Nigerian hospitals must be run like businesses to survive – Njide Ndili

Without proper management and efficiency, they risk struggling to provide quality care, expand services, or remain operational.

While their primary mission is saving lives, they must also adopt sound business principles to ensure long-term viability.

Naijaonpoint recently spoke with Mrs. Njide Ndili, PharmAccess Country Director and newly elected President of the Healthcare Federation of Nigeria (HFN), on the importance of effective financial strategies for sustaining service delivery and improving healthcare access.

According to Ndili, Nigeria’s health sector will attract more investors if stakeholders focus on improvements and drive strategic reforms to strengthen private-public collaboration in healthcare.

Naijaonpoint: Would you say hospitals as businesses will play a role in Nigeria’s health sector growth? 

Njide Ndili: The healthcare sector in Nigeria needs a paradigm shift—hospitals must be run like businesses to survive, but they must also prioritize their role in saving lives. Striking this balance will ensure hospitals are not merely profit-driven entities but sustainable institutions that serve all Nigerians effectively.

However, viewing hospitals as businesses should not mean healthcare is only for the wealthy. The government must strengthen public health funding, regulate healthcare pricing, and ensure private hospitals operate ethically. At the same time, private hospitals should embrace corporate social responsibility by offering free or subsidized services to the most vulnerable populations.

Running hospitals like businesses doesn’t diminish their humanitarian purpose—it reinforces it. Healthcare facilities, whether public or private, require efficient operations, financial discipline, and customer-centric models to deliver quality care consistently.

In the Nigerian context, many health institutions struggle due to poor management systems, weak accountability structures, and lack of strategic planning. Just like any enterprise, hospitals need strong governance, clear performance metrics, and sustainable revenue models.

Cost control, service diversification, and investment in infrastructure must be aligned with patient care objectives to drive long-term impact.

Moreover, the healthcare industry presents a significant untapped economic opportunity. Beyond service delivery, hospitals can serve as innovation hubs, training grounds, and centers for specialized care, generating employment, attracting local capital, and fostering entrepreneurship in medical tech, pharmaceuticals, diagnostics, and wellness.

Hospitals that embrace modern business tools such as digital recordkeeping, data analytics, customer relationship management (CRM), and lean operational models will not only survive but thrive in today’s evolving healthcare landscape. Integrating business strategy with compassionate care is not a contradiction—it’s a necessity for growth and sustainability.

Naijaonpoint: You’ve outlined strategic pillars for strengthening Nigeria’s healthcare sector, as you recently assumed the position of President of the Healthcare Federation of Nigeria (HFN), including public-private integration, primary healthcare, capacity building, and leveraging diaspora expertise. Could you elaborate on each of these pillars and your plans for implementation? 

Njide Ndili: Certainly. The first priority is ensuring that the private sector has a voice in policymaking, given that it provides over 60% of healthcare services in Nigeria. Strengthening relationships with policymakers is crucial for aligning policies with the realities of healthcare providers.

Second, we need to drive public-private partnerships (PPP) in primary healthcare. Despite the government’s commendable efforts in establishing over 40,000 primary healthcare centers, many remain non-functional. Through PharmaAccess, we successfully activated 15 primary healthcare centers in Delta State, improving maternal health outcomes. Expanding this model nationwide is a priority.

Second, we need to drive public-private partnerships (PPP) in primary healthcare. Despite the government’s commendable efforts in establishing over 40,000 primary healthcare centers, many remain non-functional. Through PharmaAccess, we successfully activated 15 primary healthcare centers in Delta State, improving maternal health outcomes. Expanding this model nationwide is a priority.

Third, improving healthcare quality is essential, particularly in the context of Nigeria’s National Health Insurance Act. The lack of trust in healthcare services deters people from subscribing to health insurance. Ensuring quality in infrastructure, processes, and personnel through initiatives like our SafeCare methodology will enhance service delivery.

Another key focus is technology adoption for healthcare transparency, data management, and human resource optimization. Additionally, capacity building for healthcare management is essential. We are in discussions with institutions like the University of Ghana Management Business School to provide training for healthcare professionals on efficient facility management.

