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UHC Day 2025: Unaffordable health costs? We’re sick of it!

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Universal Health Coverage (UHC) Day is a global reminder that access to quality health care is a fundamental right, not a privilege reserved for the wealthy. This year’s theme, “Unaffordable health costs? We’re sick of it!”, speaks directly to one of the biggest barriers facing millions of Nigerians: skyrocketing healthcare costs and the widening gap between health needs and the ability to pay.

While achieving UHC requires multisectoral commitment, one of the most critical systems needed to bridge this gap is health insurance, an essential mechanism designed to protect individuals from financial hardship, ensure continuity of care, and promote equitable access to essential services. Yet, despite the existence of the National Health Insurance Authority (NHIA) and state-level schemes, enrolment remains abysmally low. Out-of-pocket payments still account for over 76% of total health spending in Nigeria, pushing millions deeper into poverty every year.

Health insurance providers cannot succeed alone; they face chronic underfunding, limited subsidies, weak enforcement, and low public awareness. Sustainable progress requires stronger government leadership, increased premium subsidies for the poor, upgraded health facilities, and digital systems that make enrolment seamless.

Yet progress is possible, and CFHI is proving it every day.

Through relentless community mobilization and strategic partnerships with philanthropists like Satoshi Koiso and development partners such as the Institute of Human Virology Nigeria (IHVN), CFHI has successfully enrolled 224 vulnerable individuals into NHIA-supported health coverage this year alone.

These are not just numbers.

They are mothers who no longer skip medication.

They are children who can see a doctor without their parents selling assets.

They are families now protected from choosing between medicine and food.

Health insurance must be affordable, accessible, and functional for every Nigerian. It is not just a policy tool; it is a lifeline that protects households from falling into poverty and guarantees timely care, especially for vulnerable groups.

On UHC Day 2025, our message is unequivocal:

No Nigerian should be denied quality care because they cannot afford it.

We call on federal and state governments to:

  • Fully subsidize premiums for low-income and vulnerable households
  • Strengthen primary health care facilities that deliver insured services
  • Enforce mandatory coverage and streamline digital enrolment

It is time to end the era of unaffordable health costs.

Health care is a right for every Nigerian, irrespective of socio-economic status.

Together, we can make “We’re sick of it” a rallying cry that finally delivers results.

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Removing Gender Barriers in Healthcare Access

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Removing gender barriers to healthcare is not only a matter of equity it is a moral and practical necessity if societies are to survive and thrive. Women and girls face layered obstacles to care: constrained mobility, financial dependence, harmful social norms, and health systems that are under-resourced and sometimes discriminatory. The World Health Organization highlights that gender norms and discrimination systematically limit access to services for women and girls, reducing their ability to obtain timely information, preventive care, and lifesaving treatment (1). These barriers are compounded by grim facility gaps: recent WHO/UNICEF data show billions are treated in health settings that lack basic water, sanitation, hygiene, and reliable electricity conditions that make safe maternal care and emergency treatment precarious (2). At the same time, progress toward universal health coverage (UHC) has slowed, leaving significant groups especially women in rural and low-income communities exposed to out-of-pocket costs and unmet needs (3).

The consequences are measurable and stark. Nigeria, for example, continues to bear a disproportionate share of global maternal deaths, a reality linked to regional inequalities in access, weak infrastructure, and funding shortfalls (4). Globally, analyses of health inclusivity reveal that refugees, displaced women, women with disabilities and other marginalized groups are far more likely to be denied or excluded from care in some cases by more than twenty percentage points compared with non-marginalized groups (5). These are not abstract injustices: they translate into delayed antenatal visits, unattended deliveries, untreated complications, and endless cycles of preventable suffering. Removing gender barriers means addressing the social drivers that prevent women from seeking care as urgently as fixing the physical gaps in facilities.

Civil society organisations and local actors are essential partners in closing these gaps. The Centre for Family Health Initiative (CFHI) works at the community level to confront both practical and cultural barriers to care: we run health education and rights-awareness campaigns that equip women and families with knowledge about available services and how to claim them; we strengthen linkages between households and primary health centres through referrals and case management; we support WASH and menstrual hygiene programmes so women can access services with dignity; and we provide capacity building for community health workers and facility staff so that care is both accessible and respectful (6). Where infrastructure is missing, CFHI has partnered with donors and initiatives to deliver pragmatic solutions for example installing solar birth kits in underserved PHCs to ensure safe night-time deliveries while simultaneously training Healthcare Professionals and Community Health Extension Workers (CHEWs) to enhance their competencies in clinical care, documentation, counselling, and emergency response, ensuring that PHCs can deliver reliable and respectful services across all essential health areas

To remove gender barriers at scale, governments, donors, and health systems must act on several fronts. First, finance primary health care adequately and ensure that essential services are free or financially protected at the point of use, so women are not forced to choose between care and survival. Second, invest in facility infrastructure WASH, electricity, cold chain and privacy provisions because dignity and safety are prerequisites for access. Third, embed gender-responsive policies across health programming: mandate respectful maternity care, train providers on implicit bias and discrimination, involve women and adolescent girls in service design, and expand targeted outreach for marginalized groups. Fourth, strengthen data systems to capture gender-disaggregated indicators and unmet needs so resource allocation can follow the evidence. Finally, create accountability mechanisms community scorecards, patient charters and independent oversight so promises become measurable action.

