The Nigeria Basic Health Care Provision Fund (BHCPF) is one of the most significant reforms in health financing in Nigeria. It was created to strengthen Nigeria's health sector, improve access to healthcare, strengthen Primary Health Centres (PHCs), support emergency response and public health security, and support vulnerable groups. The BHCPF is also intended to accelerate the country's shift towards Universal Health Coverage (UHC), so that Nigerians can access equitable and affordable medical care. The National Health Act of 2014 (Section 11) established the BHCPF specifically to guarantee steady funding for essential healthcare services. It helps lower the out-of-pocket costs that push families into poverty and concentrates on improving health outcomes for those who need it most — women, children, and low-income communities. This review provides an overview of what is known about the BHCPF since 2014, including how it was developed, how it has been used in practice, what has worked, how it is managed, and where it continues to face challenges. As of 2026, official documents, policy papers, and research articles present a mixed but broadly positive picture. The BHCPF has enhanced access to critical care, improved facility budget control, expanded the number of people covered by health insurance, and improved the consistency of PHC funding. However, implementation has been limited by governance concerns, delays in fund release, inadequate state-level capacity, weak accountability, and persistent regional inequities. The review concluded that although the BHCPF is a transformative health financing model, its future viability depends on reinforcing accountability frameworks, strengthening state-level preparedness, improving transparency, and ensuring sustainable funding.
Emmanuel Bola Jonah, Mary Ojonema Onoja- Alexander, Ogwuche Igoche John et al.
Childhood immunization is a vital public health strategy for reducing morbidity and mortality associated with vaccine-preventable diseases. However, despite ongoing efforts by government and health agencies in Nigeria, immunization coverage remains suboptimal in many rural communities, including Jada Local Government Area of Adamawa State. This study examines the factors affecting the utilization of childhood immunization programmes in the area. The study adopts a descriptive research design, focusing on mothers and caregivers of children within the immunization age group. Data are collected using structured questionnaires, interview and analyzed to identify key determinants influencing immunization uptake. Findings reveal that limited knowledge and awareness of immunization benefits, misconceptions about vaccine safety, and negative cultural or religious beliefs significantly affect participation in immunization programmes. Additionally, socioeconomic factors such as low income, illiteracy, and competing domestic responsibilities hinder caregivers’ ability to access immunization services. Health system-related challenges are also identified, including inadequate healthcare facilities, long distances to vaccination centers, irregular vaccine supply, and insufficient healthcare personnel. Poor communication and lack of effective community mobilization further contribute to low immunization coverage. The study concludes that a combination of socio-cultural, economic, and institutional factors affects the success of childhood immunization programmes in Jada Local Government Area. It recommends intensified public health education, improved accessibility of immunization services, strengthening of healthcare systems, and active community engagement to enhance immunization uptake and safeguard child health.
Vaccine equity remains a major public health challenge in many low-and middle-income countries, where socioeconomic and spatial disparities continue to limit equitable access to childhood immunization services.Evidence regarding the independent drivers of vaccine equity in Plateau North Senatorial District, Nigeria, remains scarce.A cross-sectional study conducted in district among 400 mothers aged 15-49 years whose youngest child was aged 12-23 months.A multistage stratified sampling technique was used to select respondents across the six Local Government Areas of Plateau North Senatorial District.Data were collected using structured questionnaires and in-depth interviews.Descriptive statistics summarized respondents' characteristics, while Chi-square tests and binomial logistic regression analyses were used to identify factors associated with childhood immunization at a 5% significance level.Most respondents were aged 25-29 years (28.8%),tertiary education (51.0%), lived in rented accommodation (77.3%), resided in peri-urban communities (48.0%), travelled 3-4 km to access health facilities (58.5%) and 1-7 antenatal care visits (58.0%).Chisquare analysis showed that housing ownership status (χ² = 7.647, p = 0.022) had significant associations with childhood immunization.Binomial logistic regression revealed that housing ownership status (AOR = 2.074; 95% CI: 1.315-3.270;p = 0.002) and settlement type (AOR = 0.730; 95% CI: 0.545-0.978;p = 0.035) were significant independent predictors of childhood immunization.Maternal age, maternal education, distance to health facilities, and means of transportation were not significantly associated with childhood immunization after adjustment.The study concludes that vaccine equity in Plateau North Senatorial District is primarily influenced by socioeconomic and spatial inequalities.Interventions aimed at improving childhood immunization should prioritize disadvantaged households and underserved settlements through targeted outreach programmes, equitable healthcare delivery, and policies that reduce financial and geographic barriers to vaccination.
