NIGERIA’S urban health system is heading for tougher times, as new projections show that urban populations across Africa and Asia will grow by as much as 90 per cent over the next two decades, health policy experts say. 

The experts warn that without urgent reforms, cities such as Lagos, Abuja, Port Harcourt, Kano and Enugu could face deepening health crises.

This warning comes from the (community-led effective urban health systems) CHORUS Urban Health Consortium, a multi-country research group working in Nigeria, Ghana, Bangladesh and Nepal, which says cities are expanding far faster than the health systems meant to serve them.

Speaking from the Nigerian perspective, a professor, Obinna Onwujekwe, Lead of the Health Policy Research Group at the University of Nigeria and Nigeria’s lead for the Consortium, said the situation demands deliberate efforts to build resilient health systems.

“Cities across Africa and Asia are expanding faster than their health systems can contain, prompting urgent discussions about the present and future of urban health,” he said.

He added that the work of the Consortium “emphasises the need for Africa and Asia to build resilient health systems to address the challenges posed by a rapidly growing urban population and significant disease burden.”

To advance these discussions, the Consortium is convening researchers, policymakers and city officials at a major Evidence-to-Policy Forum in Accra on January 29–30, 2026, in partnership with the University of Ghana’s School of Public Health and the International Society for Urban Health. The meeting will focus on how African and Asian cities can build resilient health systems capable of coping with rapid urbanisation and rising disease burdens.

Across Nigeria’s cities and other focal countries, healthcare delivery is often fragmented, with public hospitals, private clinics, pharmacies and informal providers operating side by side with little coordination. This fragmentation according to a professor,  Helen Elsey, Co-Director of the Consortium has contributed to poor maternal and child health outcomes and a growing crisis of non-communicable diseases such as hypertension and diabetes.

She noted that CHORUS research has shown that informal providers, including traditional birth attendants, remain a major source of care for urban residents, particularly the poor.

One of Nigeria’s key breakthroughs from the research on linking informal healthcare providers into formal urban health system in Nigeria, according to Onwujekwe, is the creation of an Urban Health Unit within the Enugu State Ministry of Health, designed to formally link informal providers with government primary healthcare services.

Findings from the five-year urban health research further revealed that a large share of healthcare in urban slums is delivered by informal providers such as patent medicine vendors, traditional birth attendants, many of whom lack the training and oversight to safely manage conditions like hypertension and diabetes, despite serving more clients than formal health facilities. These insights have pushed state authorities to recognise that informal care providers must be integrated into formal health systems if quality and equity are to improve.

Beyond healthcare delivery, CHORUS Urban Health Consortium leaders stress that urban health cannot be separated from wider social and economic conditions. Poor roads, unreliable electricity, unsafe water, air pollution and weak sanitation systems all compound health risks in fast-growing cities.

The Accra forum is expected to showcase lessons from Nigeria alongside experiences from Ghana, Bangladesh and Nepal, where researchers are testing ways to integrate pharmacies and NGO clinics into government health systems to better manage chronic diseases.