Nigeria’s healthcare system faces significant challenges in financing and quality, impacting the delivery of services to its growing population. This study investigates healthcare workers’ perceptions of these challenges and their implications for healthcare policy and practice. A cross-sectional survey was conducted with 600 healthcare professionals from eight states across Nigeria, representing a variety of healthcare occupations. Participants completed a questionnaire that assessed their perceptions of healthcare financing, quality of care, job satisfaction, and motivation using a 5-point Likert scale, closed- and open-ended questions. Descriptive statistics, Chi-squared test, and regression analysis were used to analyze the data. The findings revealed that healthcare workers were generally not satisfied with the current state of healthcare financing and system quality in Nigeria. Poor funding, inadequate infrastructure, insufficient staffing, and limited access to essential resources were identified as major challenges. These challenges contributed to low job satisfaction, demotivation, and a desire to leave the profession. Socioeconomic factors, location State of practice, professional designation (clinical vs nonclinical), clinical designation (profession), and employment type (full-time vs part-time) were found to influence healthcare workers’ perceptions (p < 0.05). The findings indicated a need to improve healthcare workers’ satisfaction and retention, and quality of care in Nigeria, by increasing healthcare funding, transparent fund management protocols, investing in infrastructure and human resource development, and addressing regional healthcare disparities. By implementing these reforms, Nigeria can enhance the quality and accessibility of healthcare services and improve the health and well-being of its citizens.

Nigeria aims to enhance its healthcare quality index score of 84th out of 110 countries and its Sustainable Development Goals Index ranking of 146th out of 166. Due to increased population, disease burden, and patient awareness, healthcare demand is rising, putting pressure on funding and quality assurance. The Nigerian healthcare financing and its impacts are complex; this study gives insights into the trends. This questionnaire-based cross-sectional survey (conducted from June to August 2023) and 2010–2023 health budget analysis examined healthcare finance patterns and user attitudes (utilisation, preference and quality perceptions) in Nigeria. Data from government health budgets and a stratified random sample of 2,212 from nine states, obtained from the socioculturally diverse 237 million population, were analysed with a focus on trends, proportions, frequency distributions, and tests of association. Results show that the average rating of healthcare experiences did not vary significantly over the last decade. Healthcare system quality was rated mainly poor or very poor; structure (74.09%), services (61.66%), and cost (60.89%). While 87.36% used government healthcare facilities, 85.00% paid out-of-pocket, and 72.60% of them were dissatisfied with the value for money. Despite a preference for government facilities (71.43%), respondents cited high costs (62.75%), poor funding (85.65%), inadequate staffing (90.73%), and lack of essential medicines (88.47%) as major challenges. The budget analysis reveals an average government healthcare fund allocation of $7.12 compared with an estimated expenditure of $82.75 per person annually. Nigeria allocates only an average of 0.37% of GDP and 4.61% of the national budget to healthcare, comprising a maximum of 13.56% of total health expenditure. This study emphasises the urgent need for policy reforms and implementations to improve Nigeria’s healthcare financing and service quality. Targeted interventions are essential to address systemic challenges and meet population needs while aligning with international health services and best standards.

Background: This paper reviews some of the literature on the safety and efficacy of different COVID-19 vaccines, the attitudes, and perceptions of people towards the vaccines, and the factor underlying such perceptions and behavior. Methods: Two major databases (PubMed and Epistemonikos) were checked using search expansion mechanisms and several search strings. After the title, abstract, and full-text analysis, 19 studies were selected for review. Results: The seven different vaccines studied all have supporting data on their efficacy in the reduction of COVID-19 cases, prevention of hospitalization after infection, and reduction in the mortality rate of COVID-19 patients. There was high hesitancy about the COVID-19 vaccine and the perceived efficacy and safety of the vaccines are less than recorded in clinical data. Distrust of the vaccines, their manufacturers and different institutions and governments, personal beliefs and feelings, age, gender, education, and socioeconomic status were identified factors affecting behaviors towards the COVID-19 vaccines. Conclusion: Several articles support the efficacy of COVID-19 vaccines, but general awareness and conception about them vary, including hesitancy, distrust, and some acceptance. Many factors affected the perception and attitude of people toward these vaccines. More clinical data on the efficacy and safety of COVID-19 vaccines should be generated to help boost confidence among users.