Background Childhood vaccine hesitancy is a significant public health concern. In Nigeria, it remains a major barrier to achieving optimal immunization uptake, contributing to preventable morbidity and mortality. Yet there remains a significant research gap on the synthesis of health communication strategies to address parental hesitancy to childhood vaccination. The primary aim and original contribution of the present review is to synthesize health communication strategies to address parental hesitancy to childhood vaccination in Nigeria. Method The review strategy was underpinned by the Population, phenomenon of interest and context (PICo) model. Hence, the population (parents, carers, or primary caregivers of children between the ages of 0 and 3 years), the phenomenon of interest (health communication strategies to address parental hesitancy to childhood vaccination), and the context (vaccine hesitancy). For qualitative studies, the PICo strategy, which is a modified version of PICO, was used. Boolean operators (AND/OR/NOT) were used to ensure rigor in adopting informed search terms. Six databases were searched for published articles between 2017 and March 2026. N = 12 studies met the inclusion criteria, and the relevant data were synthesized and analyzed using a thematic synthesis approach. The review protocol was pre-registered on the PROSPERO Registry (no. CRD420261303323). Findings The synthesized studies and analyses yielded the following main findings: (i) Media campaign strategies, (ii) State-sponsored communication strategies, (iii) Community-centered strategies, and (iv) Phone-based strategies. Conclusion Childhood vaccine hesitancy remains a major challenge in Nigeria. The review recommends that vaccine communication be culturally attuned and multi-channeled (e.g., embedding community-centered mechanisms—particularly those involving trusted religious and traditional leaders, media platforms, and mobile phone text messaging). It also recommends that vaccine communication be responsive to both structural constraints and community information need to address parental hesitancy to childhood vaccine uptake.
Background Recent evidence suggests that just over a third of children aged 12–23 months in Nigeria have received basic antigens as recommended by the expanded programme on immunisation schedule; just over a quarter have received all first year antigens. Approximately 18% of children in Nigeria are classified as ‘zero-dose’. We assessed the status of immunisation services in Kano and Lagos States of Nigeria to inform the design of interventions to address high numbers of zero-dose and under-immunised children in these states. Methods We used a mixed-methods study design. We collected information from caregivers (including female and male caregivers; and caregivers of zero-dose, under-immunised, and immunised children), and healthcare workers. We conducted focus groups and key informant interviews amongst caregivers of zero-dose and non-zero-dose children. We interviewed caregivers and observed vaccination sessions. We carried out facility observation of vaccination sessions. Data collection tools were adapted from the WHO expanded programme on immunisation review guidelines. Results Whilst we identified many positive practices - and exit interviews suggested high satisfaction with vaccination services - we identified important areas for improving services. Specific challenges related to the: 1) staff (including insufficient staff to operate vaccination activities, poor information exchange with caregivers, low planning capacity, sub-optimal health and safety practices, and abrasive healthcare worker attitudes); 2) facility (including unwelcoming and uncomfortable facility environments and occasional vaccine shortages), and 3) programme design/delivery (including poor planning/service integration, and insufficient resources for transportation/outreach services). Conclusion We suspect that many of the identified challenges are interrelated (e.g. insufficient staff numbers, and an uncomfortable facility environment, may contribute to poor interaction between healthcare workers and caregivers) and that addressing some of these challenges may have cascading effect on vaccination coverage. A better understanding of improving service design and delivery to incentivise visits to vaccination services is needed.
AdekunleGaniyu Salaudeen, Oladimeji Akeem Bolarinwa, Catherine R. McGowan et al.
