Seven Doctors for Nine Million Elders: Nigeria’s Silent Crisis in Elderly Care
By Ameh Abraham
Nigeria hosts the largest population of older persons in Africa. As of 2022, over 9 million Nigerians—approximately 4.7% of the population—were aged 60 and above. By 2050, this figure is projected to exceed 25 million.
These are not abstract numbers. They represent the generation that built Nigeria’s institutions, sustained its public service, and raised its current leadership. Yet, in a troubling reversal, many now face abandonment in their most vulnerable years.
Traditionally, the extended family system provided a reliable safety net for the elderly. Today, that system is steadily eroding under the pressures of urbanization, economic migration, and shifting social values. The informal structures are weakening, while formal systems remain underdeveloped and inaccessible.
What Exists on Paper
Nigeria is not without policy frameworks. The establishment of the National Senior Citizens Centre (NSCC) in 2021 signaled an important institutional step toward coordinated elderly care. The Centre has initiated programs spanning healthcare access, social protection, income support, and caregiver training, alongside collaborations on elder justice with agencies such as NAPTIP and the National Human Rights Commission.
Similarly, the National Policy on Ageing articulates commitments to dignity, independence, and social inclusion. The NHIA Act provides a legal basis for expanding health insurance coverage.
On paper, these measures suggest progress. In practice, they remain largely aspirational.
The Implementation Gap
The most critical challenge lies not in policy design but in execution.
First is the funding deficit. The National Policy on Ageing remains chronically underfunded and insufficiently operationalized. Empirical studies consistently highlight the consequences: widespread poverty among older persons, particularly women, and low utilization of healthcare services due to cost barriers, distance, and systemic neglect. This is not incidental; it reflects a pattern of policy commitments unsupported by fiscal allocation.
Second is the human resource crisis. Nigeria reportedly has only seven consultant geriatricians serving over 9 million elderly citizens.
Seven—for nine million.
This figure alone captures the scale of institutional neglect. While initiatives such as the Geri-Care Health Scheme at JBS Gerontology Centre in Lekki demonstrate innovation, they remain isolated efforts. The broader system suffers from a severe shortage of trained specialists, limited geriatric education, and a persistent underestimation of ageing-related healthcare needs.
Third is the legal protection gap. Nigeria lacks a comprehensive and enforceable legal framework specifically addressing elder abuse and protection. Although efforts are underway to harmonize relevant laws, progress has been slow, and most states have yet to domesticate or operationalize existing provisions.
Fourth is unequal access to care. Available services are heavily concentrated in urban centers, leaving rural populations—where poverty is often most acute—largely excluded. The result is a deeply inequitable system that privileges geography over need.
Lessons from Comparable Countries
Nigeria’s challenges are not unique, but its response has been comparatively weak.
Countries such as South Africa and Brazil have demonstrated the transformative impact of structured social protection systems. South Africa’s Old Age Pension has significantly reduced elderly poverty, while Brazil’s Bolsa Família has provided consistent income support to vulnerable populations. Ghana, through its National Health Insurance Scheme, has made measurable progress in tailoring healthcare services to older adults.
These are not high-income countries. They are peers who have made deliberate policy choices to prioritize social protection.
A Path Forward
Nigeria’s elderly care system is underperforming, but the solutions are neither novel nor unattainable.
A universal social pension for citizens aged 65 and above would provide a basic layer of income security. Properly designed, regular, unconditional, and digitally administered, it could significantly reduce vulnerability and improve access to essential services.
Equally urgent is investment in human capital. Expanding geriatric training across medical and nursing institutions, establishing specialized fellowships, and scaling up caregiver certification programs are critical steps toward closing the workforce gap. Incentives must also be introduced to encourage service delivery in underserved rural areas.
Legislatively, Nigeria needs a comprehensive Elder Justice Act—one that criminalizes abuse, mandates reporting, and institutionalizes protective mechanisms at both federal and state levels.
At the service delivery level, integrating elderly care into primary healthcare guided by the WHO’s Integrated Care for Older People (ICOPE) framework would ensure more accessible, preventive, and community-based care.
Finally, sustainable financing mechanisms are essential. Earmarking a portion of the Basic Health Care Provision Fund for elderly care, alongside establishing a dedicated National Elderly Care Trust Fund, would provide the fiscal backbone required for meaningful reform.
As Omobolanle Akinyemi-Obe, Director-General of the NSCC, aptly noted, too many older Nigerians face poverty, isolation, neglect, and a profound erosion of dignity. Ageing with dignity is not a privilege; it is a fundamental right.
The evidence is clear. The policies exist. Pilot initiatives have shown promise. What remains is the political will to act decisively, fund sustainably, and prioritize consistently.Ultimately, elderly care is not a marginal issue; it is a reflection of national values. The systems Nigeria builds today will determine not only how it treats its current elderly population, but how it will care for future generations.
The question, then, is no longer whether Nigeria can afford to care for its elderly.
It is whether it can afford not to.