The uncontrolled growth of Nigeria's population should be a matter of concern to all the authorities within the country. It has huge potential benefits, given the fact that a large, young, and productive population, which characterises Nigeria's population pattern, ought to serve as an engine of economic growth and development.
The added benefit is that Nigeria's population is mainly youthful, with a median age of about 18 years.
However, the odd thing about all of that is that our youthful population is poorly educated, and those who have an education are not employable. Many of them have turned to crime and drugs.
The concern about all of that on this page today is how these pressures impact the healthcare system of the country. The health system is like a small, underfunded clinic that was built for, maybe, about 100 people.
Overnight, it seems like 500 people have begun to use the clinic, with more arriving every day. That is what rapid population growth feels like for Nigeria's health services. Definitely, the clinic cannot keep up.
Nigeria's population is growing faster than the government can build new hospitals, train new doctors, or provide medicines. Right now, there are far too few doctors and nurses for the number of people.
In Lagos, for example, as many as 30,000 doctors are needed to provide optimum care for residents, but there are fewer than 7,000 overworked and underpaid doctors. The statistics are just as bad for nurses.
That means many patients wait for hours or days. Delays in diagnosis and treatment are common, with some patients turned away and many others not getting treatment at all. The buildings themselves are often old, run-down, and lacking basics like clean water and electricity for fridges to store vaccines. There are not enough beds.
But diseases do not take turns, as we have seen over the past year. Usually, they all attack at once. So, we have to deal with cholera, Lassa fever, malaria, gastroenteritis, tuberculosis, and HIV/AIDS all at once.
In rich countries, they first solved deadly infections like malaria, measles, diphtheria, tuberculosis, and other killer diseases, and later, as people lived longer, they started dealing with lifestyle diseases like high blood pressure, diabetes, arthritis, and heart disease.
But in Nigeria, both problems are happening at the same time. You still have malaria and TB spreading easily, especially in crowded areas with poor sanitation. At the same time, as more people move to cities and eat processed foods, you see a huge rise in diabetes, heart disease, and cancer.
This is called a "double burden," a little like fighting two wars on separate battlefields with half the required number of soldiers.
As a result, maternal and child deaths continue at shocking rates because there are not enough clinics and hospitals with trained birth attendants, midwives, and nurses.
It is shocking to know that even within Lagos, many women give birth at home without qualified medical help, or at contraptions called "Alagbo," which translates roughly to people who hawk herbs. If something goes wrong, like heavy bleeding or a baby being stuck in the wrong position, there is no one to save them. Sometimes, these things happen even within shouting distance of a healthcare facility.
But in communities with strong adherence to traditional birth methods or among those who exercise faith, it is amazing how many women choose such a path to deliver their babies. That is why Nigeria has such a high number of mothers dying in childbirth. And for babies, the first month of life is extremely dangerous. Many die from infections, lack of oxygen, or being born too small or too early. Even though fewer older children are dying now than before, newborn deaths have not improved much.
Most Nigerians pay for healthcare out of their own pockets. There is no safety net. If a child gets malaria, a mother might have to choose between buying the required medicine and food for the week. If someone needs surgery or cancer treatment, families sell their land, cattle, or borrow money for years.
Over 70 per cent of all health spending in Nigeria is paid directly by patients. As usual with Nigeria, this is an estimate. Very many people pay for treatment with traditional birth attendants and caregivers, even when such bills exceed what hospitals might charge them. This pushes millions deeper into poverty every year.
In addition, poor conditions outside the clinic make everything worse, so that even if you had enough doctors and hospitals, many Nigerians still live in homes without clean drinking water or toilets.
They have to defecate in the open. They live in crowded rooms with poor ventilation. These conditions spread diarrhoea, cholera, typhoid, and respiratory infections like wildfire. So people keep getting sick from things that are totally preventable.
Over the years, governments have failed to adequately and sincerely invest in providing clean water or sanitation, so the cycle never ends.
If you are rich in Lagos, Warri, Port Harcourt, or Ibadan, you can fly to London, Paris, Jeddah, or Bengaluru for treatment, or go to a private hospital with air conditioning and American, British, or Canadian-trained doctors.
But if you are poor, which is the lot of some 85 per cent of Nigerians, people are multidimensionally poor, meaning they lack several basic needs at once.
The local clinic might have no drugs, no doctor, and no running water. This means your village or neighbourhood suffers 10 times more disease and death than the wealthy parts of the same city.
