Health

By Oladoja M.O

The Ministry of Health convened a timely, critical, and necessary gathering earlier last month: the National Health Financing Dialogue. A gathering with so much relevance and significance to address the almost comatose state of the Nigerian health sector. Reflecting on all said during the “dialogue,” there are just many thoughts creeping in here and there, which I feel compelled to just put up here for public consumption, and hopefully get across to the rightful authority to pick one or two important things. 

The dialogue, as noted earlier, was undeniably timely. I was not disappointed at all at various thematic areas buttressed on, ranging from health financing, health out-of-pocket spending (OOP) reduction, call for increment of the Basic Health Care Provision Fund (BHCPF), accountability and budgeting, over reliance on external health funding, insufficient resources as needed in the health sector, the need for proper, timely data to guide government decisions, the role of the media, and civil society organization in health sector, and holding government accountable, inclusivity of citizens in the budgeting process, budget execution, status of LG autonomy, the gap between research and policy making, establishment of proper framework for mental health in Nigeria, amongst many other things the dialogue rallied around. Reiteratively, all of these are core and vital to ensuring a positive paradigm for the national health sector state and to delivering on the interests of the citizen at large. Indeed, it was a worthwhile and insightful meeting. 

Though we still have quite a long way to go, I cannot help but acknowledge the works of the government of today on how far we’ve come in policies, increased allocation, investment in facilities, equipment, and a healthy workforce as regards health, captured in my work “Tinubu’s Healthcare Reforms: A Turning Point or Déjà Vu?”. During the course of the dialogue, a lot of observations kept creeping in, questions, suggestions, which there was not enough time to even express.

On observation

(1) We are unprepared to solve the country’s health problems, especially the issue of LG autonomy. The government focuses on superficial solutions instead of addressing root causes. LG autonomy is treated lightly compared to its importance. Primary care, which, if improved quickly, could significantly boost our health status. Unfortunately, the government is unable to do so. When I talk about autonomy, I mean actual, constitutionally granted autonomy, not superficial gestures like the Supreme Court’s jamboree. My writings, “LG: The Employed Man with no Office” and “Federalism and the Paradigm of Healthcare Accessibility,” elaborate on my views on this. The primary health issue affects p

(2) Make us talk truth, behind the blinking good intentions, health-related matters are often used for political publicity rather than long-term structural impact. Hence, many government interventions in healthcare are politically motivated rather than development-driven. 

(3) Still on the LG thing, I am more than disappointed at the way and manner in which the ALGON representatives at the dialogue spoke. What do you mean that you, as a stakeholder, come to such a stage to complain like every other person?? Basically, no form of cognitively presented way forward or suggestion, just another “we are being victimised” rhetoric. So Shameful! I was expecting them to flare up, demand something meaningful, but chai! My expectations were shattered. I thought they would speak about actual autonomy, driven by the constitution, not some half-baked, almost non-enforceable liberation.

In fact, the LG people present were just disappointed. We are talking about how to mobilise money, generate revenue for development, generate more liquidity to fund health, fund infrastructure, and none of them could make a meaningful comment on how funds can be generated rather than “if the autonomy sets in, we will ensure that all the allocation from the FG will be fully maximised.” As cool as that sounds, it was just another “we cannot do anything aside from what the FG says” kinda statement, and it only made me feel like this autonomy thing sef fit be another set-up… God abeg…. 

(4) On the role of media, it is crucial to even lean towards the perspective that the media is a culprit for where we are. Unfortunately, many media outlets and media handles are so fixated on just saying something, rather than saying something correct, and something from a knowledgeable stance, which to me, is even more dangerous than no information at all. Notably, the media are failing to pass information effectively. Especially the way they handle headlines. It is unfortunate, but it is the reality of our Nigerian populace that we have less of a reading habit. Hence, it is easy just to pick a headline, usually different from the content of the post, and run with it. Which is causing more harm to available information in the media space? Careless or sensational headlines have the potential to mislead the public, especially regarding sensitive policies such as those related to health. The issue of meaningless government secrecy is another thing I observed… and much more the issue of partisanship in politics by various media platforms and handling is another very obvious issue, causing every bit of information, especially unfinished policies or updates that are still in the pipeline, to be twisted for “political goals.” 

(5) In research, I observed that independent researchers and young passionate individuals in public health are often ignored, not encouraged, nor recognised, despite the need for data provision to help the government in setting priorities on health, and assisting in policy-making. 

(6) There’s just little or no innovative lawmaking pursued to fix systemic problems, especially wasteful constituency projects.

(7) Also, there seems to be too much focus on “there’s limited of…” What happened to the effective and efficient usage of the ones available?? Both in resources and in data.

And upon all the gbogbo atotonu of the dialogue, I was able to curate some suggestions which might be found useful;

(1) One of the major highlighted themes of the dialogue is the need for health insurance. It cannot be overemphasised that the importance of awareness still needs to be emphasised, especially to get the informal sector on board, because even among the small number of health insurance adopters, the major participants are those in the formal sector, with government employment. This awareness is not just something that will be around; “there is health insurance, and it is good for you.” But down to explaining various packages and what they cover, which can help guide expectations, correct misconceptions, and promote positive word-of-mouth about health insurance.

