Health workers’ strike remains a recurrent feature of healthcare systems in many low- and middle-income countries, with significant implications for service delivery and population health. This paper examines the systemic impact of strike action on healthcare delivery within a resource-constrained setting, drawing on evidence from the wider research conducted in selected health facilities in Maiduguri, Nigeria. The study adopts a cross-sectional design, integrating primary data from healthcare workers with secondary insights from institutional records to explore disruption across five key domains: morbidity and mortality, out-of-pocket expenditure, private hospital patronage, laboratory and diagnostic services, and medical tourism.

The findings indicate that strike action generates widespread disruption across the health system. Access to care is reduced, contributing to delayed treatment and perceived increases in disease severity and mortality. Financial burden intensifies as patients shift towards private providers, resulting in higher out-of-pocket expenditure in a context where health insurance coverage remains limited. Private healthcare facilities experience substantial increases in patient turnout, reflecting a redistribution of demand rather than an expansion of system capacity. Diagnostic services are constrained, with reliance on basic investigations and reduced access to advanced imaging, thereby affecting clinical decision-making. Medical tourism is perceived to be rising, although it appears to be driven by broader system challenges rather than strike alone.

The study also highlights critical weaknesses in health information systems, particularly the absence of reliable morbidity and mortality data during strike periods. This limitation constrains effective evaluation and policy response, underscoring the importance of strengthening data governance within the health sector.

The paper argues that health workers’ strike should be understood as a system-level stressor that exposes underlying structural deficiencies, including inadequate financing, weak governance, and limited workforce coordination. Addressing these challenges requires sustained investment in health system resilience, alongside mechanisms that safeguard essential services during periods of industrial action. The findings contribute to ongoing debates on health system stability in resource-constrained settings and emphasise the need for integrated policy responses that balance workforce welfare with the continuity of patient care.