Drones are changing healthcare delivery, particularly in sub-Saharan Africa (SSA), where traditional logistics face geographical, infrastructural, and resource limitations. This review maps where drones have been used in SSA, how they have been used, the outcomes and challenges, and the potential to expand drone systems to address other healthcare problems. A rapid scoping review methodology was employed, sourcing literature from Google Scholar, PubMed, SCOPUS, Web of Science, Cairn.info, and grey literature using targeted keywords such as 'drones,' 'medicine delivery,' and 'sub-Saharan Africa' to build a search query. Twenty-nine papers met the inclusion criteria, covering 12 countries, although the evidence base was heavily concentrated in Ghana and included a mix of peer-reviewed articles, technical reports, and media or organisational sources. Drone delivery systems have improved healthcare logistics across SSA by reducing delivery times, addressing rural access issues, improving maternal, neonatal, infectious disease, and emergency outcomes, and optimising supply chains. However, challenges such as payload limitations, dependency on donor funding, regulatory and policy restrictions, and workforce shortages hinder scalability. Drones have great potential for healthcare delivery in SSA, offering rapid, efficient, and cost-effective solutions that are transferable to non-communicable diseases (NCDs) and to potential and emerging applications such as vector surveillance and public health messaging. While their contributions to improving maternal health and emergency response are notable, addressing systemic issues is crucial. Drones show promise for improving healthcare logistics in underserved settings, but their long-term value depends on resolving regulatory, infrastructural, workforce, and financing constraints, and on generating stronger comparative generalisable evidence.
Background: Nigeria introduced a second dose of measles-containing vaccine (MCV2) to improve population immunity, but second-year uptake remains insufficiently described in urban settings. Objective: To determine MCV2 uptake, MCV1-MCV2 dropout, associated factors, and caregiver-reported barriers among age-eligible children in Benin City. Methods: This mixed-methods cross-sectional study analysed 460 children aged 15-23 months from a survey of 620 caregiver-child pairs. Six focus group discussions involved 54 mothers. Pearson's chi-square test and multivariable logistic regression assessed factors associated with MCV2 receipt; qualitative data were analysed thematically. Results: MCV1 and MCV2 uptake were 90.0% and 82.2%, respectively. Among MCV1 recipients, dropout was 9.7%. Antenatal-care attendance and health-facility delivery were associated with uptake at bivariate analysis. After adjustment, antenatal-care attendance remained independently associated with MCV2 receipt (adjusted odds ratio 3.71; 95% confidence interval 1.72-8.01). Caregivers described poor awareness, forgetfulness, weak reminders, competing responsibilities, occasional service unavailability, and distance. Conclusion: MCV2 uptake remained below the 95% elimination target. Antenatal and immunisation counselling, reliable sessions, reminder-recall systems, and active defaulter tracking should be strengthened.
Efemena Daniel Onowugbeda, Pius Agbalugo Odunze, Oghenerukevwe Trinitas Omonigho et al.
Background Surveillance of adverse events following immunization (AEFI) and appropriate reporting are essential ingredients of an effective immunization programme. Despite increasing recognition by caregivers, the response to it remains a major problem, with the majority being inappropriate. This study is therefore intended to determine the prevalence, pattern, and determinants of caregivers’ response regarding AEFI in Nigerian hospitals. Methodology A descriptive cross-sectional study was conducted among 368 caregiver-infant pairs across 3 Nigerian hospitals, using semi-structured questionnaires to document sociodemographic characteristics and the prevalence, pattern, and determinants of caregivers’ response. Statistical analyses were performed using SPSS version 27. Predictors of AEFI and determinants of caregivers’ response were assessed using Pearson’s chi-square and logistic regression. A p-value < 0.05 was considered statistically significant. Results The prevalence of AEFI was 71.7%, with inconsolable crying/irritability, fever, and swelling at the vaccination site as the leading cases. Infant age, weight, and gestational status at birth were predictors of AEFI occurrence. Only 8 (3.0%) caregivers presented at a healthcare facility when AEFI was noticed (appropriate response), while 360 (97.0%) did not (inappropriate). The relationship of the caregiver to the vaccinated infant (mother) was found to be a determinant of caregivers’ response to the occurrence of AEFI. Conclusion An increasing prevalence of AEFI that was not followed by an optimally appropriate response from caregivers has been demonstrated. This calls for more public enlightenment focusing on the need to report AEFI at healthcare facilities, as this will help in ensuring vaccine safety and improvement in the immunization programme.