To meet up the ambiguous target of 40 million by 2030 and get more people from the informal sector onboard, I think a referral model (like those used in Ponzi schemes or digital marketing) could be adopted, making Civil servants primarily to act as “agents of change” or in this case, referral ambassadors, with promise of small tokens as reward for each successful referral. Because these civil servants are friends of people in communities, and even in places where government jingles and banners cannot reach, they help propagate.  No matter how we put it, the mouth-to-mouth campaign remains a powerful promotional strategy.

Another strategy is to tie health insurance enrolment to certain civic entry points, such as marriage registration. It can be mandated as part of the requirement to be submitted to the registry, where intending couples must show evidence of insurance. Procedural inefficiencies and bottlenecks should be removed to improve efficiency and ease the process, because I believe they are part of what discourages enrollees. Because even some who are already on health insurance coverage sometimes, because of long processes, delays, and stress, abandon the health insurance thing and pay out-of-pocket to get “sharp sharp” attention to their need. These negative experiences contribute to negative user feedback, and it spreads faster to non-users, worsening perceptions of health insurance enrollment.

(2) Though it may feel morally vexing, I suggest that health subsidies be tied to individual health behaviours. Those with risky lifestyles (alcohol, smoking) could face different treatment costs compared to people with unavoidable illnesses or accidents. This could encourage preventive lifestyles and behavioural change.

(3) On constituency projects, motorcycles, tricycles, food items… even outreaches) seems wasteful. I would suggest that a ban be placed, or at least regulations be given to what exactly these funds can be used to do… but then, who are those to impose that ban or restrictions, other than the actual people guilty of the bad behaviour? By direct analysis, these funds can be used to build facilities instead… whether school, or even hospitals, in this regard, left to the management of an independent body to be used efficiently and be used productively to generate money, money that can even be enough to run the operations and cover costs on its own, at least, and since the focus is to be able to generate liquidity to operationalize the facilities, the cost would be meager. They should not be free but rather run like a private entity to promote productivity. The billions lavishly spent on those meaningless things, if used in this manner, will result in more than 5–10 facilities at the senatorial district level or at whatever level of representation. Imagine if this number of facilities joined what we have??

(4) On the failure of some states in meeting their counterpart funding for BHCPF, they should not receive interventions from the FG. FG should publicly announce those states, carry the citizens along, and allow them to hold such state(s) accountable. There’s not enough funding. Therefore, the one we have must be spent in a way that is strictly tied to value and commitment.

(5) It is my suggestion that stronger media regulation be deployed to curb the spread of harmful and incorrect information (such as more dangerous than no information). And there should be a regulation/restriction on every journalist’s participation in politics. The place of media is quite sensitive, and they must remain sterile and neutral. Involvement in politics should be punishable by a ban on practising. This will give credibility to the profession and what their position is in the process of building a better state of the nation.

(6) On mobilisation of funds for health, I would suggest that the FG create something like a Health Bond, similar to commercial papers, to mobilise funds for health.

(7) Research should be given all the support it may ask for. A nation without accurate data is one with a lack of radar for progress… and I think one of the ways the government can support young, enthusiastic researchers (especially to gather young brains who are ready to help the government generate actual data for purpose of health policy and priorities) is to create access to platforms to show their works, something like a journal. We all know how much publications mean to researchers, and for young fellas like that, it can boost morale, knowing that their work is not wasted and is seen, whether it is to publish for free or at a very subsidised cost.

Lastly, I have been, and I remain, an advocate for the proper integration of the traditional health care system into the general healthcare system in Nigeria, especially at the grassroots level (Primary Health Care). My advocacy and thoughts are captured in some of my writings on Blueprint and HealthDigest. Health is people; people are culture. Nothing screams culture more than the traditional health care system. We cannot only tech-chase ourselves into a proper healthcare system in Nigeria.

Yes, technology is excellent, and AI is great, but the actual health burden we face requires that we not focus solely on these technologies. To me, I ask: why are we running? There’s a system that has been in place all this time; it should not be ignored. Many big economies have this included. The place of this traditional health system is beyond just provision of care (because, yes, a lot needs to be moderated). Still, these people can be brought in as agents, and their already established, patronised platforms can be used to promote government activities. Yes, they can assist in care provision. In fact, they have to. Knowledge of healing from generation to generation should not be neglected or allowed to die out.

Oladoja M.O writes from Abuja and can be reached at: mayokunmark@gmail.com.

By Isah Kamisu Madachi

On Thursday, 4th December 2025, my cousin Tajuddeen bade us farewell on his way to Lafia, Nasarawa State. They left early in the morning in a Hummer bus. Around 10 a.m., they had a terrible accident in a town near Bauchi metropolis. All the passengers in the vehicle were badly injured. Tajuddeen, along with the bus driver and two others, instantly slipped into coma.

