Health Care

By Sadam Abubakar

I wish I could blow life into words. I wish the words could be woven to assume a shape and posture palpable to human beings.

My recent experience in bed with sickness made me long for words to have the ability to breathe, talk, and describe by themselves certain events that occurred to us in our lives. Some events and situations in our lives are beyond our ability to describe. The words should talk themselves.

The event that sparks my scribbling hand is a disease condition that turned me almost lifeless. It started as something not uncommon but metamorphosed into a thing of mystery and convolutions.

At a particular time of one day, my legs began to appear as if they didn’t belong to me. There was a slight headache and some traces of loss of appetite. These symptoms are common among people with malaria, an endemic disease in our region, especially this time of year. The next thing was the thought of taking P-Alaxin, a particular brand of antimalarial drugs, and some supporting drugs.

Two days later, my disease condition appeared to be getting worse, even though it didn’t cripple me in bed. I rushed to a particular medical lab for diagnosis, and after a rapid test for malaria, it appeared that the malarial parasite was still in my blood, running through my veins. The P-Alaxin drug didn’t kill the parasite in my blood? Maybe I needed to take more for a couple of days. I continued with the medication with P-Alaxin the next day, but to my surprise, the malarial parasite was still in me—perhaps even more active, since the disease succeeded in stagnating me at home for the whole day.

Combining therapeutics to treat a particular disease is arguably one of the best strategies to eliminate a disease that appears intractable. Thus, I received an intramuscular injection of chloroquine, continued with the P-Alaxin, and some supporting drugs. That day was the beginning of more suffering from the disease. I sustained a severe headache, and my body temperature kept alternating between high and low. I also occasionally shivered, and fatigue became my friend. I kept telling myself that today I would beat the malarial parasite in me, considering the combinatorial therapy. Was I right?

After a brief respite from the pain, I felt I could go out to the Masjid to pray Asr. I whispered to myself, no matter what, go and pray—who knows if it would be your last Asr to offer. I crawled to the bathroom, performed my wudu, and headed to the Masjid. I was walking while holding my head, as I could still feel the hammering of the disease in my head. I thought I could surmount that pain, and I kept going. Halfway to the mosque, the pain intensified, and I succumbed to the idea that I could only proceed to the mosque.

I managed to return home. But then another episode of the disease set in. My neck started bending, and my head followed. At some point, I had to ask my wife to straighten my neck to mitigate my pain. Meanwhile, I could feel my teeth gnawing at themselves, and some were abrading. I continued shivering while my wife still tried to cover me with a blanket. The situation escalated. The guy running the best medical lab in our town came. One of the best community health practitioners in our town, who is also my good friend, was summoned. They did what they could and assured things would be alright.

It seemed like they were right, given the temporary relief I had, but then things escalated around Isha prayer time. My mum came and prayed to me profusely. Almost all my family members came and offered their prayers for a speedy recovery, but things appeared to stand still. No progress in my health whatsoever! Finally, they all admitted I should be rushed to Ahmadu Bello University Teaching Hospital (ABUTH).

I already succumbed and felt I was going to die. My beloved brother, Alhaji Garba, shouted that his car should be driven out of the garage and that they should rush me to ABUTH. We started the journey, but before driving out of Soba, it started raining heavily. Musbahu, who was not only my good friend and neighbour, was the driver. He wanted to turn on the long-distance light, but he couldn’t because of confusion. He phoned Alhaji Garba to say the car’s lighting system was faulty. Another car was sent with another driver, and we journeyed to Zaria.

The road from Soba to Zaria is in poor condition. So many potholes on the main road, and the shoulder is no longer in existence in most parts of the road. I was lying with my head on the lap of my wife, in extreme pain. With every bump into an unavoidable pothole on the road, the incessant pain in my head increased. I lost hope. I started whispering Kalimatus Shahada, hoping it would be my last word, since I already knew we couldn’t reach the hospital while I was still alive.

With the pain still sustained, we reached Zaria while it was still raining. Instead of going to ABUTH, some argued that with the urgency of my situation, we should head to a private hospital, and that the bureaucratic process of ABUTH before my treatment could worsen my situation. We headed to Pal Hospital. They quickly examined me while I was telling the doctor I knew I couldn’t make it. The doctor, from my history, suspected immediately that I was suffering from cerebral malaria. He argued that because I was out of Nigeria for a very long time, my immune system might not be robust against malarial parasites, and that worsened my situation.

Alhamdulillah. I am writing this because I survived. After the medication, I finally recovered. But this whole experience has reminded me again that it doesn’t matter our age; we can die anytime. Our health is pretty tenuous, and death is always around the corner. May we live our lives with God consciousness so that we go to paradise in the hereafter.

Sadam Abubakar wrote via sadamabubakarsoba@gmail.com.

By Mallam Tawfiq

The scaffold that sturdily supports the pillar of success in everything is “unity”, without which we will somberly watch every beautiful thing in our everyday life running into a complete fiasco.

In healthcare settings, unity and peaceful coexistence among healthcare professionals are of paramount importance and a necessity for ensuring the delivery of effective, high-quality healthcare services.

