Credit Adeyinka Olaiya, Ancestral News
Nigeria faces a major healthcare challenge: millions of people still struggle to access affordable, quality care, while public health infrastructure remains uneven and heavily dependent on out-of-pocket payments. Unlike Brazil, Nigeria does not have one universal public healthcare system. Instead, healthcare is fragmented across federal, state and local facilities, private providers, insurance schemes, community initiatives and traditional medicine.
Brazil offers an important lesson through its Sistema Único de Saúde (SUS), one of the world’s largest universal public healthcare systems. Nigeria does not need to copy SUS exactly. Our political structure, economy, population and social realities are different. But we can learn from its central principles: healthcare as a right, strong primary care, public financing, decentralization, prevention, community participation and national coordination.
Brazil’s 1988 Constitution recognized health as a fundamental right and a responsibility of the State. This principle helped create SUS and shifted healthcare away from being determined mainly by an individual’s ability to pay.
The idea is simple: nobody should have to choose between buying food, paying school fees and seeking medical treatment. A mother should not die in childbirth because her family cannot afford a hospital bill, and a child should not miss vaccination because his parents cannot pay.
SUS provides services ranging from primary healthcare, vaccination and maternal care to emergency treatment, surgery, cancer care, mental-health services and specialized procedures. Its approach is built around universality, integrality and equity—healthcare for everyone, care that covers prevention through treatment and rehabilitation, and services designed around different community needs.
For Nigeria, the lesson is clear: a national healthcare system should be more than a collection of hospitals. It should be an integrated network reaching people where they live.
Start with Primary Healthcare
One of Brazil’s strongest lessons is its emphasis on primary healthcare through the Family Health Strategy. Community-based teams focus on prevention, vaccination, maternal and child health, chronic diseases and early diagnosis instead of waiting for patients to become seriously ill.
Nigeria has thousands of primary healthcare centres, but many lack doctors, nurses, medicines, equipment, electricity and water. Building more facilities alone will not solve the problem. Existing centres must become functional, properly staffed, supplied and accountable.
Community health workers, nurses, midwives and doctors should serve defined populations. Mobile clinics, vaccination teams, maternal-health services and telemedicine can extend care to remote communities.
Whether someone lives in Lagos, Abuja or a rural village, there should be a reliable first point of contact with the health system.
Give Communities a Greater Role
Brazil’s SUS operates through cooperation between federal, state and municipal governments. Nigeria already has a similar three-tier structure, but coordination, financing, accountability and implementation remain major weaknesses.
Nigeria could give Local Government Areas greater responsibility and predictable funding for primary healthcare, while the federal government sets national standards and provides coordination.
Decentralization, however, must come with accountability. Health funds should reach the facilities they are meant for. Procurement must be transparent, workers must be paid, and communities should have a voice in monitoring services.
Reduce the Burden of Out-of-Pocket Payments
A medical emergency can quickly become a financial emergency for a Nigerian family. The NHIA can help expand insurance coverage, but universal healthcare cannot depend mainly on formal employment or insurance contributions because a large part of Nigeria’s population works in the informal economy.
Brazil shows how public resources can be pooled through government budgets and taxation to support universal care. Nigeria could gradually strengthen public financing for essential healthcare while allowing private hospitals and insurance to continue operating.
The goal is not to abolish private healthcare. It is to ensure that being poor does not mean being excluded from essential care. Private healthcare can provide additional choices, but the public system must guarantee a basic standard for everyone.
Make Medicines and Prevention a Priority
Nigeria also needs stronger systems for procuring and distributing essential medicines and vaccines. Coordinated public procurement could help government agencies buy in larger quantities, negotiate better prices and distribute medicines more reliably to public facilities.
But healthcare must go beyond treating illness. Vaccination, clean water, sanitation, nutrition, maternal care, health education and disease surveillance can prevent suffering before people reach hospitals.
This means health policy must connect with education, water, sanitation, agriculture, housing and social protection. A healthy society is built not only in hospitals but also in homes and communities.
Build a Nigerian Model
Universal healthcare is ultimately a political choice. Brazil’s SUS required constitutional recognition, legislation, public financing, institutional reform and sustained political commitment. Nigeria already has many of the institutions and professionals needed to begin a similar transformation.
But Nigeria should build its own model, reflecting its more than 250 ethnic groups, hundreds of languages, large informal economy and wide differences between urban and rural communities.
A Nigerian universal healthcare system could bring together:
- Strong, properly funded primary healthcare centres.
- Community-based healthcare teams.
- Universal access to essential services.
- Greater public financing and reduced out-of-pocket spending.
- Better federal, state and local coordination.
- Transparent procurement of medicines and equipment.
- Reliable emergency and maternal healthcare.
- Universal vaccination and disease prevention.
- Digital health and telemedicine.
- Stronger regulation of private healthcare.
- Community participation and accountability.
Brazil’s SUS has its own problems, including funding pressures, regional inequalities, shortages of professionals and waiting times for some specialized services. Universal healthcare is not a magic solution. But its experience demonstrates that a large and diverse country can organize healthcare around the principle that essential medical care should not depend entirely on personal wealth.
The fundamental question for Nigeria is simple: What happens to a Nigerian who has no money but becomes seriously ill?
The answer should not be abandonment.
Nigeria has doctors, nurses, universities, hospitals, pharmaceutical companies and growing technological capacity. What is needed is the political will to organize these resources around a clear national vision.
Brazil’s SUS shows that healthcare can be treated not simply as a commodity, but as a public responsibility and a fundamental right.
Nigeria can learn from that experience and develop its own Universal Nigerian Health Service—one adapted to our realities but guided by universality, equity, prevention, community care and public responsibility.
The goal should be straightforward: whether in Lagos or a remote village, whether rich or poor, employed or unemployed, every Nigerian should have access to essential healthcare when they need it.
That is more than healthcare policy. It is a statement about the kind of nation Nigeria wants to become.