Other passengers were either with more than one fracture or several wounds. On the evening of 6 December, the driver’s suffering came to an end as he passed away. The following day, another one of the passengers in the coma also died. On 8 December, the third victim in coma breathed his last, leaving my cousin still in the ICU section of the Abubakar Tafawa Balewa University Teaching Hospital, Bauchi.

The cause of the accident was tyre failure. While they were on the road hoping to reach Jos in the afternoon, their back tyre burst and the bus somersaulted several times. The primary cause of the tyre failure was actually overload. Coincidentally, as I was on a phone call with a friend, he narrated how another terrible accident occurred close to my hometown as a result of tyre issue which instantly claimed two lives and left others badly injured.

I was really shocked and worried because not long ago, on a trip to Lagos, our own bus was carrying two commercial vehicles in addition to overloaded luggage of passengers and waybills. Even before the vehicles were brought, one had to ask whether humans would still get a seat after such loads were mounted. Lo and behold, the vehicles were arranged in a way that you couldn’t even see them inside the boot.

Last month, on our way back home from Kano, we witnessed another accident around Shuwarin town in Jigawa State. It was a jam-packed hummer bus obviously heading to either Damaturu or Maiduguri. They also had a tyre failure which resulted in several deaths. By the time we arrived at the accident scene, out of more than 20 passengers including the driver, only two people were still alive. The rest appeared lifeless.

If I were to narrate all the road accidents I have witnessed, most of them caused by tyre failure, I would have to write a book of a hundred pages. Road accidents are too many across Nigeria. Less than one week ago, I saw a picture on social media that stirred wide reactions. A commercial bus was overloaded to the extent that if one wanted to go out at a transit point, they had to pass through the boot as the doorway was blocked by bags. Even in the case of an emergency, no one could use the door because luggage completely covered the entrance. Many people commented that this is common in Nigerian motor parks.

When we talk about things that claim the lives of Nigerians, I believe road accidents is of course one of the biggest culprits, even more than insecurity in some cases. Anyone who travels widely by road knows this fact. And most of these accidents are avoidable if only we take transport safety seriously.

To bring to an end or at least reduce the intensity of the problem, we need a comprehensive transport policy that tackles overload and the abuse of luggage space. Parks should be mandated to use dedicated cargo buses. If a passenger’s luggage is above 10kg, it should automatically be transferred to a cargo vehicle, not stuffed into a bus carrying humans. For waybills, there should be separate buses whose only function is to transport goods from one state to another; especially the popular routes between Northern and Southern Nigeria or even within the North along routes like Kano-Borno, Taraba-Kaduna, Abuja-Adamawa and others.

Another important solution is the deployment of safety personnel to every major park. Their only job should be to inspect buses and car tyres to ensure they are in good condition before departure. Once there is no compliance, the driver must not be allowed to go. Of course in Nigeria some people may try to offer bribes to bypass checkpoints. To address that, these safety officers should not be local staff. They should report directly to an independent transport safety unit with strict oversight, rotating officers frequently to reduce compromise.

Still, digital systems can be introduced. Each bus should be scanned and cleared through an electronic checklist linked to a central database. If a bus fails safety checks, it should not receive the clearance code required to leave the park. With this kind of structure, even bribery becomes difficult to offer because safety approval will depend on digital authentication, not an individual officer’s discretion.

Nigeria needs to take road safety as seriously as other deadliest national issues. The number of lives cut short on our roads is heartbreaking. Families are losing loved ones every day due to accidents that could be prevented if we enforce discipline, regulate overload, inspect tyres, and treat transport safety as a matter of policy, not luck. 

Isah Kamisu Madachi is a policy analyst and development practitioner. He wrote from Abuja, and can be reached via: isahkamisumadachi@gmail.com

By Saifullahi Attahir

I had the privilege of attending the Africa Youth Health Summit organised by the Federation of African Medical Students’ Associations (FAMSA). It was a 3-day event, a highly engaging program in which over 200 young and passionate healthcare students and professionals gathered at the United Nations House to learn, network, discuss, and chart the future of the healthcare system in Africa.

The delegates come from many African countries and represent diverse cultures, languages, backgrounds, religions, and colours. We had the privilege of hearing from representatives of leading agencies, including the World Health Organisation (WHO), the Africa Centre for Disease Control (CDC), the United Nations, the Nigerian Minister for Youth, Information Technology experts, and several other non-governmental organisations (NGOs).

Several hands-on workshops were organised on public health advocacy, cutting-edge cancer management, transformational leadership, reproductive health issues, and policy formulation. I was fortunate to sit next to the Nigerian Minister for Youth, Mr Ayodele, and even took a memorable photo.  

As a side trip, we visited memorable places like the Africa Medical Centre of Excellence Hospital (AMCE), the NIKE ART AND GALLERIES, and Abuja Magic Land.

AMCE is a state-of-the-art facility built by AFREXIM Bank to curb health tourism by Africans to Europe. The facility is a replica of King’s College Hospital in London, featuring the latest technologies and expertise.

