Access to quality surgical care in Nigeria: A narrative review of the challenges, and the way forward.

Introduction: Nigeria is the most populous African country and primary healthcare makes up 88% of health facilities in Nigeria. The majority of these centers are unable to provide surgical care due to unequal distribution of equipment, doctors, and facilities, hence creating a problem. In this paper, we sought to identify, by reviewing the existing literature, the challenges of access to quality surgical care in Nigeria, and also to proffer possible solutions. Methods: We collated data from articles sourced from PubMed, Google Scholar, and African Journal Online (AJOL). We searched keywords which included 'Challenges surgical care Nigeria' and 'Challenges Surgery Nigeria' to ensure we allow us to find a broad range of articles. We included both articles that specified the challenges faced in accessing quality surgical care in Nigeria and those that offered solutions. Results: The reasons for unequal access to quality surgical care can be grouped into three. Poverty and affordability, poor health insurance coverage and timeliness of care, and the insufficient number and inequitable distribution of Surgeons. Only about 36% of households in the Nigerian population can afford to pay for essential surgical care without devastating consequences to their finances. Less than 5% of Nigerians are covered under the National Health Insurance Scheme (NHIS). The solutions include the revamping of the NHIS, Scaling up rural surgical services, increasing the surgical workforce, ensuring political commitment, global support, and interventions. Conclusion: There is considerable work to be done in realizing the vision of the Lancet Commission in Nigeria. More in-depth studies are required to adequately highlight the level of access to quality surgical care in the different geopolitical regions of the country.