Background This scoping review assessed the COVID-19 impacts on mental health and associated risk factors. Methods A systematic literature search for relevant articles published in the period March 2020 to July 2022, was conducted in the APA PsychInfo, JBI Evidence Synthesis, Epistemonikos, PubMed, and Cochrane databases. Results A total of 72 studies met the inclusion criteria. Results showed that the commonly used mental health assessment tools were the Patient Health Questionnaire (41.7%), Generalized Anxiety Disorder Scale (36%), 21-item Depression, Anxiety, and Stress (13.9%), Impact of Event Scale (12.5%), Pittsburgh Sleep Quality Index (9.7%), Symptom Checklist and the General Health Questionnaire (6.9% each). The prevalence rate of depression ranged from 5-76.5%, 5.6-80.5% for anxiety, 9.1-65% for Post-Traumatic Stress Disorder, 8.3-61.7% for sleep disorders, 4.9-70.1% for stress, 7-71.5% for psychological distress, and 21.4-69.3% for general mental health conditions. The major risks included female gender, healthcare-related/frontline jobs, isolation/quarantine, poverty, lower education, COVID-19 risk, age, commodities, mental illness history, negative psychology, and higher social media exposure. The incidence of mental disorders increased along with the increasing cases of COVID-19 and the corresponding government restrictions. Conclusion Standard assessment tools were used for mental health assessment by the reviewed studies which were conducted during COVID-19. Mental health disorders like depression, anxiety, and stress increased during the COVID-19 pandemic and lockdowns. Various factors impacted the prevalence of mental health disorders. Policymakers need to provide social protective measures to improve coping capacities during critical health events to avoid negative impacts on the population. Further studies should investigate the effectiveness of interventions for reducing the prevalence and risk factors for mental health conditions during a public health challenge.

Background: The COVID-19 pandemic has disrupted various aspects of human life worldwide, causing economic and social hardships, and claiming millions of lives. To combat the virus, several efforts have been made to develop and distribute effective vaccines. This paper examines some of the literature on the performance and safety of different COVID-19 vaccines, the views and opinions of people about the vaccines, and the factors that influence such views and behaviors. Methods: Two major databases (PubMed and Epistemonikos) were checked using search expansion mechanisms and several search strings. After the title, abstract, and full-text analysis, 19 studies were selected for review. Results: The seven different vaccines studied all have supporting data on their efficacy in the reduction of COVID-19 cases, prevention of hospitalization after infection, and reduction in the mortality rate of COVID-19 patients. There was high hesitancy about the COVID-19 vaccine, and the perceived efficacy and safety of the vaccines are less than recorded in clinical data. Distrust of the vaccines, their manufacturers and different institutions and governments, personal beliefs and feelings, age, gender, education, and socioeconomic status was identified factors affecting behaviors towards the COVID-19 vaccines. Conclusion: Several articles support the efficacy of COVID-19 vaccines, but general awareness and conception about them vary, including hesitancy, distrust, and some acceptance. Many factors affected the perception and attitude of people toward these vaccines. More clinical data on the efficacy and safety of COVID-19 vaccines should be generated to help boost confidence among users.

Background: Delta State implemented the Delta State Contributory Health Commission to expand healthcare access and financial protection, yet gaps in service availability and system readiness threaten the realisation of universal health coverage. This study examined public healthcare access, users’ perceived challenges, and proposed strategies for improvement. Methods: A cross-sectional mixed-methods design was used in six local government areas, involving 1,191 quantitative surveys and 23 interviews. Quantitative data were summarised descriptively and analysed using chi-square tests, while qualitative data were explored through thematic analysis. Results: Overall, 75.66% of respondents lived within one hour of a government health facility, whereas 24.35% lived farther away; only 14.69% were aware of emergency-service hotlines. Reported challenges included inadequate healthcare funding (76.57%), poor facility condition and maintenance (75.05%), insufficient medicines and equipment (73.22%), inadequate staffing or incompetent providers (73.21%), management problems or strike actions (72.80%), healthcare costs (60.29%), and distance to facilities (60.12%). Perception of most challenges varied significantly by local government area, except healthcare costs. Education, age, marital status, family size, and employment status were associated with reported challenges. Respondents strongly supported building a system with improved administrative transparency (93.45%), facility renovation (93.12%), subsidised healthcare costs (92.44%), enhanced training and research (90.01%), recruitment of healthcare professionals (89.84%), and construction of additional facilities (85.64%). Support for selected strategies varied by local government area, education, age, gender, family size, income, and employment status. Qualitative findings reinforced concerns about distance, infrastructure, essential resources, staffing, affordability, and accountability. Conclusion: Users believe that investments in facilities, medicines, workforce, financial protection, emergency awareness, and transparent management could strengthen healthcare access and quality in Delta State, Nigeria.