My visit to NIKE GALLERY left a lasting impression on me about the human ability to turn waste into wealth through talent. The gallery contains thousands of beautiful paintings, some made from trash (bola/shara). Indeed, Nigeria is full of untapped potential!

As a President, National Association of Jigawa State Medical Students (NAJIMS) National Body, I make the best use of the opportunity in this summit to network with a lot of like-minded individuals, to voice out my opinion, and to shine Jigawa State on the radar of African maps.

I am aware of the challenges of the healthcare system in Jigawa State, ranging from maternal mortality, under-5 infants mortality, vaccination misconceptions, mental health, adolescent challenges, infrastructural and manpower shortages. I’m fully equipped with the knowledge to help my dear state and medical students back home.

Panels were organised around essential topics such as the efficient use of Artificial Intelligence in medical practice, data-driven research, Japa syndrome, and youth inclusion in healthcare system leadership.

The trip was worth attending, the investment priceless, and the experience handy. I love travelling to important places like these, as it broadens my horizons, pushes me out of my comfort zone, lets me interact with like-minded individuals, and teaches me things books or classrooms could never teach me.

Saifullahi Attahir is the President of the National Association of Jigawa State Medical Students, NAJIMS National Body. He can be reached via saifullahiattahir93@gmail.com.

By Engr. Khalilah Yahya Aliyu 

September was the month dedicated to raising awareness of various medical conditions, among them hydrocephalus, which is commemorated in the United States on the 20th. This article was meant to have been published as my contribution to this course, but you will have to forgive me. The pen became too heavy for me to write as it required revisiting emotional wounds and acknowledging future fears.

I am a mum to a vibrant two-year-old blessed with this little-known condition–Hydrocephalus. Or so I thought, until I had him and realised hydrocephalus has quietly existed around us all along. During my final ultrasound before delivery, I curiously read the note from my OB-GYN: “mild ventricular dilatation.” At the time, “dilatation” only meant one thing to me, which was that my body was preparing to bring my baby into the world. What caught my attention, though, was how different this report was from the one I received during my first pregnancy.

As soon as I got home, I turned to Google: “What is mild ventricular dilatation in a foetus?” I learned it’s also called ventriculomegaly. It is a condition characterised by enlarged ventricles (fluid-filled spaces in the brain). The diagnosis was mild, and I read that it might normalise. I was still advised to watch for signs like visible veins on the scalp, projectile vomiting, and a rapid increase in head size.

Let me take you back a bit. Hydrocephalus, in direct translation from Greek, means ‘hydro’ (water) and ‘cephalus’ (head). Literally speaking, “water in the head”. But it’s not just any water. It’s cerebrospinal fluid (CSF). While CSF is essential, an excess of it leads to hydrocephalus.

Although some cases are congenital, it is critical to note that hydrocephalus can be acquired either due to old age or blunt trauma to the head. The case that scared me to my bones was when we were researching for a registered Medtronic vendor to purchase Ja’far’s shunt. We heard about a ten-year-old whose head accidentally hit a wall. The trauma distorted the flow of CSF, and he was not diagnosed on time till he nearly lost his mobility and sight. The shunt surgery restored his health.

I gave birth via emergency C-section after a prolonged labour. The first thing I checked when I held my baby was his head. It looked normal, covered in a full mass of hair. I couldn’t even see his scalp. Due to the labour complications, we stayed in the hospital longer. On the second day, neonatal jaundice set in, and my baby was admitted to the Intensive Care Baby Unit (ICBU). By the third day, I noticed something unusual. He vomited after every feed, and not just regular spit-up. It was forceful, the typical definition of projectile vomiting. I informed the paediatrician, who advised smaller, more frequent feeds. I followed the advice, but the vomiting persisted. Luckily for us, he had a voracious appetite, and after each episode, he’d eagerly refill his tummy.

We were discharged after 10 days. Grandma gave him his first haircut, and that’s when we noticed the intricate network of veins on his scalp. Visitors had all sorts of suggestions, from saffron oil to headache “ciwon kai” remedies. But deep down, I knew what it was. I anxiously waited for the final symptom to appear. Within days, his head began to enlarge, and his fontanelle (Madiga) wasn’t pulsating as it should. The vomiting continued. I turned to my husband and said solemnly, “Baby Ja’far needs urgent medical attention.” Grandma agreed. I trusted my instincts, and kudos to my husband, family, and friends for providing me with the strength to keep hope alive. They left no stone unturned to make this trial bearable.

At precisely one month old, we took him to Aminu Kano Teaching Hospital. We first saw a paediatrician at the GOPD, who ordered a scan, and my fears were confirmed. He has Dandy Walker Syndrome (DWS), which has led to excess fluid buildup in his head. I cried. Yes, I did. But I was also hopeful because I had read that early intervention could improve his chances of living an everyday life. We were given a medicine, Acetazolamide, that must be compounded to suit a child’s dosage. The medication is to reduce cerebrospinal fluid (CSF) production and help manage intracranial pressure. We were then transferred to the Neurosurgical Department, where we met the neurosurgeons on their clinic day, a Wednesday. A strike by resident doctors worked in our favour, allowing Ja’far to be seen directly by a consultant neurosurgeon. 