The government knows this is a crisis.
They are trying to rebuild thousands of primary healthcare centres, the small clinics in villages and poor urban areas that are the first line of defence. They are also trying to produce more medicines locally so they can rely less on expensive imports. And they are promoting family planning and helping women space out their pregnancies or have fewer children.
Slower population growth would give the health system time to catch up. The fertility rate has already dropped from over six children per woman a few decades ago to about 4.8 now, which is progress, but it is still among the highest rates in the world.
In communities often worst affected by these depressing conditions, there is a deep suspicion of these family planning efforts, and many young women, even after having five or more children, leave one marriage to start a new life in another, with the hope of having a similar number of children in the new home. Many have never even heard of family planning.
Nigeria simply has too many people, too little money for health, and too few hospitals, nurses, and doctors. That means preventable diseases kill millions, mothers and babies die needlessly, families go bankrupt from medical bills, and the whole system is overwhelmed.
It is like trying to fill a swimming pool with a cup while the pool keeps getting bigger every day.
It is a vicious cycle that reinforces the terrible anguish of poverty, ignorance, and disease, and we are only still scratching the surface.
Questions and answers
Good evening, Dr Sylvester. Thank you for the wonderful charity work you have been doing for us over the years through the Sunday PUNCH newspaper. May Almighty God continue to protect, guide, and guard you always.
My daughter, who is 19 years old, has been coughing constantly for years. We have done tests to ascertain the cause of the cough, and the laboratory results keep coming out negative, with no underlying illness detected, but the cough has persisted.
She is currently at the university. I have told her to stop using cough syrup and antibiotics for now until she comes back from school in September, or, if she has a free period, to come home for another comprehensive test at a reputable laboratory in Lagos.
This problem started when she inhaled a mixture of Hypo and Harpic while washing the toilet at home. Is there anything you can recommend for us for now, perhaps? I have also told her to stop drinking cold water and avoid harsh perfumes, body sprays, deodorants, air conditioners, or anything that could trigger the cough for now, so that we can see what the outcome will be.
Thank you for your understanding and kindness. 08093002000
Thank you very much for your kind words and prayers. With regard to your daughter, she ought to be more aggressive in trying to determine the cause of her cough. As an undergraduate, the minimum she should do is visit the university's health centre for a proper examination and appropriate testing.
It does not appear at this point that a doctor has even been involved in her treatment. She may have some form of allergy, which her exposure to Hypo and Harpic provoked. She may also have an underlying illness that was triggered by that exposure and has thus far not been diagnosed.
As a result, a chest X-ray is probably the minimum investigation she needs, in addition to some blood tests.
However, she should not simply walk into a laboratory and request investigations on her own or at your direction. That will not necessarily reveal what is wrong.
Good day, doctor. Perhaps it will help if, once in a while, you publish guidelines for letters sent to you, advising readers to always include the sender's gender, age, and other basic details. Thank you. 08148138000
Good evening to you. Thank you for keeping a date with us every week.
Well, that would actually be a good thing, but there is no specific platform on which to do that except here on this page. However, through feedback such as yours, readers will see various questions and answers and understand that those extra details are important in guiding the advice they can receive here.
We appreciate your contribution and comments very much.
Good day, Doctor. In response to your article in The PUNCH newspaper on Sunday, May 23, 2026, I wish to request an appointment with you. Thank you. 08022224000
Good day to you. If you are referring to the essay titled Understanding ED Will Help You Manage It, you will benefit more from the advice several other readers have been given since then, which is that they should begin their journey towards solving this problem by being examined by a doctor.
The remaining aspect of their journey towards improved sexual health will then be directed by that doctor through appropriate guidance and referrals.
Please, sir, good morning to you. The results I will forward to you on WhatsApp belong to my younger brother, who is 41 years old.
He developed jaundice about six weeks ago, but before then, he was always complaining of stomach pain. He said it felt like heartburn, and he went to a hospital here in Abuja. He was placed on ulcer medication because the doctor told him he had a peptic ulcer.
He does not eat well. He is losing weight, perhaps because he is not eating properly. But now, despite the medicines he was given, he does not even sleep. He is in pain all the time.
I do not know if you understand Yoruba, sir, but I will also forward the voice note he sent to me just five days ago. He is itching all over his body.
I am a nurse, and I advised him to do an abdominal scan, which he did before the doctor advised him to undergo a CT scan of the abdomen. Both reports are there. They also recommended another test. I do not know what that one is, please.
