Addressing stigma to achieve healthcare equity and universal health coverage in Nigeria

Stigma remains a strong barrier to achieving the Sustainable Development Goals (SDGs) and Universal Health Coverage (UHC) in Nigeria’s healthcare system. Stigma is deeply embedded in cultures and historical contexts and has marginalized entire populations affected by HIV/AIDS, mental health disorders, disabilities, and ethnic minorities. It is propagated through social exclusion that aggravates health inequities with aversive expected social reactions, discouraging healthcare-seeking behaviors in time, compromising treatment adherence, and continuing to increase social exclusion for people from stigmatized groups. What has equally remained elusive is the implementation of legislative reforms, with targeted interventions by agencies like the National Agency for Control of AIDS, having policies such as the Mental Health Act. This has created discriminatory attitudes to healthcare settings and limited access to key services for these groups, affecting reproductive health and maternal care, including mental health services. There has been a double burden of communicable diseases and non-communicable diseases in Nigeria, exacerbating the current condition of limited resources and infrastructure gaps in health care. Combating stigma requires a multifaceted approach targeting individual, interpersonal, organizational, community, and societal levels if the country is to effectively meet the challenge. This involves hard-hitting education campaigns, enhanced training in cultural competence among healthcare providers, ensuring confidentiality, and creating an inclusive healthcare environment. Indeed, societal perceptions can be changed through community-driven efforts and advocacy for fair access to health care and further, realize equitable quality health access toward full coverage and sustainable development in Nigeria.