I mentioned how warm his head felt, and the consultant reassured me it wasn’t related to hydrocephalus. “He’s like any other baby,” he said. “He can have a fever”. That was the beginning of our journey. I was frantic. I just wanted him treated quickly to relieve the cranial pressure. He needed brain surgery to insert a shunt that would regulate the CSF flow. Delays could cause irreversible damage. The medical team was dedicated and compassionate, particularly the doctors. He had the surgery successfully at two months old, and we watched him ace his developmental milestones. We celebrated his second shunt anniversary on June 19, 2025.

After Ja’far’s diagnosis, my curiosity deepened. I consumed every piece of literature I could find related to hydrocephalus. Wednesdays became my learning days, not just from the doctors but from fellow patients and caregivers. I remember overhearing a professor of neurosurgery advising a mother of another shunted warrior: “You and your partner should properly plan subsequent pregnancies. Gone are the days of ‘just taking in'”. He emphasised starting folic acid six months before conception, staying healthy, and avoiding harmful practices. And of course, make prayer your closest ally as you follow the healthiest regimen possible. Take your child to the hospital because even with limited resources, our healthcare workers continue to perform wonders, saving lives every day. They are our true heroes. 

It is pertinent to add, though solemn, that a shunt is a foreign body and can be prone to infection, blockage or malfunction. You must be alert; should you observe the slightest recurrence of any of the pre-surgery symptoms, hasten to the hospital for proper diagnosis. The doctors often reassure us that milestones might be delayed for our warriors. Still, with the appropriate care, they accomplish them over time. Seeing the scars where the shunt is placed, be it the catheter or the pump, and knowing that it is going to be there for life, can be heartbreaking. But I have learned to overcome this feeling by viewing it as a lifesaver because without it, you might not even be able to hold your bundle of joy. Brace up, not everyone’s journey is the same, but be ready for bumps. They can come in the form of incessant headaches, seizures or double incontinence.

I cannot conclude without a strong plea to the government. Congenital diseases are rare. Ja’far’s DWS, for example, ranges from 1 in 10,000 to 35,000 live births. Setting aside funds that low-income parents can access to cover medical expenses will go a long way toward improving our warriors’ quality of life. Make the health sector more robust. Map out a lasting plan to eradicate strikes. It might have worked in our favour, but it has also stalled the needed intervention for some of our warriors, leading to irreversible brain damage. Mandatory, accessible antenatal care, overseen by qualified medical practitioners, will help preserve the rarity of these conditions.

To all my fellow hydro mums, be grateful to the Almighty for the gift and celebrate your little warriors. Whether it’s an inch or a milestone, every step is worth celebrating. Also, you are not alone. We have a community, and we’re here to support one another, always. To everyone who stood by us throughout this journey, I want to say thank you. Where could we have found the strength to carry on without you?

Engr. Khalilah Yahya Aliyu wrote via khalilah20@gmail.com.

By Sabiu Abdullahi

Nigeria’s long struggle with disease outbreaks has repeatedly shown how weak communication systems can worsen health emergencies.

In recent years, states have battled diphtheria, malaria, meningitis, Lassa fever, cholera and measles, often without clear public guidance at the peak of outbreaks.

In many cases, rumors travelled faster than official updates. Fear spread before facts reached the public. Misinformation filled the gaps left by delayed or poorly coordinated communication.

With memories of these challenges still fresh, the Kano State Centre for Disease Control (KNCDC) has launched a major step meant to strengthen outbreak communication.

This comes through a three-day workshop in Zaria, supported by the Foreign, Commonwealth & Development Office (FCDO) Lafiya Programme.

The initiative seeks to unite health agencies, media professionals, risk communication experts and government institutions to create a stronger, faster and more reliable information system ahead of future outbreaks.

Officials say the programme will help states avoid the costly lessons of the past. During Nigeria’s diphtheria crisis, many communities were unaware of symptoms before outbreaks escalated.

During meningitis outbreaks, myths overshadowed medical guidance in some states. During the COVID-19 pandemic, conflicting messages damaged public trust.

These experiences, experts say, prove that communication failures can be as deadly as the diseases themselves.

The Director-General of KNCDC, Prof. Muhammad Adamu Abbas, declared the workshop open. He said the goal is no longer just to respond to outbreaks, but to communicate with clarity, speed and authority.

“This workshop is about building a united front — where health officials, journalists, and communication experts speak with one voice, guided by facts and science,” Prof. Abbas stated.

He described the partnership with FCDO-Lafiya as strategic, timely and necessary. He commended the organisation for sustained support in improving Nigeria’s health emergency systems.

He added that communication must stand alongside testing, vaccination and treatment in outbreak control.

Participants were drawn from health institutions, media organisations, government agencies and civil society groups.

