Nigeria
The largest population in the African set, federated across states with separate health budgets.
9 domains reviewed · 8 high-confidence · 2 dated estimates · 9 material gaps
WHO region: Africa. World Bank income group: Income group not yet retrieved.
- Domains reviewed
- 9 of 9
- Hospice: 4 of 4
- Backed by a primary document
- 0 of 9
- Open questions
- 12
- Sources behind this dossier
- 15
- Newest source 2026
Lessons from Nigeria
- A policy that lets primary care cadres prescribe morphine did not put morphine on primary care shelves. Permission for non-physician prescribing needs a supply chain beside it.65
- Local reconstitution was built through a single donor partnership. Decide early whether compounding capacity is government infrastructure or a project that can lapse.65,68
- A national insurer existed and still excluded palliative medicines. Inclusion has to be sought deliberately.65
- Building the fellowship through the existing family medicine route is a lower-friction option where trainers are too few for a new specialty board.65
- A teaching hospital that pays hospice staff salaries while an NGO funds home visits can start hospice care, but patients still face costs when medicines are left out of national insurance.291,65
- A short, structured in-hospital psychoeducation program can reduce burden for family caregivers of children with cancer in a low-resource setting.613
Palliative care
Is morphine available in Nigeria?
Opioid supply. Is a therapeutic opioid physically available in the wards that need it? Every country on this question
- 0.01 index, reference average of 100MODELED ESTIMATE · 2015
Adequacy of Opioid Consumption index, Nigeria, 201567
Last checked 2026-09-24.
The lowest value found globally in 2015. A composite index, not consumption per person.
Cite this figure:
Oral morphine solution is reconstituted locally from imported powder at selected tertiary hospitals, established with the American Cancer Society's Treat the Pain programme and the Federal Ministry of Health. Stock-outs outside those centres are described as persistent.65,68
What is national consumption on a morphine-equivalent basis, and what share is reconstituted locally?
Help answer it:Search PubMedHow does Nigeria regulate opioids for pain?
Narcotics regulation. What licensing regime governs stocking and dispensing, and when did it last change? Every country on this question
A National Policy for Controlled Medicines, with implementation strategies, governs prescribing and dispensing of controlled drugs alongside the older poisons and dangerous drugs statutes.65
What federal and state permits must a hospital hold to stock morphine, and when was the controlled medicines policy issued? The year rests on a search summary only.
Help answer it:Search PubMedWho can prescribe morphine in Nigeria?
Prescriber authority. Who is legally allowed to prescribe, and can that group be widened? Every country on this question
A 2025 review reports that the controlled medicines policy allows community health officers and extension workers to prescribe controlled medicines, morphine included, at primary health centres where no doctor is present. A separate 2025 review of addiction treatment reports prescribing of controlled opioids limited to doctors and dentists, which may reflect that narrower use.65
Does the non-physician authority exist in the policy text, and with what training conditions? The policy itself was not read.
Help answer it:Search PubMedHow does palliative care reach patients in Nigeria?
Service delivery. Through what structure does care actually reach a patient at home? Every country on this question
- 8 centresSOURCE-CHECKED · 2016 DATA
Palliative care centres at tertiary institutions facilitated by the national association, Nigeria, 201666
Last checked 2026-09-24.
With over twenty further emerging sites.
Cite this figure: - 13 staffSOURCE-CHECKED
Palliative care staff per unit, median across five tertiary sites, Nigeria, 202366
Last checked 2026-09-24.
Range nine to 25.
Cite this figure:
Care runs through consultative units in federal teaching hospitals, described as isolated services rather than a network. Five surveyed units, established between 2001 and 2012, each offered inpatient, outpatient and home-based care.65,66
How many units and home teams operate, and in which states?
Help answer it:Search PubMedWho pays for palliative care in Nigeria?
Financing. Who pays for the drug, the visit and the workforce? Every country on this question
Care is paid largely out of pocket. Palliative medicines were outside the national health insurance benefit package and the national budget carried no palliative line, with donors supporting training and morphine access.65
Has the National Health Insurance Authority added palliative medicines or services since the 2022 act?
Help answer it:Search PubMedHow are palliative care clinicians trained in Nigeria?
Training and recognition. What credential exists, who awards it, and does anyone recognize it? Every country on this question
No specialist credential exists yet. Palliative content sits in undergraduate curricula at a few universities and in the family medicine diploma, and a fellowship through family medicine was still in development in the 2025 review.65
Has the postgraduate medical college launched the palliative fellowship, and how many hold it?
Help answer it:Search PubMedHow does Nigeria prevent opioid misuse without blocking pain relief?
Opioid safeguards. How are misuse and diversion controlled, and are treatment and naloxone available, without blocking pain relief? Every country on this question
Women who use drugs in Uyo said opioid prescribing restrictions, cost and stigma kept them from medical pain care and pushed them toward falsified or substandard medicines from informal sources. A 2026 review found opioid agonist therapy highly centralized, and clinicians named opioid costs and stigma as barriers to palliative care.607,608,609
Does Nigeria run a prescription monitoring system or community naloxone distribution, and how many people receive methadone or buprenorphine outside central sites?
