When Damola* arrived at the emergency ward after a road accident, there was only one doctor on duty, no available beds, and he had to wait for a very long time. When it was finally his turn, the doctor requested payment before examining him. The examination was done, but because he had no visible external injuries, he was left in the waiting area, writhing in pain, while other patients were attended to.
Hours later, he was rushed into surgery. He had been bleeding internally.
This account is a true-life story shared by an interviewee in a Premium Times vox pop. It reflects a reality too many Nigerians have become too familiar with. Hundreds of Nigerians have visited hospitals seeking care, only to face barriers to receiving the urgent medical attention they need. Many are left waiting for hours because they cannot make immediate payments, because no doctor is available, or because hospitals are simply overcrowded.
This isn’t just about a few tragic cases. It’s about a system that leaves patients too often powerless. Ideally, emergency care is a fast, smooth race against time, an ambulance arrives in minutes, trained medics start treatment immediately, and the hospital is ready and waiting with a bed and a doctor the moment you arrive. In Nigeria, this ideal is lost to a broken system. According to the WHO, there is only one ambulance for every 289,000 Nigerians, compared to the recommended standard of 1 ambulance per 100,000 people. In practical terms, nearly 65% of Nigerians are left without access to an ambulance during an emergency. Instead of an ambulance, families have to carry patients in the back of a car to an overcrowded hospital that turns them away because they can’t pay up front.
This is a systemic crisis. Premium Times reports on a woman in Jigawa who lost her unborn child due to the Katanga PHC having no working clinic, no open pharmacy, and no available health worker to call. The centre lacks toilets and a water supply. The old, deteriorating structure is also unfenced, as it has been since its construction in the 1990s. This weak oversight and lack of accountability in the health sector mean that stories like these will recur.
By definition, medical negligence occurs when a healthcare professional or institution fails to provide the expected standard of care, thereby causing injury or death to the patient. Recently, widely reported cases have reignited public anger. Earlier this year, author Chimamanda Ngozi Adichie’s son allegedly died after being administered excessive propofol and not being properly monitored during a procedure at a Lagos hospital. Likewise, the Kano State Hospitals Management Board admitted negligence when surgical scissors were mistakenly left inside a patient’s body during surgery.
Similarly, an upcoming gospel musician died of a snake bite in Abuja and although the Federal Medical Centre (FMC) stated the Nigerian singer’s death was from severe neurotoxic complications arising from the snake bite and not medical negligence, health services must not become a matter of chance. The severity of these cases necessitates immediate change.
This reduced quality of care cannot be separated from the evidence that many Nigerian hospitals are understaffed, underfunded, and overwhelmed. In 2024, 4,193 doctors and dentists left Nigeria to practice medicine overseas. Nigeria has 66,000 practising doctors, but with a population exceeding 230 million, it needs at least 400,000 more doctors to meet the WHO standard of 17 doctors per 10,000 people. Nigeria currently operates at one doctor for 3,474 people. This report from Premium Times shows a debilitating PHC in Akwa Ibom with only one full-time employee, a Community Health Environmental Worker (CHEW), who is also delivering beyond her role.
In 2025, doctors and nurses went on a 29-day strike after months of demanding unpaid salary arrears, full implementation of the 2025 Medical Residency Training Fund (MRTF), and improved working conditions. These professionals face overwhelming burdens, unsafe working hours, and an impossible workload, putting both their health and patient care at serious risk. An exhausted professional builds up frustration, impairing their empathy and skill, and in a medical emergency, a delay in judgment can be the difference between life and death.
Policy and Budgetary Gaps
In 2025, the Nigerian health sector got 5% of the national budget. In the same year, the UN named Nigeria as the ‘worst place to give birth’, accounting for 29% of all maternal deaths worldwide. This year, the sector is receiving even less, just 4.2% of the national budget allocated to the health sector, despite ongoing cholera and diphtheria outbreaks, below the Abuja Declaration’s agreement of at least 15%.
Chronic underfunding keeps salaries low and working conditions poor, fueling the ‘Japa Effect’ exodus of medical professionals. The remaining practitioners are forced to work long weeks, often surpassing 100 hours. An exhausted doctor is statistically more likely to miscalculate a dosage or miss a critical symptom. The majority of Nigerian hospitals still lack basic diagnostic tools. When a doctor is forced to make a “blind diagnosis” because an MRI or even a basic lab kit is unavailable due to budget cuts, the resulting misdiagnosis is technically medical negligence, but its root is a state-induced failure.
