The Nigerian Economic Summit Group (NESG) has called for the establishment of a national framework for public-private partnerships (PPPs) in primary healthcare to attract more private investment and improve access to quality healthcare services across the country.
The group also proposed the creation of a dedicated primary healthcare investment and risk-sharing facility to give investors clearer information about the risks involved in funding and operating healthcare facilities, particularly in underserved communities.
The proposals formed part of discussions at a pre-summit dialogue organised by the NESG, in collaboration with the Federal Ministry of Budget and Economic Planning, ahead of the Nigerian Economic Summit.
The virtual meeting, held on Thursday, September 17, 2026, focused on ‘Powering PHC to UHC: Unlocking Private Sector Partnership’ and brought together government officials, healthcare providers, development partners and private-sector operators.
Chairman, House Committee on Health Care Services/Establishments, Dr Amos Mogaji, said uncertainty over revenue, fragmented regulation, lengthy government procedures and weaknesses in contracting and procurement were discouraging private investors from participating more actively in primary healthcare.
He said investors needed to know clearly what government and private operators were expected to do, the risks each party would carry and the results expected from their investments.
Mogaji called for a national framework that would set out the responsibilities of government and private-sector participants in PHC partnerships.
He also proposed an investment and risk-sharing facility that would provide greater certainty for investors and help reduce some of the risks associated with operating healthcare facilities in underserved areas.
According to him, stronger coordination between government agencies and private operators would also reduce unnecessary bureaucracy caused by multiple regulatory and reporting requirements.
The lawmaker said policy continuity was equally important, arguing that agreements and frameworks established to encourage private investment should continue even when administrations change.
The need for stronger private-sector involvement is significant because private operators already account for an estimated 60 to 70 per cent of healthcare service delivery in Nigeria.
Dr Sade Adebanjo, a member of the Steering Committee of the NESG Health Policy Commission, said the scale of private-sector participation meant that the country could not make significant progress towards Universal Health Coverage (UHC) without finding better ways to work with private healthcare providers.
She described primary healthcare as the foundation and first point of contact for most Nigerians seeking healthcare, but said inadequate financing, shortages of healthcare workers, poor infrastructure and weaknesses in service delivery continue to affect its ability to serve communities, especially those that are underserved.
Adebanjo said combining the resources and expertise of government and the private sector could help expand access to affordable and quality healthcare while making the PHC system stronger.
Dr Nkata Chuku, Deputy Director, Health Systems Strengthening and Primary Healthcare at the Gates Foundation, said government must take ownership of PPP projects from the beginning if such arrangements are to grow and remain sustainable.
He said government should be involved from the design stage and throughout implementation instead of waiting until private-sector models had already been developed and tested.
Chuku also said Nigeria needed clearer arrangements for paying healthcare providers. He explained that strategic purchasing systems could help protect poor and vulnerable Nigerians from excessive out-of-pocket spending while also giving private healthcare providers a reliable way to recover their investments.
He said viability-gap funding and other measures to reduce investment risks could make it easier for private companies to provide healthcare services in communities where commercial returns may initially be limited.
Rather than creating entirely new structures, Chuku called for better use of existing health financing arrangements, including the National Health Insurance Authority (NHIA), Basic Health Care Provision Fund (BHCPF) and state health insurance schemes.
He said improvements in provider accreditation, quality control, purchasing arrangements and payment systems could create more opportunities for private healthcare operators to work in underserved communities.
The issue of health insurance was also identified as central to the sustainability of private investment in primary healthcare.
Dr Ifunanya Ilodibe, Chief Executive Officer of EHA Clinics, said healthcare providers, including those operating for social impact, needed predictable and sustainable financing to continue serving communities.
She said low insurance coverage, dependence on patients paying directly for healthcare and delays in reimbursement were making it difficult for providers to maintain services in underserved areas.
Ilodibe called for wider health insurance coverage, particularly among Nigerians working in the informal sector, saying a larger pool of insured patients would give healthcare providers more predictable patient numbers and revenue.
She said timely payments through the NHIA and state health insurance schemes would also give private operators greater confidence to invest in primary healthcare facilities.
The EHA Clinics chief executive also called for greater accountability between government and private-sector partners under PPP agreements.
She described the existing situation as ‘regulatory asymmetry’, noting that private healthcare providers were subject to strict accreditation, regulatory and auditing requirements while government obligations under some PPP agreements might not be enforced with the same level of rigour.
She called for contracts to clearly state government responsibilities, including facility improvements, patient enrolment, capitation guarantees and payment schedules. The contracts, she said, should also contain penalties where either party fails to meet its obligations.
Dr Ben Nkechika, Managing Director of Almond Healthcare Services Limited, said the private sector’s role in primary healthcare should go beyond simply being engaged as contractors.
He said private companies could contribute to health education, community mobilisation, advocacy, financing, technology and service delivery.
Nkechika said private-sector interventions should be designed around the actual needs of primary healthcare centres rather than being introduced as isolated projects that do not address the main problems facing the facilities.
He also called for stronger involvement of local governments and communities, saying their participation would be important for ensuring that PHC projects are accepted locally and remain sustainable.
Nkechika cited a programme in Delta State involving the concession of 15 primary healthcare facilities to private operators as an example of what structured partnerships could achieve.
He said the programme combined private-sector incentives, technology and expertise with the involvement of local governments and communities.
According to him, the participating facilities recorded no maternal deaths over a five-year period and also recorded improvements in infant health outcomes.
The discussions also identified the absence of integrated systems linking public and private primary healthcare providers as another challenge that needs to be addressed.
Mogaji said clearer responsibilities and better coordination between the two sectors would make it easier to deliver services and monitor results.
The NESG and its partners said the broader objective of the dialogue was to identify practical ways of improving PHC financing, infrastructure, service delivery, quality and access as Nigeria works towards Universal Health Coverage.
The discussions suggest that unlocking private investment in primary healthcare will require more than simply asking private companies to provide services. It will also require clear government commitments, predictable financing, wider health insurance coverage, effective regulation, risk-sharing arrangements and policies that remain stable over time.