Change requires more than policy papers; it requires citizens, health workers, NGOs and governments to demand it and to act. We call on policymakers to prioritise gender responsive UHC financing and facility upgrades, on donors to fund long-term health system strengthening rather than short-term projects, on facility managers to adopt respectful care protocols today, and on community leaders to champion women’s right to health. If we truly value half our population, we will remove the gender barriers that deny women the healthcare they are owed.

References

  1. World Health Organization. Gender and health. Available from: https://www.who.int/health-topics/gender.
  2. World Health Organization; UNICEF. Countries making unprecedented efforts but billions still lack basic services in health-care facilities — WHO-UNICEF report warns. WHO website. 24 Sep 2025. Available from: https://www.who.int/news/item/24-09-2025-countries-making-unprecedented-efforts-but-billions-still-lack-basic-services-in-health-care-facilities—who-unicef-new-report-warns.
  3. World Health Organization. Universal health coverage (UHC) fact sheet. Available from: https://www.who.int/news-room/fact-sheets/detail/universal-health-coverage-(uhc).
  4. The Guardian. ‘Difficult choices’: aid cuts threaten effort to reduce maternal deaths in Nigeria. 21 May 2025. Available from: https://www.theguardian.com/world/2025/may/21/aid-cuts-threaten-effort-reduce-maternal-deaths-nigeria.
  5. Economist Impact. Understanding health inclusivity for women. Available from: https://impact.economist.com/projects/health-inclusivity-index/inclusivity-topics/articles/understanding-health-inclusivity-for-women.
  6. Centre for Family Health Initiative (CFHI). Who we are / What we do. Available from: https://www.cfhinitiative.org.

 

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Human Rights and Access to Quality Healthcare for All

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Access to quality healthcare is recognized globally as a fundamental human right. Yet, billions of people still cannot exercise this right. Recent WHO and UNICEF estimates, about 1.1 billion people received healthcare in facilities without basic water services, while 3.0 billion lacked access to sanitation services, creating unsafe environments for patients and health workers alike (1). Additionally, 1.7 billion individuals were cared for in facilities without proper hygiene standards, and about 2.8 billion lacked access to safe health-care waste management, exposing communities to preventable infections (1). Another WHO report highlights that nearly one billion people depend on facilities with unreliable or no electricity, making safe childbirth, emergency care, vaccine storage, and laboratory services extremely difficult (2). To address such challenges, CFHI, with support from Grand Challenges Nigeria, recently installed solar birth kits at Rumde PHCC in Adamawa and Gusau PHCC in Zamfara States. These kits provide reliable solar-powered lighting, enabling skilled birth attendants to conduct deliveries safely at night or during power outages, support emergency care, and ensure essential medical equipment can function consistently.

Such deficits represent clear violations of the right to health. Quality healthcare must be safe, clean, affordable, and accessible. Studies further show that poor healthcare access contributes to increased maternal mortality, preventable illnesses among children, late health-seeking behaviour, and financial hardship. Globally, millions face catastrophic out-of-pocket spending on healthcare, pushing vulnerable families into poverty each year (3). Universal Health Coverage frameworks emphasize equity; however, implementation remains slow in many developing countries, especially in rural and underserved communities where health investment is still low.

In Nigeria, although relevant health policies exist, many communities still lack the enabling environment to exercise their health rights, the government has the primary responsibility to provide healthcare services and maintain facilities, the reality is that many health centres remain dilapidated and under-resourced. This situation underscores the urgent need for authorities to prioritize investment in health infrastructure, provide functional equipment, and ensure every facility meets minimum standards to protect the lives of mothers, newborns, and communities. This is where organizations such as Centre for Family Health Initiative (CFHI) contribute meaningfully to bridging the gap. CFHI works to expand equitable healthcare access by implementing interventions that support orphans and vulnerable children, adolescents, caregivers, and low-income households. The organization improves community knowledge on health rights, offers psychosocial support, conducts HIV counselling, testing, and referrals, and assists vulnerable families in navigating access to healthcare facilities (4).

Through capacity building for healthcare workers, stronger health facility linkage, and participatory learning sessions, CFHI promotes informed decision-making and encourages service utilization which are critical elements of health rights implementation. Ultimately, improved health outcomes must go beyond policy frameworks; communities must receive accessible services delivered in dignity, and families must be able to seek care without financial ruin.

Achieving true universal access requires investment in basic facility infrastructure, elimination of discriminatory practices, improved health financing, and strengthened accountability mechanisms. When communities are assured of safety, fairness, and affordability, healthcare becomes a right in practice not merely in principle.

