Nigeria’s Healthcare System: Local Insurance, Hospitals, Emergencies and Health Risks

In Nigeria, care is provided by public establishments and by a growing private sector, in a very large country where provision varies markedly from one region to another. France Diplomatie (“Health” page) describes the healthcare system as precarious and points out that, outside Abuja and Lagos, the possibilities of emergency care and hospitalisation in good conditions are uncertain. Road accidents are numerous, which makes it all the more worthwhile to know in advance the facility closest to your home and your workplace.

For a French resident, everyday use therefore combines a first-contact doctor chosen in Lagos or Abuja, private facilities for planned care and international cover that organises evacuation when needed. The page on living in Nigeria recalls the safety advice that conditions access to care: avoid night travel and identify a hospital in advance.

The National Health Insurance Authority was created by the law signed on 19 May 2022, which replaced the 1999 law on the national health insurance scheme. According to its website, it manages contributory programmes (formal sector, organised private sector, federal civil servants, private plans) and non-contributory programmes, including the Basic Health Care Provision Fund and the Vulnerable Group Fund. It states that it serves all Nigerians and legal residents.

• Benefits: beneficiaries do not have to pay for care at the counter, apart from a 10% co-payment on medicines (NHIA). The contribution covers the employee, their spouse and up to four biological children; other dependants may be added.
• Conditions for a foreigner: the pages consulted detail neither the contribution amounts for the formal sector nor the rules for enrolling an expatriate. In practice, enrolment goes through the local employer; it should be checked with the NHIA.
• Scope: access is limited to approved providers in the network. It does not, on its own, cover medical evacuation or the return to France.

The first-contact doctor is chosen from a practice or clinic in Lagos or Abuja; the French consulate general in Lagos (Ikoyi) and the embassy in Abuja (+234 201 343 89 38) can point you towards practitioners and facilities. Insurance with direct billing avoids advancing costs. In zones under heightened vigilance or advised against, access to care, like all travel, depends on the safety conditions described by France Diplomatie.

Emergencies: the France Diplomatie pages consulted give no national emergency number; they recommend saving the numbers of hospitals and of the embassy or consulate in your phone. In a serious emergency, the assistance platform of the insurance contract organises transport, admission and, if necessary, evacuation; keep this number to hand and pass it on to your family and employer.

France Diplomatie recommends bringing only the medicines that are strictly necessary, in their original packaging with the labels, together with a prescription giving the names as international non-proprietary names. Check that the medicines are authorised in Nigeria and never buy medicines in the street, because of counterfeits. For a chronic treatment, it is useful to build up a reserve, keep the prescription and ask the insurer about the conditions for covering medicines abroad. See also the page on healthcare reimbursement in Nigeria.

According to France Diplomatie, malaria is Nigeria’s main health risk. Prevention combines protection against mosquito bites (covering clothing, repellents, mosquito nets, removal of standing water) and preventive treatment decided with a doctor.

• Cholera: endemic, above all in the north during the rainy season from May to September; a sharp upsurge is sometimes reported, notably in Borno State, with outbreaks in Plateau State.
• Meningitis: cases reported mainly from January to March and epidemics in the northern states during the dry season.
• Lassa fever: no vaccine; prevention through hygiene and avoiding rodents.
• Others: diphtheria (regular epidemics), dengue, chikungunya, Zika, rabies, poliomyelitis, tuberculosis, mpox, typhoid fever and hepatitis A. France Diplomatie also reports occasional measles alerts.

The recommended daily hygiene measures: wash your hands, drink safe water, cook food thoroughly, avoid raw vegetables and cold buffets, and avoid night driving and two-wheelers.

France Diplomatie recommends being up to date with the French vaccination schedule (diphtheria, tetanus, poliomyelitis, whooping cough, measles). Depending on the length and conditions of the stay, additional vaccines are discussed with a doctor or an international vaccination centre well before departure: hepatitis A, typhoid fever, hepatitis B (frequent or long stays), meningitis ACWY (dry season or epidemic), tuberculosis for children under fifteen on a long stay, rabies for young children in rural areas, but also chikungunya, dengue and mpox in case of exposure.

Yellow fever: the “Health” page states that vaccination is no longer compulsory for entry, except when arriving from endemic zones, but that it is strongly recommended, and that the authorities may demand the vaccination record at the border; the “Entry and stay” page mentions the possibility of an international certificate being required. Bringing your vaccination record remains the simplest precaution.

France Diplomatie considers it imperative to take out an assistance contract or insurance covering medical costs, surgery, hospitalisation and medical repatriation, because the embassy cannot cover any costs. With no social security agreement between France and Nigeria (CLEISS list; the CLEISS is the French liaison centre for international social security), no coordination exists between the schemes: the choice is between the employer’s insurance, the CFE (Caisse des Français de l’étranger, the French social security fund for French nationals abroad) and international insurance. Reference points can be found in the pages on expat health insurance and repatriation and assistance; Expavy helps you weigh these options against your situation.