Finally, enhancing local manufacturing is critical for Nigeria’s health sovereignty. COVID-19 highlighted the need for self-sufficiency in vaccine and drug production. We are collaborating with the Presidential Initiative on Unlocking the Healthcare Value Chain (PVAC) to drive investments in local production.

Naijaonpoint: Foreign direct investment (FDI) in healthcare has been slow. What strategies can Nigeria adopt to attract and retain FDI in the healthcare sector? 

Njide Ndili: Attracting FDI requires addressing multiple factors. First, investors need assurance of a stable economic climate and the ability to repatriate funds. Second, we must demonstrate viable markets for healthcare services. Investors seek assurance that services such as cancer treatment centers and diagnostic facilities will have sufficient clientele.

Regulatory consistency is another critical factor. Changes in government often lead to contract cancellations, discouraging long-term investment. Strengthening contract sanctity and ensuring political will to uphold agreements is key.

A promising development is the government’s strategic appointment of qualified professionals in key healthcare agencies. The introduction of a sector-wide approach (SWAp) by the Federal Ministry of Health aims to harmonize funding and implementation efforts, creating a more structured investment landscape.

Nigeria’s large population, growing middle class, and increasing health awareness present a compelling market for FDI in the healthcare sector. However, to unlock this potential, the country must aggressively position healthcare as an investible sector.

This means developing clear return-on-investment (ROI) models, simplifying regulatory pathways, and showcasing successful PPPs as proof of concept. Investors want certainty—they need to see that a diagnostic lab, private clinic chain, or medical equipment plant can scale profitably in Nigeria.

Creating sector-specific investment guides, easing bureaucratic bottlenecks, and offering risk mitigation frameworks (like investment insurance or currency risk hedging) would send the right signals to global health investors.

Additionally, FDI shouldn’t only mean foreign hospitals setting up centers in Nigeria—it should involve knowledge transfer, joint ventures, equipment leasing, and innovation partnerships.

For instance, attracting venture capital for health-tech startups, encouraging pharmaceutical manufacturing with multinationals, and offering investment zones or clusters dedicated to healthcare can deepen investor confidence.

With Africa being a strategic frontier for global health security, Nigeria has a chance to position itself as a regional healthcare hub—if it crafts the right investment narrative backed by consistent, transparent, and investor-friendly policies.

Naijaonpoint: How do you see Nigeria’s healthcare sector evolving over the next five years with the current government’s policies and initiatives? 

Njide Ndili: The current administration has laid a solid foundation with strategic initiatives like SWAp and increased investments in infrastructure, capacity building, and digital health. If these initiatives are sustained, we can expect improvements in healthcare access, service delivery, and outcomes.

Significant investments are being made in cancer treatment, with new centers expected to become operational this year. There is also a focus on addressing the brain drain in the health sector by accrediting more doctors and improving working conditions.

While funding remains a challenge, targeted investments in health insurance, primary healthcare, and local manufacturing can drive sustainable growth. Overall, the sector’s outlook is promising, provided there is continued commitment from both the government and private sector stakeholders.

Naijaonpoint: What role do you see digital technology playing in bridging healthcare gaps, particularly with the shortage of healthcare professionals? 

Njide Ndili: Digital technology is a game-changer in addressing healthcare inefficiencies. Telemedicine can expand access to care, especially in remote areas where there is a shortage of specialists. Artificial intelligence and data analytics can also improve disease surveillance and treatment outcomes.

Technology can enhance transparency in healthcare financing, ensuring proper utilization of resources. For instance, electronic medical records and digital insurance platforms can streamline service delivery and reduce fraud.

With the right investments in digital infrastructure, Nigeria can overcome many existing challenges in healthcare delivery.

Naijaonpoint: You’ve highlighted the importance of private sector participation. What incentives should be put in place to encourage private sector investment in healthcare? 

Njide Ndili: The government should introduce tax incentives, reduced import duties on medical equipment, and low-interest financing options for healthcare providers. Additionally, strengthening regulatory frameworks and ensuring ease of doing business in the sector will attract more private investment.

Public-private partnerships should also be structured to offer long-term benefits to investors. For example, lease agreements for private management of government-owned healthcare facilities should be structured with clear terms and investment guarantees.