expensive political gesture. But Africa should not allow the imperfections of resource nationalism to become an excuse for maintaining a system in which the continent remains primarily an exporter of raw materials.

Nigeria illustrates the urgency. The country has oil, gas, gold, lithium, iron ore, coal and other minerals, but its economic history has repeatedly demonstrated the danger of exporting natural resources without developing sufficient downstream capacity.

The Tinubu administration has increasingly emphasised local processing and value addition in critical minerals. In July 2026, President Bola Tinubu commissioned a $250m lithium mining and processing plant in Nasarawa State with a capacity of 6,000 tonnes of lithium processing per day. It was described as Africa’s largest lithium processing facility.

Nigeria should not stop at processing lithium. It should be thinking about the battery industry, electric vehicles, energy-storage systems, industrial chemicals, research and the skilled workforce required to support those industries.

The same thinking should apply across Africa. A Congolese citizen living beside cobalt deposits should have access to opportunities created by cobalt. A Zambian living around copper mines should benefit from industries built around copper. A Ghanaian should see gold not merely as something extracted and exported, but as an opportunity for refining, jewellery, financial services and manufacturing. A Nigerien should be able to look at uranium and see engineering, science, technology and industrial opportunities. And a Nigerian should be able to look at oil and gas without accepting that the country’s natural destiny is simply to export crude and import refined products.

If Africa can retain more value from its resources, that value can help finance universities, technical schools, electricity, transport infrastructure, healthcare, manufacturing and technology. Those investments can create productive employment. Productive employment can reduce the economic pressure pushing young Africans towards foreign shores.

The real lesson from Niger, therefore, is not that every African government should wake up tomorrow and nationalise every foreign-owned mine, oilfield or industrial operation. That would be a simplistic reading of what is happening. The lesson is that the old bargain deserves serious reconsideration.

Africa should welcome investors, but it should negotiate better. It should welcome technology, but build its own capacity. It should welcome international capital, but ensure that African capital also grows. It should permit extraction, but demand value addition. It should collect royalties and taxes, but also build industries around the resources generating them.

Analysis

Will Africa Follow Niger Republic? By Alabidun Shuaib AbdulRahman

Published

1 week ago

October 8, 2026

editordiasporawatch

Will Africa Follow Niger Republic? By Alabidun Shuaib AbdulRahman

Africa’s greatest economic contradiction is buried beneath its own soil. Across the continent lie enormous deposits of oil, gas, uranium, gold, lithium, cobalt, copper, diamonds and other strategic minerals, yet many of the countries sitting on these resources continue to struggle with poverty, unemployment, weak industrialisation and the steady movement of their young people towards Europe, North America and other destinations in search of better opportunities.