Sunday Charles Adeyemo, Funso Abidemi Olagunju, Abimbola Ololade Odeyemi et al.
Hepatitis B is a leading preventable cause of liver cancer, and in high-burden settings most chronic infection is acquired around birth. Nigeria carries Africa’s largest hepatitis B burden. Preventing mother-to-child transmission requires a chain of antenatal steps: testing pregnant women, acting on the result, and vaccinating the newborn. No nationally representative study has assembled these into a single prevention cascade. We built the first national hepatitis B mother-to-child prevention cascade for Nigeria and measured how far it falls from the World Health Organization’s triple-elimination targets. We analysed the 2023-24 Nigeria Demographic and Health Survey, the first Nigerian survey to carry both a maternal hepatitis B module and infant birth-dose records. Among 13,341 women with a most recent live birth in the preceding three years, each linked to that child’s immunisation record, we estimated coverage at each cascade step (antenatal attendance, hepatitis B testing in antenatal care, result received, and the infant birth dose) using complex-survey methods, and examined patterning by wealth, education, residence, travel time, and region. Although 72% of mothers attended antenatal care, only 12.3% (95% CI 11.4-13.2) were tested for hepatitis B there, and among the few tested almost all received a result: the loss fell at testing, not at result-return. The infant birth dose reached 55.0% (53.1-56.9), 35 points below target, and ran at a level unrelated to maternal testing, consistent with universal, non-targeted delivery; place of delivery, not maternal testing, was the dominant correlate of an infant receiving it. Both steps were steeply patterned: antenatal testing ranged from 2.6% in the poorest wealth quintile to 32.4% in the richest, and was lowest in the North-West, the zone with Nigeria’s highest prevalence. Nigeria already reaches most mothers through antenatal care but rarely uses that contact to test for hepatitis B, and the universal birth dose is only half delivered. The country is far from elimination, and furthest where the virus is commonest. Integrating hepatitis B testing into antenatal care, made free and weighted toward the highest-burden north, would convert contact already achieved into protection.
Samson Ikenna Abanni, Bifom Melwin Ekure, Jean Omotosho
Nigeria’s agricultural sector is central to food security, employment generation, economic diversification, and rural development, yet its transformative potential remains constrained by persistent structural, environmental, institutional, and socioeconomic challenges. This narrative review critically examines contemporary issues affecting Nigerian agriculture between 2020 and 2025, evaluates strategies for sectoral revitalisation, and draws lessons from relevant international experiences. Secondary data were obtained from peer-reviewed literature, policy documents, and national and international databases, including Scopus, Web of Science, Google Scholar, African Journals Online, and the Central Bank of Nigeria, the National Bureau of Statistics, FAOSTAT, the World Bank, and FEWS NET. Evidence was synthesised thematically around key agricultural problems, transformation models, international experiences, and policy recommendations. The review identifies declining land and labour productivity, weak input and extension systems, inadequate irrigation, poor rural infrastructure, high post-harvest losses, limited agro-processing capacity, climate variability, environmental degradation, insecurity, policy inconsistency, underinvestment, land constraints, and unequal access to digital technologies and agricultural finance as major barriers to agricultural transformation. Although initiatives such as the Anchor Borrowers’ Programme, NIRSAL, digital agriculture, climate-smart practices, and value-chain development have generated important opportunities, their impacts have been limited by weak implementation, institutional fragmentation, inadequate funding, and exclusion of smallholders, women, and youth. International experiences from Asia, Latin America, India, and the Sahel demonstrate the importance of sustained public investment, effective farmer organisations, community-led adaptation, integrated value-chain development, and stable policy institutions.
