Mistrust of the Nigerian health system and its practical implications: Qualitative insights from professionals and non-professionals in the Nigerian health system

Aim: Health system mistrust, a public health issue, is poorly understood in Nigeria, a country with a fragile health system. Understanding this public health issue will inform mitigation strategies against it. Thus, this study explores mistrust of the Nigerian health system and offers practical implications for mitigating it. Subject and Methods: Through a qualitative method, data were collected from 54 Nigerians, comprising diverse professionals and non-professionals in the health system. Data saturation was observed, and thematic analysis was used for data analysis. Results: Participants report mistrust of infrastructure in the Nigerian health system. The mistrust of infrastructure is linked to a jeopardized educational system, low morale of health workers due to poor remuneration, lack of professionalism among health workers, misinterpretation of laboratory investigation results leading to misdiagnosis, dilapidated medical equipment, unavailability of ambulances, inaccessibility to essential services, shortage of health workers, absence of patient-centered care, and poor healthcare financing. Further, participants report mistrust of, pharmaceutical products due to substandard drugs in the health system, government and privately owned health facilities, documentation of patients’ information due to incompleteness in the documentation, and confidentiality of patients’ information. Trust levels in the health system limit utilization of health services and link to health inequities. To strengthen their trust in the health system, participants recommend surveillance efforts from the government, and infrastructural development including the construction of standard health facilities, computerization of operations in health care, provision of up-to-date medical equipment, employment and training/retraining of health workers, and constant water and power supply. Participants also recommend healthcare financing, investment in health research and education, a multidisciplinary approach to health care, and discouragement of medical tourism. Conclusion: This study adds to the understanding of health system mistrust. Findings offer practical implications for mitigating mistrust of the Nigerian health system. Avenues of inquiry for future work are also offered.