References

  1. World Health Organization and UNICEF. Countries making unprecedented efforts but billions still lack basic services in health-care facilities. WHO website. Available at: https://www.who.int/news/item/24-09-2025-countries-making-unprecedented-efforts-but-billions-still-lack-basic-services-in-health-care-facilities—who-unicef-new-report-warns
  2. World Health Organization. Global progress report on universal access to WASH services in healthcare facilities. WHO website. Available at: https://www.who.int/news/item/24-09-2025-countries-making-unprecedented-efforts-but-billions-still-lack-basic-services-in-health-care-facilities—who-unicef-new-report-warns
  3. World Bank Group. Billions left behind on the path to universal health coverage. World Bank website. Available at: https://www.worldbank.org/en/news/press-release/2023/09/18/billions-left-behind-on-the-path-to-universal-health-coverage
  4. Centre for Family Health Initiative (CFHI). Programme information and reports. CFHI website. Available at: https://www.cfhinitiative.org

 

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MONDAY HEALTH BURST ON HEALTH RISKS OF TOBACCO USE

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According to the World Health Organization (WHO), The tobacco epidemic is one of the biggest public health threats the world has ever faced, killing over 8 million people a year around the world. Tobacco use poses severe health risks not only to users but also to those exposed to second-hand smoke. Despite global efforts to reduce its consumption, tobacco remains a leading cause of preventable diseases and premature death.

Understanding the dangers of tobacco is crucial to protecting public health. Below are some of the major health risks associated with its use:

Lung and Respiratory Diseases

Tobacco damages lung tissue and airways, increasing the risk of Chronic Obstructive Pulmonary Disease (COPD), chronic bronchitis, and emphysema. It also worsens asthma and makes the lungs more susceptible to infections like pneumonia and tuberculosis.

Cancer

Tobacco is a major cause of multiple types of cancer, including those of the lung, mouth, throat, oesophagus, pancreas, bladder, kidney, and cervix. This is due to the carcinogenic substances in tobacco products and smoke,

Cardiovascular Damage

Tobacco use increases the risk of heart disease, stroke, and peripheral artery disease. It narrows blood vessels, raises blood pressure, and reduces oxygen supply to vital organs.

Reproductive and Prenatal Health Risks

Tobacco harms reproductive health. It can cause infertility in both men and women. In pregnant women, it increases the risk of miscarriage, stillbirth, low birth weight, and premature delivery.

Oral Health Issues

Users of tobacco face an increased risk of gum disease, tooth decay, tooth loss, and oral cancer. It also causes persistent bad breath and delayed healing after dental procedures.

Harm from Second-hand Smoke

Second-hand smoke puts non-smokers at risk of serious health issues, including heart disease, lung cancer, asthma, and sudden infant death syndrome (SIDS) in infants. Children exposed to smoke are more likely to suffer respiratory infections and developmental delays.

Tobacco use remains a significant threat to global health. The good news is that quitting tobacco has immediate and long-term health benefits. Through public awareness, supportive policies, and community engagement, we can reduce tobacco-related harm and move toward a healthier, tobacco-free future.

Reference:
World Health Organization. Tobacco. Available at: https://www.who.int/news-room/fact-sheets/detail/tobacco (Accessed May 2025).

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MONDAY HEALTH BURST

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DRUG ABUSE

According to Environmental and Public Health Journal in December 2018, drug abuse refers to the use of drugs to treat self-diagnosed disorders or symptoms, and the continued use of a prescribed drug for chronic or recurrent disease or symptoms. It is “the taking of drugs, herbs or home remedies on one’s own initiative, or on the advice of another person, without consulting a medical expert. Also, according to Dr. Ananya Mandal, drug abuse or substance abuse refers to the use of certain chemicals for the purpose of creating pleasurable effects on the brain.

Medical Life Sciences reports that there are over 190 million drug users around the world and the problem has been increasing at alarming rates, especially among young adults under the age of 30. Apart from the long term damage to the body drug abuse causes, drug addicts who use needles are at risk of contracting HIV and hepatitis B and C. Not only does this affect the drug abuser directly, the family members and the society at large are affected negatively in one way or another.

Drug abuse in regards to the usage of antibiotics is reported as being highly prevalent and common in developing nations in Africa, according to World Health Organisation, which can pose a risk to the abuser. Another drug that is constantly abused is Paracetamol and Vitamin C tablet. Research has it that the excessive use of Paracetamol causes the inflammation of the liver and weakens the immune system, and high doses of Vitamin C can cause neurological symptoms, such as tingling and numbness, and possibly permanent nerve damage.

It is essential to consult a medical expert before treating any form of illness. Centre for Family Health Initiative continues to sensitize people especially in rural communities to the dangers ascribed to drug abuse on their health.

Monday Health Burst is an initiative of Centre for Family Health Initiative (CFHI) to tackle issues of basic health concerns. Join us every Monday for more health related articles on all our social media platforms.

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