Nigeria’s Healthcare Gaps Leave Families and Startups Filling the Void

Nigeria’s healthcare system is leaving critical gaps for families, informal providers and healthtech companies to address, according to an account of the country’s emergency response, primary healthcare and sexual and reproductive health challenges.

In Lagos, people seeking urgent medical assistance may face delayed connections, repeated calls and reliance on someone with a car or a personal contact. The account describes ambulances as existing but poorly coordinated across the wider network of hospitals and first responders.

Building a link between distress and care

Medwaka’s founders initially focused on blood donation shortages affecting pregnant women in Ondo State. Their experience, however, repeatedly exposed a broader problem: people in distress could not reliably get to a point of care.

The company subsequently rebuilt its model around dispatch and coordination. Its service is described as a coordination layer operating on top of existing hospitals, ambulances and first responders, rather than as a replacement for those services.

The example reflects a wider pattern in which healthtech founders try to work around weaknesses in public systems. Such companies can help organise access, but they cannot create a functioning national emergency number or provide services that require government-wide systems and policy.

Underfunded facilities and informal care

Nigeria’s primary healthcare centres are described as chronically underfunded. Healthcare allocations may be included in budgets without being released, while released funds may not reach facilities in ways that improve patient care.

Research by TC Insights identified an informal healthcare economy that includes patent medicine vendors, unlicensed clinic operators and community-level caregivers. These providers absorb patients who might otherwise be served by the formal system.

The reliance on informal care exists alongside a broader financing problem. During the past two decades, most of Nigeria’s health financing reportedly came from external partners. The account also places government health spending well below an African regional range of 2 to 12 percent, without providing a specific figure for Nigeria.

Donor dependence exposed

The pullback by USAID in 2025 highlighted the healthtech sector’s dependence on external funding and partnerships. According to the account, such relationships had helped provide startups with credibility and links to public health programmes.

Donor dependence also affected infrastructure. A disease-surveillance system reportedly went dark after a funding line closed because an independent, donor-free version had not been established. The specific funding line and surveillance systems involved were not identified.

Barriers to sexual and reproductive healthcare

Access to contraceptives is constrained by stigma, while sex education is described as barely present in Nigerian schools. The account also says women do not functionally control every decision concerning their own bodies.

Whispa, a Nigerian digital platform, provides young people with confidential and affordable sexual and reproductive healthcare. It was built around anonymous, judgment-free access to sexual health information for girls who might otherwise have nowhere to ask questions.

These services address immediate access problems, but they do not remove the wider institutional barriers affecting healthcare and education.

Responsibility shifted to those left standing

The health edition of The Nigerian Life Compendium, an initiative of Zikoko Citizen, documents how healthcare responsibilities are transferred to families, founders or, at times, no one at all.

Together, the examples show how emergency coordination failures, weak public financing, donor-dependent infrastructure and restricted reproductive healthcare access push responsibility away from public institutions. Families, informal caregivers and healthtech founders may fill some of the gaps, but the underlying system remains dependent on stronger public coordination and sustained domestic support.