They are expected to co-design a communication framework that prioritises rapid information flow, public engagement, rumor control and stakeholder alignment.

Facilitators will lead sessions on crisis media handling, digital risk communication, misinformation control, emergency coordination and broadcast-ready public messaging for disease outbreaks.

The workshop will also include group simulations, panel discussions and field scenarios aimed at turning knowledge into practice.

Public health analysts have strongly welcomed the initiative. They say outbreak preparedness in Nigeria must go beyond medical response. They argue that a well-informed public remains one of the strongest defenses during a health emergency.

Observers say Kano is taking a rare but necessary lead. Many states, they note, still lack structured outbreak information systems. Some states depend solely on federal communication during epidemics, leaving gaps in local response messaging.

Some wait until outbreaks are full-blown before launching public awareness efforts. Health experts warn that this delay has repeatedly cost lives.

By moving toward a structured communication plan, Kano is now positioning itself as one of the best prepared subnational systems in outbreak information management.

The workshop continues throughout the week, with officials stating that the final outcome will be a deployable outbreak communication model meant to guide real-time response within Kano and potentially across other Nigerian states.

By Muhammad Abubakar

Efforts to strengthen vaccine delivery systems across northern Nigeria received a major boost as the All Babies program, implemented by New Incentives – All Babies Are Equal (NI-ABAE), convened a two-day Roundtable Meeting of Cold Chain Stakeholders in Kano.

Held at Tahir Guest Palace from October 24 to 25, the meeting brought together 35 participants from state and zonal cold chain offices, development partners, and the Kano State Primary Health Care Board. The focus was on improving coordination, data management, and logistics in vaccine distribution across 14 northern states.

During the technical session, program officials presented encouraging results from the third quarter of 2025. Katsina and Zamfara states recorded the sharpest declines in zero-dose infants, each achieving a 40-percentage-point reduction, while Kaduna saw a 15-point drop. So far, All Babies has enrolled over 5.6 million infants, supported 7,128 clinics, and facilitated more than 85 million vaccinations through conditional cash transfers to caregivers.

Stakeholders at the meeting resolved to improve real-time vaccine data reporting through Nigeria’s OpenLMIS platform, enhance coordination between state and local levels, and push for increased transportation funding via the Association of Local Governments of Nigeria (ALGON) to ease vaccine movement to remote areas.

Niger State’s Cold Chain Officer, Abubakar Hussaini, praised the program’s impact, saying, “All Babies has done a great job increasing vaccination awareness and turnout. We hope the program expands nationwide so every child benefits from these life-saving vaccines.”

The roundtable ended with a joint communiqué reaffirming partners’ commitment to ensure that every child, regardless of location, receives timely and essential vaccines.

By Abdullahi Adamu

Poor health facilities in Nigeria stem from severe underfunding, causing inadequate infrastructure, outdated equipment, drug shortages, and breakdowns in essential services like electricity and clean water. This affects rural and primary healthcare centres most, where facilities are dilapidated and staff insufficient. A shortage of medical professionals and brain drain overloads the system, leading to increased medical tourism and poor outcomes. Healthcare access is severely limited due to various systemic factors. 

Misconceptions about primary health care and poor leadership have hindered the health system, which hasn’t aligned its structures to achieve universal health access. Improving financial access alone won’t suffice without comprehensive primary health care reform to fix system flaws, deliver quality, efficient, acceptable care, and ensure sustainability and growth for the health system and country. A primary health care movement of government health professionals, the diaspora, and stakeholders is needed to drive this change and overcome political inertia.

In 2014, the National Health Act established the Basic Health Care Provision Fund (BHCPF) to address funding gaps hampering effective primary healthcare delivery across the country. The BHCPF comprises 1% of the federal government Consolidated Revenue Fund (CRF) and additional contributions from other funding sources. It is designed to support the effective delivery of Primary Healthcare services, provision of a Basic Minimum Package of Health Services (BMPHS), and Emergency Medical Treatment (EMT) to all Nigerians.

Despite the provisions of the BHCPF, the report’s findings expose the precarious state of healthcare in Nigeria, where access to and utilisation of health services remain marred by systemic challenges across states.

Public health facilities in all 36 states and the FCT are deficient, and the experiences of community members seeking care at these facilities are consistently awful.

Primary Health Care (PHC) is the foundation of the healthcare system in Nigeria and serves as the level at which non-emergency, preventive health issues are addressed. But sadly, many PHC centres in the FCT are poorly equipped and lack well-trained personnel.

 Kulo PHC was built with solid infrastructure and equipped with solar panels as part of a 2019 federal initiative aimed at strengthening primary care in hard-to-reach areas. Today, that promise lies in ruins. The solar panels are now dysfunctional—some stolen, others damaged by harsh weather and lack of maintenance. At night, the clinic plunges into darkness, leaving staff to work by torchlight or with dying cell phone batteries.

Three patients on life support at Aminu Kano Teaching Hospital were reported dead following an interruption to the hospital’s electricity supply by Kano Electricity Distribution Company.