Help answer it:Search PubMedHow do children get palliative care in Nigeria?
Children's palliative care. How do children with life-limiting conditions get palliative care and the medicines they need? Every country on this question
A 2026 scoping review found only 10 dedicated pediatric palliative care centers, with most children with life-limiting illness managed in general wards, and 52% of surveyed providers had never prescribed morphine. Two structured psychoeducation sessions for family caregivers of children with cancer in four tertiary hospitals reduced caregiver burden and unmet needs.612,613
Are child-appropriate oral morphine formulations available outside tertiary hospitals, and what rules govern consent and disclosure for children?
Help answer it:Search PubMedHospice care in Nigeria
How the hospice model works here, who can use it, who pays and who it reaches. Covered 4 of 4.
What does hospice care look like in Nigeria?
Hospice model. What does hospice mean here, who runs it, and in what settings? Every country on this question
Nigerian sources use the joint term hospice and palliative care. Hospice Nigeria was set up in Lagos in 1998 as a registered charity, and University College Hospital Ibadan, a federal teaching hospital, opened a hospital-based hospice and palliative care unit with inpatient, day care and home-based services in 2007. A stand-alone pediatric hospice opened in Lagos in 2023.65,291
How many hospital-based hospice units and stand-alone hospices operate in Nigeria today, and which are public, faith-based or charitable?
Help answer it:Search PubMedWho can get hospice care in Nigeria?
Hospice eligibility. Who can enter hospice, on what criteria, and how late do patients arrive? Every country on this question
At the Ibadan unit, referred patients with life-limiting illness judged to need palliative care were enrolled, and home care required consent and residence within a 30 km radius. In this single-site review, 80% of referred cancer patients had stage III or IV disease, and some were referred on the day they died.291
Do other Nigerian hospice services use written admission criteria, such as prognosis limits or disclosure requirements?
Help answer it:Search PubMedWho pays for hospice care in Nigeria?
Hospice funding. Who pays for hospice care: a public benefit, insurance, charity or families? Every country on this question
Nigeria has no national budget line for palliative care, patients rely heavily on out-of-pocket payment, and palliative care medicines are excluded from the National Health Insurance Scheme. At Ibadan, the hospital pays unit staff while a non-governmental organization subsidizes home visits through fundraising (single site).65,291
How many people reach hospice in Nigeria?
Hospice reach. How many dying people use hospice, and who is left out? Every country on this question
Palliative care services are restricted to a few tertiary facilities, and morphine is available only in a few urban tertiary institutions. Lagos has the country's only stand-alone pediatric hospice. At Ibadan, most referred patients did not receive home care, partly because they lived outside the 30 km catchment area.65,291
What share of Nigerians who die of cancer or other life-limiting illness receive any hospice care?
Help answer it:Search PubMedWhat fills the gap in Nigeria
How people get care outside formal services: families, faith communities, volunteers, health workers, healers, other medicines and charity. Described, not scored.
- Family caregiving
Informal caregivers of people with advanced cancer in Nigeria, Uganda and Zimbabwe reported handling most medical, physical, financial and emotional needs. They described sacrifices in employment, finances, health and social life.433
- Faith communities
Breast cancer survivors at one Jos teaching hospital relied on strong religious belief and on traditional healers to cope, given little formal psychosocial support. Clinicians saw cultural and religious beliefs as barriers to treatment.432
Single-site evidence- Traditional and complementary healers
In focus groups in Ibadan, patients described turning to traditional and faith-based healers for financial reasons, convenience and a fit with their spiritual beliefs. Patients and healers both said they wanted closer collaboration with hospital doctors.431
Subnational evidence
Sources cited here
- 65Olasinde T, Onyeka T, Adenipekun A, Otene S, Kajang V, Soyannwo O.
Decoding the palliative care landscape in Nigeria: progress, challenges, and the road ahead. Palliative and Supportive Care 2025;23:e123. DOI 10.1017/S1478951525100321. Dates the National Policy and Strategic Plan for Hospice and Palliative Care to 2021; reports that the National Policy for Controlled Medicines allows community health officers and extension workers to prescribe controlled medicines at primary health centres where no doctor is present; palliative medicines outside the national health insurance benefit package; no dedicated national budget line; a palliative care fellowship through family medicine still in development.
- 68O'Brien M, Schwartz A, Plattner L.
Treat the Pain program. Journal of Pain and Symptom Management 2018;55(2S):S135-S139. DOI 10.1016/j.jpainsymman.2017.03.033. Abstract read. The American Cancer Society programme partnered with governments including Nigeria to expand locally produced oral morphine solution.
- 67Scholten WK, Christensen AE, Olesen AE, Drewes AM.
