The Nigeria Basic Health Care Provision Fund (BHCPF): A Systematic Review of Policy Design, Implementation, Achievements and Challenges

The Nigeria Basic Health Care Provision Fund (BHCPF) is one of the most significant reforms in health financing in Nigeria. It was created to strengthen Nigeria's health sector, improve access to healthcare, strengthen Primary Health Centres (PHCs), support emergency response and public health security, and support vulnerable groups. The BHCPF is also intended to accelerate the country's shift towards Universal Health Coverage (UHC), so that Nigerians can access equitable and affordable medical care. The National Health Act of 2014 (Section 11) established the BHCPF specifically to guarantee steady funding for essential healthcare services. It helps lower the out-of-pocket costs that push families into poverty and concentrates on improving health outcomes for those who need it most — women, children, and low-income communities. This review provides an overview of what is known about the BHCPF since 2014, including how it was developed, how it has been used in practice, what has worked, how it is managed, and where it continues to face challenges. As of 2026, official documents, policy papers, and research articles present a mixed but broadly positive picture. The BHCPF has enhanced access to critical care, improved facility budget control, expanded the number of people covered by health insurance, and improved the consistency of PHC funding. However, implementation has been limited by governance concerns, delays in fund release, inadequate state-level capacity, weak accountability, and persistent regional inequities. The review concluded that although the BHCPF is a transformative health financing model, its future viability depends on reinforcing accountability frameworks, strengthening state-level preparedness, improving transparency, and ensuring sustainable funding.