The basic causes of Nigeria’s deteriorating health care system are the country’s weak governance structures and operational inefficiencies.

In 2014, the National Health Act established the Basic Health Care Provision Fund (BHCPF) to address funding gaps hampering effective primary healthcare delivery across the country. The BHCPF comprises 1% of the federal government Consolidated Revenue Fund (CRF) and additional contributions from other funding sources. It is designed to support the effective delivery of Primary Healthcare services, provision of a Basic Minimum Package of Health Services (BMPHS), and Emergency Medical Treatment (EMT) to all Nigerians.

Despite the provisions of the BHCPF, the report’s findings expose the precarious state of healthcare in Nigeria, where access to and utilisation of health services remain marred by systemic challenges across states.

Public health facilities in all 36 states and the FCT are deficient, and the experiences of community members seeking care at these facilities are consistently awful.

The Basic Health Care Provision Fund (BHCPF) was poorly implemented in 13 states.

The basic causes of Nigeria’s deteriorating health care system are the country’s weak governance structures and operational inefficiencies

Abdullahi Adamu wrote via nasabooyoyo@gmail.com. 

By Halima Abdulsalam Muhd

For decades, many Nigerian communities benefited from a rigorous weekly sanitation exercise led by duba gari or community health monitors who inspected homes and surroundings for hygiene compliance. These dedicated individuals went from house to house, checking toilets, kitchens, bedrooms, and waste disposal areas. Offenders were fined ₦50, a penalty that not only discouraged negligence but also ensured that communities maintained high sanitation standards.

Today, however, that once-vibrant practice has largely disappeared, leaving neighbourhoods grappling with mounting sanitation challenges, from blocked drainage to increased cases of cholera and malaria. Residents and experts alike are calling for the revival of this community-driven initiative.

Voices from the Community

Malama Hadiza Musa, a trader in Naibawa, recalled how effective the system used to be. “When the duba gari came every week, we had no choice but to clean up. Everywhere was tidy, even the backyards. Now, people dump refuse carelessly, and it is affecting all of us,” she lamented.

Mr Aliyu Garba, a retired civil servant, shared similar sentiments, “Back then, sanitation was part of our lives. Today, gutters are clogged, and mosquitoes breed everywhere. We need to bring back that system before things get worse.”

For Zainab Abdullahi, a mother of four, the absence of weekly inspections has created health concerns for families. Children now play around in dirty environments. If sanitation checks were still happening, parents would take cleaning more seriously.”

Community leader Malam Ibrahim Tukur believes the fines encouraged responsibility, “₦50 may look small today, but it carried weight at that time. It wasn’t about the money—it was about discipline. People feared being fined, so they kept their homes clean.”

Meanwhile, younger residents like Suleiman Adamu, a university student, argue that modern approaches should complement the old system, “We can bring it back, but alongside awareness campaigns and community waste management systems. Punishment alone may not be enough.”

Expert Perspectives

Environmental experts warn that abandoning structured sanitation monitoring has far-reaching effects.

Dr Fatima Yakubu, an environmental health specialist, emphasised the connection between sanitation and public health: “Poor sanitation directly contributes to outbreaks of cholera, typhoid, and malaria. Weekly inspections used to act as preventive measures. Reviving them could save lives and reduce health costs.”

Similarly, Prof. Emmanuel Okafor, an environmental scientist at Ahmadu Bello University, stressed the economic implications, “Communities spend more on healthcare when sanitation breaks down. By reinstating duba gari inspections, we are not just promoting cleanliness—we are reducing disease burden and increasing productivity.”

The Way Forward

Local governments, community associations, and traditional rulers are being urged to reintroduce house-to-house sanitation, perhaps updating the fines to reflect current realities while also integrating modern waste management solutions.

As Mrs Aisha Danladi, a public health advocate, put it, “We need a collective effort. The duba gari system worked before; it can work again. Our health and environment depend on it.”

Halima Abdulsalam wrote from Bayero University, Kano, via haleemahm42@gmail.com.

By Uzair Adam

The Kano State Government has expanded its hypertension prevention and treatment services to 208 Primary Health Care (PHC) facilities across the 44 local government areas of the state, according to the Ministry of Health.

The initiative, which builds on an earlier pilot phase, was launched under the administration of Governor Abba Kabir Yusuf to strengthen early detection and management of hypertension — a leading cause of heart disease, stroke, and premature deaths in Nigeria.

In a statement issued on Saturday, the Public Relations Officer of the Ministry, Nabilusi Abubakar K/Na’isa, said the expansion followed the successful implementation of the programme in 52 PHCs under the National Hypertension Control Initiative (NHCI).

He explained that the initiative, with technical support from Resolve to Save Lives and Project HOPE, has now been scaled up to 208 facilities to ensure more residents have access to regular blood pressure checks, treatment, and follow-up care within their communities.

Quoting the Commissioner for Health, Dr. Abubakar Labaran Yusuf, the statement noted that the government’s decision reflects its commitment to strengthening the primary healthcare system and addressing non-communicable diseases across the state.

