In July 2025, Nigeria mourned the passing of several distinguished figures. Among them were former President Muhammadu Buhari, 82; the revered Awujale of Ijebuland, Oba Sikiru Adetona, 91; and celebrated former Super Eagles coach, Monday Sinclair, 88. What united their passing was not just their national significance, but that they lived well into their 80s and 90s.
As we acknowledge and honour the long lives they lived, we must ask ourselves: how prepared are we, as a nation to support Nigerians aged 65 and above, as well as the growing number expected to live longer, more fulfilling lives?
Nigeria is experiencing quiet demographic shift. The population of Nigerians over the age of 65 has tripled from 2 million in 1980, to 6 million in 2020. Projections indicate this number will reach 16 million by 2050 and 74 million by 2100.
Every stage of life, from infancy to older adulthood, places unique demands on our bodies. From a healthcare perspective, older adults often require geriatric services and specialised care — multiple prescriptions, routine medical checkups, and long-term management of chronic conditions. Are we adequately prepared for the unprecedented demand this welcome, yet challenging transition will place on our healthcare infrastructure?
Attitudes towards growing older in Nigeria
A Situation Analysis on Ageing in Nigeria, conducted by the Federal Ministry of Humanitarian Affairs and partners, revealed that older persons face a range of challenges, including social isolation, health issues, and economic hardship.
Describing her healthcare challenges, Mrs N (name withheld), a 74-year-old retired professor who moved from urban to rural Nigeria three years ago, said, “Because of my age, I have to go to the hospital often for a check-up. The health centres close to me are not equipped for my needs. The nurses here say, ‘Mama, why are you here? You are healthy.’ So, I have to travel long distances on bad roads to get the care I need.”
Her experience highlights systemic challenges. “I don’t feel as though the hospital system was planned with people my age in mind because we have long wait times and are made to walk from one department to another, plus sometimes we must climb stairs, which can be difficult.”
The challenges extend beyond infrastructure to include concerning attitudes toward elderly patients. Mrs A (name withheld), another septuagenarian, shared that she no longer visits her local hospital after a doctor’s inappropriate response when she sought treatment for a concerning growth on her labia.
Policy and progress
Hubert Humphrey, the 38th Vice President of the United States, once observed that a government’s moral character is revealed through its treatment of vulnerable citizens like the elderly. With policies, plans and strategies such as the National Senior Citizens Act (2017), National Policy on Ageing (2020), National Plan of Action on Ageing (2021-2025) and Strategic Roadmap on Ageing (2022-2032), Nigeria has made commendable policy-focused progress in recognising the needs of its ageing population. However, unlike other areas of public health where indicators such as immunisation coverage or maternal mortality rates provide a clear picture of progress, there are no clear measures to show their impact on the lives of older Nigerians.
This absence of structured monitoring makes it difficult to assess what is working, where gaps exist, and how interventions are evolving over time. Also, the extent to which these policies have been adopted or operationalised by state and local governments, which are responsible for delivering many of the services outlined in the documents, is unclear.
The UHC gap
While recent health reforms aim to improve health outcomes and achieve Universal Health Coverage UHC), neither the National Health Sector Renewal Initiative (NHSRII) nor the 2024-2027 Health Sector Strategic Blueprint specifically address geriatric care or the needs of Nigeria’s ageing population.
Historically, Nigeria has not prioritised care for the aged. Although the 1999 Constitution promises comprehensive social protection including old age care, pensions and healthcare, this commitment has remained largely unfulfilled.
Failing to invest in elderly healthcare is a missed opportunity, not just morally but economically. Untreated or poorly managed chronic conditions often leads to costly complications. With Nigerian households bearing nearly 75% of health expenditures through out-of-pocket payments, families may face particularly acute financial distress when managing age-related health conditions. The lack of specialised geriatric services also drives medical tourism, care that could be provided locally through targeted infrastructure and workforce investments. The African Medical Centre of Excellence (AMCE) aims to fill this gap by offering specialist care, developing the health workforce, and reducing medical tourism.
Ultimately, Nigeria cannot achieve UHC without ensuring older people have equitable access to quality, affordable, age-appropriate healthcare. After all, UHC is indeed “health for all.”
Systemic challenges and solutions
In an article on geriatric services in Nigeria, Dr Ogugua Osi-Ogbu, Head of Geriatric Medicine Unit at National Hospital Abuja, discussed the urgent need for comprehensive geriatric care systems. She identified poor rural healthcare access, economic challenges, lack of trained workers, and age-unfriendly facilities as systemic barriers. While market-driven responses such as GeroCare are emerging to bridge this gap, such solutions must become universally affordable to reach more elderly Nigerians.
Health insurance coverage must be expanded for older persons under schemes like the National Health Insurance Authority (NHIA), with attention to long-term care and chronic disease management.
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With fewer than 20 formally trained geriatricians serving Nigeria’s elderly population, the country must urgently expand geriatric subspecialty training programs and establish accredited centres across all geopolitical zones.
Comprehensive geriatric centres must be established within tertiary and secondary healthcare institutions, following integrated care models including wellness, acute care, chronic disease management, and rehabilitation services.
Basic geriatric care must be integrated into Nigeria’s Primary Healthcare (PHC) system for early detection, prevention, and timely referrals. PHC and community health workers should be trained to provide age-appropriate care and basic NCD management for the elderly.
According to Dr Osi-Ogbu, “to ensure that our older persons remain healthy to play their expanding roles in society, they need access to affordable, good quality, and person-centred care provided in an environment that embodies respect and dignity with zero tolerance for ageism and the risk of elder abuse.” This vision requires coordinated action between the NSCC and Ministries, Departments and Agencies like the Federal Ministry of Health and Social Services.
Achieving UHC in Nigeria requires urgent prioritisation of elderly care. We need a health system we are willing to grow old in, one that outlines a clear blueprint to address systemic gaps in elderly care. We cannot build a health system for the future while neglecting those who shaped our past.
