Assessing the Poor State of Nigeria’s Healthcare System: Infrastructure, Workforce Gaps, Uneven Access, Maternal Mortality, Communicable Diseases, and the COVID-19 Pandemic

Abstract

Nigeria’s healthcare system continues to face serious challenges, including weak infrastructure, shortages of healthcare workers, and unequal access to care. This scoping review examines these long-standing problems and explores how they affect maternal mortality, communicable diseases, and the country’s response to the COVID-19 pandemic. Six databases: PubMed, Scopus, CINAHL, APA PsycINFO, Web of Science, and Google Scholar were searched for studies published between 2020 and 2024. The review focused on research related to Nigeria’s healthcare infrastructure, workforce, healthcare access, maternal mortality, communicable diseases, and COVID-19. The review was guided by the Joanna Briggs Institute methodological framework and reported in line with the PRISMA-ScR guidelines. The evidence shows that Nigeria’s healthcare system is weakened by poor infrastructure, especially in rural communities where health facilities are often under-equipped or unavailable. Shortages of healthcare workers, absenteeism, and migration further reduce the quality and availability of care. Access to healthcare remains uneven, with poorer households and rural populations facing the greatest barriers. Maternal mortality remains high, while communicable diseases such as malaria, tuberculosis, and HIV/AIDS continue to place heavy pressure on the system. The COVID-19 pandemic exposed these weaknesses even more clearly by disrupting essential services and revealing major gaps in emergency preparedness. Nigeria shares many health system challenges with other low- and middle-income countries, including chronic underfunding, weak governance, and unequal distribution of resources. The findings point to the need for stronger investment in health infrastructure, better strategies to retain healthcare workers, wider access to universal health coverage, and improved disease surveillance. Building a more resilient healthcare system is essential for reducing preventable deaths, improving equity, and preparing the country for future health emergencies.