Dr. Yusuf commended the dedication of health workers participating in the programme and urged them to sustain their efforts to ensure lasting success in hypertension prevention and control.

“The scale-up of hypertension services across 208 PHCs demonstrates Kano’s leadership in improving access to essential care. This should serve as a model for other states in advancing equitable and sustainable health services,” the commissioner said.

The Ministry expressed optimism that the initiative will help prevent costly complications, reduce hospital admissions, and promote healthier, more productive lives for Kano residents.

By Oladoja M.O

There’s a video, “Why did Mrs X die?” that is very popular in the public health sphere. At first, the video seemed like the tale of one woman, faceless, nameless, known only by a letter. But the more I analyse and reflect on it, the more it has dawned on me that Mrs X was never just one person. She was and still is the embodiment of Nigeria’s healthcare story. Her death was not a singular tragedy, but a parable. A mirror held up to a nation’s bleeding system.

Mrs X died, not simply because of childbirth complications, but because everything that could have worked didn’t. Everything that should have stood for her failed her. Her death was not a moment; it was a long, silent, accepted process. In her story, there was the collapse of planning, access, and empathy. She died from a slow national rot that had found flesh in her body.

The story of Mrs X began not with the bleeding, but with the absence of preventive orientation that characterises the experience of many Nigerian pregnant women. She went through pregnancy the way most Nigerians face illness, hoping it would not demand too much. She never considered going for checkups, not because she was reckless, but because the culture of prevention was never truly instilled in her.

In a society where survival itself is a daily hustle, prevention often feels like a luxury. There was a health facility, yes, but it was far, tired, and overstretched. The system had blood, but not enough. Staff, but overworked. Beds, but unclean. And behind it all were the silences of policymakers, the rust of forgotten community health centres, and the dust on abandoned government project files. So, when she finally needed help, it was already too late to start looking. 

That story, the scramble at the end, is too familiar. We see it in Ekiti, Katsina, Owerri, and Makurdi. Patients running from one hospital to the next, files in hand, hope on lips, only to be turned back by bureaucracy, distance, or a quiet “we have no space.”

But beyond the infrastructure and logistics, Mrs X bore the weight of something heavier: culture. She was told, directly and indirectly, that her place was to endure. To cook. To clean. To birth. Her pain was duty. Her tiredness was weakness. To seek help was indulgent. So, she bore her cross in silence. Culture had taught her that a good woman asks for little, demands nothing, and dies quietly.

Gender inequality was not just in her home; it was in the policy rooms that never included her voice. It was in budgets that prioritised politics over health. It was in the subtle shrug of indifference that attends women’s complaints in clinics, especially poor women in rural areas. Her being female had already placed her lower on the ladder.

But perhaps what haunts me most is how everything seemed normal until someone opened the files. That day, long after she had gone, someone went back to the data room and began to look. Patterns emerged. Cases connected. Questions rose. “How many more like her?” they asked. “Could we have seen this coming?” It was research that awakened conscience. Data that pulled the curtain back. And isn’t that Nigeria’s truest shame that we often act only after counting the dead?

Mrs. X, for all her anonymity, is Nigeria. She is our health system in human form: underserved, overburdened, overlooked. Her blood loss is our policy hemorrhage. Her silence is our governance gap. Her death is our diagnosis.

It’s easy to talk about reforms. There have been many. Policies, papers, pilot schemes. But for every speech made in air-conditioned halls, there’s a Mrs X still sitting miles from care, still unsure if help will come. Nigeria does not lack ideas. It lacks continuity. It lacks compassion in implementation. It lacks the urgency that comes when you see the system as your own mother, your own sister, your own unborn child. We must stop planning in the abstract. We must stop building for applause and start building for impact. 

Health must become a right, not a privilege wrapped in bureaucracy. We must fund primary health care not as a checkbox but as a foundation. We must decentralize emergency care so that help is never more than a few kilometers away. We must invest not only in infrastructure but in mindsets, teaching every citizen that prevention is not a scam, and that seeking help is not weakness.

And crucially, we must disaggregate our data and listen to it. Research must not be something we dust off only when we need donor funds. It must be lived, continuous, grounded in our local realities. Because without data, we’re only guessing in the dark, while more Mrs. Xs are buried under statistics that came too late.

So, no, the story of Mrs X is really not about maternal mortality. It is about us. All of us. It is the story of a system that watches a woman bleed and scrambles for gauze. That waits until the final breath before asking the first question. That blames culture, then feeds it. That builds hospitals without building access. That speaks to the importance of health equity while communities barter herbs in silence. I saw Mrs X die. But more than that, I saw Nigeria in her eyes; tired, forgotten, hoping someone would care enough to fix what’s broken. 

Maybe, just maybe, if we learn to listen to her story, we won’t need another parable. Maybe her death won’t be in vain.

Oladoja M.O writes from Abuja and can be reached at: mayokunmark@gmail.com.