Quantifying the adequacy of opioid analgesic consumption globally: an updated method and early findings. American Journal of Public Health 2019;109(1):52-57. DOI 10.2105/AJPH.2018.304753. Abstract read. Adequacy of Opioid Consumption index across eighteen controlled opioid medicines, with the 2015 extremes reported as Germany and Nigeria.
- 66Ogbenna AA, Caputo M, Onyeka TC, et al.
Organizational models and patient-reported outcomes for palliative care across five tertiary hospitals in Nigeria: an environmental scan. PLOS Global Public Health 2025;5(6):e0004638. DOI 10.1371/journal.pgph.0004638. Survey of five hospital palliative care units in Enugu, Ilorin, Lagos, Port Harcourt and Abeokuta in 2023; the national association, founded in 2007, had facilitated centres at tertiary institutions and emerging sites by 2016; dates the national hospice and palliative care policy to 2021.
- 607Nelson EE.
Structural violence and barriers to pain management during an opioid crisis: accounts of women who use drugs in Nigeria. Health Sociol Rev 2021;31(3):232-246. Qualitative study of 16 women who use drugs in Uyo; shows opioid prescribing restrictions, cost and stigma blocking pain care; single-city scope. Abstract read.
- 608Albert OM.
Opioid Addiction Medicine in Nigeria: Bridging Clinical Gaps in a Silent Epidemic-A Narrative Review. Niger Med J 2026;66(6):2024-2041. Narrative review of 30 studies on opioid use disorder in Nigeria; reports centralized opioid agonist therapy; single author based in Canada. Abstract read.
- 609Folorunso S, Yibrehu B, Mann EJ, et al.
"What you don't have, you can't give": a mixed methods assessment of healthcare professionals' palliative care knowledge and attitudes in Nigeria. BMC Palliat Care 2026;25(1). Mixed-methods survey of 117 health professionals in 26 hospitals plus focus groups; opioid costs and stigma named as barriers; online convenience sample. Abstract read.
- 610Onyechi KC, Onuigbo LN, Eseadi C, et al.
Effects of Rational-Emotive Hospice Care Therapy on Problematic Assumptions, Death Anxiety, and Psychological Distress in a Sample of Cancer Patients and Their Family Caregivers in Nigeria. Int J Environ Res Public Health 2016;13(9). Small randomized trial of rational emotive hospice care therapy in 32 patients and 52 family caregivers; trial run by the developers of the intervention. Abstract read.
- 611Agha AA, Onalu C, Chidebe R.
Bridging the Gap: Investigating the Role of Social Workers in Supporting Metastatic Breast Cancer Patients in Nigeria. Soc Work Public Health 2021;37(3):244-257. Qualitative key informant study of 12 professionals on social work roles in metastatic breast cancer care; small sample. Abstract read.
- 612Collins NN, Oghenekaro I.
Pediatric Pain Management and Palliative Care in Nigeria: A Scoping Review. Paediatr Anaesth 2026;36(8):908-922. Scoping review of 11 Nigerian studies on pediatric pain and palliative care; reports 10 dedicated pediatric palliative care centers and low morphine prescribing. Abstract read.
- 613Onyeka TC, Emodi I, Mohammed AD, et al.
In-hospital psychoeducation for family caregivers of Nigerian children with cancer (The RESCUE Study). Palliat Support Care 2024:1-12. Quasi-experimental pre-post study of a psychoeducation program for family caregivers of children with cancer in 4 tertiary hospitals; no control group. Abstract read.
- 291Omoyeni N, Soyannwo O, Aikomo O, et al.
Home-based palliative care for adult cancer patients in Ibadan-a three year review. Ecancermedicalscience 2014;8:490. Single-site record review of 60 home-care patients at the University College Hospital Ibadan hospice and palliative care unit, 2009 to 2013; written by the unit's own staff (self-evaluation). Full text read.
- 433Adejoh SO, Boele F, Akeju D, et al.
The role, impact, and support of informal caregivers in the delivery of palliative care for patients with advanced cancer: A multi-country qualitative study. Palliat Med 2020;35(3):552-562. Secondary analysis of 48 caregiver interviews pooled across Nigeria, Uganda and Zimbabwe; findings are not reported separately for Nigeria in the abstract. Abstract read.
- 432Jidong DE, Ike TJ, Pwajok JY, et al.
Lived experiences of breast cancer survivors, family caregivers and clinicians' perspectives of service provision in Nigeria: An interpretative phenomenological analysis. J Health Psychol 2026;31(12):13591053261423728. Small qualitative study at one Jos teaching hospital reporting religious belief and traditional healers as coping strategies amid limited psychosocial support. Abstract read.
- 431Asuzu CC, Akin-Odanye EO, Asuzu MC, et al.
A socio-cultural study of traditional healers role in African health care. Infect Agent Cancer 2019;14:15. Focus groups in Ibadan with nine cancer patients, six traditional healers and five faith-based healers on reasons for using healers and views on collaboration; small single-city sample. Abstract read.