What do we do? 08133297000
Thank you very much for your detailed history and question. To be brief, this looks like lymphoma, mainly because of his age. However, the description indicates that it is more likely to be cancer of the pancreas, which is very surprising given his age.
Unfortunately, it has already spread to the liver and has also grown around the major blood vessels in that area. That seems to be the major reason why he is losing weight. This makes the overall outlook much worse.
Therefore, surgery is no longer possible in his case. The report is recommending an MRCP (Magnetic Resonance Cholangiopancreatography) examination, which is a way of introducing a contrast material into the body so that the bile ducts, gallbladder, and pancreatic duct can be examined in detail with the benefit of MRI. This will help evaluate the severity of his condition and assist in mapping out a treatment plan, including the possible placement of a stent to relieve the obstruction.
Unfortunately, there can be no hope of a cure; the disease is already too advanced.
Question:
Dear Doctor, good day to you. I am a 54-year-old woman, and I have suffered from pain in my lower back for more than 24 years. I attribute the pain to the three times I was given spinal anaesthesia for my caesarean sections. The first time, the doctors inserted the needle into my back up to four times.
When the pain starts, I am usually miserable because the area feels as though it is being hit with a hammer, and the pain spreads to the back of my right thigh. I have been to the Orthopaedic Hospital here in Lagos and also to the Lagos University Teaching Hospital, where X-rays and other tests were done.
Now, they have told me that I need to do an MRI of the spine to take my investigations further. I am so confused. What should I do?
08028261000
Answer:
There is no reason for you to be confused about your current situation because, between the Orthopaedic Hospital and LUTH, you have access to some of the best doctors available to manage your condition.
It is important that you follow their instructions because, while you link the onset of this pain to your unpleasant experience with spinal anaesthesia, the cause of the pain could be something else. That possibility needs to be explored so that you can receive the proper treatment your back requires.
Question:
Good morning, Doctor. The way my body has been feeling over the last three weeks is difficult to describe. I was treated for malaria by the doctor at my office clinic with Fansidar tablets. Although I felt better, I was no longer able to sleep.
After about four days, I went to my HMO, where they carried out a number of tests and later confirmed that I had malaria and typhoid. They prescribed P-Alaxin and Ciprofloxacin for seven days. I completed the treatment, but I still do not sleep well, and I experience a kind of internal heat between 5 p.m. and 8 p.m. every evening. Then the headache starts.
Yesterday night, I almost lost consciousness when a nurse who is my neighbour checked my blood pressure and found it to be 180/88mmHg. Now I am afraid that I may be having a stroke. Please advise me.
08033672000
Answer:
Thank you for your detailed history. You have done the right thing by seeing doctors regarding your complaints.
The likely reason for the rise in your blood pressure may be your inability to sleep properly. Stroke does not usually begin in this manner, and although you did not indicate your age, gender, or occupation, you are most likely an adult.
Therefore, the first thing is to ensure that you are able to sleep properly. To achieve this, you may need to repeat your malaria tests to determine whether the infection has been successfully treated. If it has, your doctors will follow the normal protocols to help you regain healthy sleep.
If the malaria has not cleared, which can happen for several reasons, another antimalarial medication may be prescribed to ensure your return to good health.
The most likely cause of your current dilemma is that you did not follow up adequately with the doctors managing your treatment.
Question:
Good day, Sunday Doctor. My baby is three weeks old and will be one month old soon. I noticed a swelling on the right side of his neck shortly after delivery. I showed it to the nurses, and they informed the doctor. The doctor said it would go away.
However, it has not gone away, and now the swelling has become hard. My baby cannot turn his head properly to the left side. We went to another hospital and, after some tests, they advised us to do a CT scan. Another doctor said we should do an MRI.
Sir, we do not have the kind of money they are asking for. Please help us. This is my first baby, and we do not know what to do. Thank you, sir.
07040667000
Answer:
Well, this swelling is visible in the middle of the neck. Although the picture quality is poor, it appears to be related to the manner in which your baby was delivered.
There was likely some bleeding into the belly of that muscle, and the blood has congealed over time, so that what you described above as "the thing" has now become a solid lump.
I will not bother you with its medical name, but what your baby needs is gentle physiotherapy to massage the muscle and gradually turn the neck from side to side. Do not attempt to do this yourself.
With proper physiotherapy, the lump should gradually reduce in size and soften.