This review examines the economics of social care in Nigeria, focusing on financing, equity, governance, and policy pathways to build inclusive support systems. We conducted a comprehensive literature search across PubMed, Scopus, Web of Science, Embase, and African Journals Online, covering peer reviewed studies published between 2015 and 2025. After a PRISMA guided screening of 1,243 records, 28 studies met the inclusion criteria and were synthesized using narrative and thematic methods. Findings highlight that Nigeria’s social care sector remains fragmented and underfunded, with out-of-pocket payments dominating financing and exposing households to catastrophic expenditure. Political economy factors shape reform timing and implementation, while governance weaknesses and workforce shortages undermine service delivery. Comparative lessons from Ghana, Rwanda, Thailand, and Costa Rica indicate that tax based financing, strong political commitment, and integrated systems can expand coverage and protect vulnerable groups. Promising reform instruments in the Nigerian context include state supported insurance schemes, earmarked funds such as the Basic Health Care Provision Fund, public private partnerships, sustainable bonds, and digital monitoring platforms. However, tradeoffs between equity, efficiency, and fiscal sustainability require careful design. We propose a roadmap with short term priorities for strengthening oversight and piloting financing innovations, medium term actions to scale integrated social care and deepen partnerships, and long term alignment with national development plans and the Sustainable Development Goals. Equity oriented measures should combine universal approaches with targeted support for rural populations, older adults, women, and persons with disabilities. Strengthening governance, transparency, accountability, and institutional capacity is essential to translate financing into equitable outcomes. This review identifies gaps in empirical evidence and calls for implementation research to evaluate financing models and the impact of integrated social care reforms in Nigeria. Policymakers, donors, and civil society must coordinate to fund and monitor reforms that prioritize equity and sustainability urgently.