Accountability Gaps
Despite the number of accounts of medical malpractice and negligence, formal complaints or lawsuits for compensation remain surprisingly low. This gap is partly rooted in the legal framework governing medical accountability. Section 343 of the Criminal Code stipulates that any person who administers medicine or medical treatment in a rash or negligent manner that endangers life is guilty of a misdemeanour. In contrast, Section 317 provides for prosecution in cases of unlawful killing without intent to cause death. Proving negligence on the part of a medical practitioner can be difficult under the current law, as patients are often required to meet a high burden of proof, navigate complex legal procedures, and rely on medical records and expert testimony that may be inaccessible or tightly controlled by the very institutions they are challenging. Although the Medical and Dental Practitioners Act serves as the primary mechanism for professional regulation and discipline, its processes are often slow and opaque, further weakening accountability and allowing negligence cases to remain unresolved.
Recommendations
The following recommendations are offered:
- Adopt a Treatment-First Policy: In emergencies, financial considerations should never take precedence over life-saving medical intervention. Medical facilities should adopt a treatment-first policy to ensure that patients receive care before being asked for payment. The fundamental, professional duty of healthcare providers is to prioritise life-saving treatment. Regulatory bodies must clearly define and enforce sanctions for institutions that deny urgent care due to the inability to pay. Medical professionals and institutions should recognise that the moral obligation to assist vulnerable patients and provide collective, equitable care to those in need should outweigh the financial costs.
- Improved access to Insurance Information: Simplify and strengthen access to information about emergency services and health insurance. Many Nigerians lack clear guidance on accessing the National Health Insurance Authority (NHIA), and current provisions don’t adequately cover individuals in informal or non-skilled employment. The NHIA should be expanded to deliberately include informal workers, who make up to 92% of the population. Public education campaigns must also be launched to ensure Nigerians understand how the scheme works, what it covers, and how to enrol.
- Improve Access to Emergency Information: Ensure clear access to information on emergency services. Emergency contact systems must be streamlined. In most Nigerian states, multiple emergency numbers exist, which creates confusion and delays. A single, nationwide emergency line linked to ambulance services, fire services, and other first responders would significantly improve response coordination and reduce fatal delays during crises. The current toll-free emergency numbers, ‘112’ and ‘767’, must be fully functional across all 36 states to ensure timely access to help.
- Improved working conditions for medical professionals: The government must urgently address the deteriorating conditions faced by medical professionals. Competitive remuneration, improved workplace safety, access to equipment, and reasonable working hours are critical to retaining skilled personnel. Chronic understaffing forces doctors and nurses to work excessively long shifts, increasing the risk of medical errors and burnout. By investing in workforce retention strategies, expanding employment opportunities, and prioritising staff welfare, Nigeria can begin to curb the persistent brain drain, commonly referred to as the “Japa Effect,” and stabilise its healthcare workforce.
- Increased health allocation: Government investment is necessary to ensure essential health services are both available and affordable. When essential services are heavily privatised due to weak public infrastructure, low-income Nigerians are effectively excluded from access to care. Increased budgetary allocation should prioritise strengthening primary healthcare centres, upgrading diagnostic facilities, improving drug availability, and ensuring consistent power and water supply in hospitals. Public health infrastructure must be robust enough to reduce dependence on expensive private alternatives.
Expand Emergency Response Capacity: Increase emergency response capacity by procuring and distributing well-equipped ambulances across all states. Ambulance services must be staffed with trained paramedics, and response times should be monitored and regulated to ensure efficiency.
Although it is commendable that the government has established a National Task Force on Clinical Governance and Patient Safety in January 2026, this step must now be matched with concrete action, including the implementation of patient safety frameworks, stronger systems for preventing and reporting adverse events, and continuous training to build a more competent and responsive healthcare workforce.
In the ideal scenario, Damola* arrives at the emergency ward following a road accident and is immediately triaged by trained staff. He is examined without delay, stabilised, and given pain relief while his vital signs are monitored. Despite no visible external injuries, doctors perform necessary imaging and tests to rule out internal damage. Treatment begins before any discussion of payment, the internal bleeding is quickly detected, and Damola is taken straight into surgery, where timely intervention saves his life.
Watch the video showing Nigerians’ reaction to Medical Negligence here: YouTube/PremiumTimes
*Names redacted for privacy
References
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Chukwu, L. (2025, November 30). Resident doctors suspend indefinite strike after 29 days. Nairametrics. https://nairametrics.com/2025/11/30/resident-doctors-suspend-indefinite-strike-after-29-days/
Chukwuma, M. (2024). 4193 doctors, dentists left Nigeria in 2024 – Report. Punch Newspapers. https://punchng.com/4193-doctors-dentists-left-nigeria-in-2024-report/
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Premium Times. (2025). In Akwa Ibom, pregnant women, babies die due to poorly equipped PHCs while govt wastes billions. https://www.premiumtimesng.com/health/health-investigations/820166-in-akwa-ibom-pregnant-women-babies-die-due-to-poorly-equipped-phcs-while-govt-wastes-billions.html
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