To easily fathom the significance of that, should we reflect and ponder on the biological level of organisation of life? It succinctly and holistically depicted that the degree of unity among various cells leads to the formation of “body tissues”, and that the harmonious agreement among these tissues leads to the formation of “organs”.

Organs, however, organise to form a system, and thus the effective functioning of the respective systems yields a healthy life. Snags created by pathological factors deflect the spirit of harmonious union at different levels of this organisation, resulting in abnormality and disruption of robust, sound well-being.

The milieu of the hospital/healthcare settings comprises various health specialities from different professional backgrounds. This includes Medical Laboratory Science, Medical Radiography, Physiotherapy, Pharmacy, Nursing Science, Dentistry and Medicine, among others. The aims and objectives of each and every profession can only be appraised by rendering its best to the prime concern, and that is the patients.

As interdependent social animals tightly bound by the strong bond of humanity, we must interact, socialise, and, above all, reciprocate love and respect everywhere, be it in worship places, hospitals, banks, medical schools, and so on. The essence of so doing is to set our hearts and souls free from the bondage of emotional malice, attain optimum peace and maintain both physical and emotional well-being within ourselves. Unfortunately, the hostility, ranging from an exaggerated self-compliment and a show of self-worth and superiority to contempt for other professions in the name of rivalry amongst medical students and, to some extent, healthcare professionals, is worrisome and indeed condemnable.

Under whose tutelage in the medical school are students being mischievously taught that the six years of MBBS discipline should make them condescend and disregard other professions from being part of the healthcare system? Or the greater dispersion in the juxtaposition of the tense and heinous atmosphere under the five years of Radiography training with that of Medical Laboratory Science or Nursing renders the significance of the former and the insignificance of the latter. This is absolutely puerility of the highest degree. Each profession is worthwhile, and its ethics are centred on meeting the needs of patients.

Can we patiently have a proper dekko at how the systems of our body unite to execute their functions and maintain an equilibrium conducive to survival? What will happen if, for instance, the neural tissue says it is superior and appears to boss other systems, while the circulatory system, in response, denies it sufficient oxygen to meet its basic metabolic demand? Or what do we think is going to happen when the renal system quarrels with the immune system, whose function serves the body best, and both react so that one can predominate over the other and effectively carry out both the functions concurrently? Will this ever happen!? Capital NO.

Conspicuously, the hospital/healthcare environment is analogous to our biological level of organisation and how bodily systems work.

Togetherness leads to the existence of all sorts of misunderstandings; this is inevitably true, and the ripple effect of us not allying with one another is directed towards our subject of interest, which is the patient, because a medical doctor alone cannot efficiently run a whole hospital, nor can pharmacists or physiotherapists. As such, we need to come close, close enough together, thus respect our differences and welcome each other to specialise in one skill or the other and benefit from each other’s knowledge. Only by doing so can we render our best compassion to our patients.

There is a saying, “united we stand, divided we fall.”

Service to humanity is service to the Lord. May everything we do be solely for the sake of God and to attain the reward of God. Ameen.

Mallam Tawfiq, Physiotherapist, writes from Federal Teaching Hospital, Gombe.

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 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 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 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.

By Bashir Abubakar Umar 

Malaria remains one of the world’s most persistent public health challenges, particularly in tropical and subtropical regions. To gather more information about the disease, I contacted Dr Musa Muhammad Bello, who works with Aminu Kano Teaching Hospital (AKTH) in the Department of Community Medicine. It is a life-threatening disease caused by parasites of the Plasmodium genus, transmitted to humans through the bites of infected female Anopheles mosquitoes.

Despite advances in medicine and public health campaigns, malaria continues to claim hundreds of thousands of lives each year, with children under five and pregnant women among the most vulnerable groups.

Infection with Plasmodium falciparum, P. vivax, P. ovale, or P. malariae primarily causes the disease. The infection begins when an infected mosquito bites a person, releasing parasites into the bloodstream. These parasites travel to the liver, where they mature and multiply before re-entering the bloodstream to infect red blood cells.

Malaria is not spread directly from person to person; instead, it requires the mosquito as a vector. However, it can also be transmitted through blood transfusions, organ transplants, or from an infected mother to her child during pregnancy.

Symptoms of malaria typically appear 7 to 10 days after infection. Early signs include fever, chills, headaches, muscle aches, sweating, body weakness, vomiting, diarrhoea, and a change in taste. In severe cases, the disease can lead to anaemia, respiratory distress, organ failure, and even death if left untreated. Diagnosis is usually confirmed through laboratory methods, such as microscopic examination of blood smears or rapid diagnostic tests, which detect malaria antigens in the blood.

Malam Abdurrahman, a resident of Dorayi Babba, said that the mosquitoes used to bite him not only at night, but he also advises the general public to use nets for prevention.

Prevention is the most effective way to reduce malaria cases and deaths. Sleeping under insecticide-treated mosquito nets can significantly reduce the risk of being bitten at night, while indoor residual spraying kills mosquitoes that rest inside homes.

Eliminating stagnant water, clearing drainage systems, using window and door nets, applying body lotion, and fumigation are all measures that help reduce mosquito breeding grounds. In some high-risk regions, preventive antimalarial medication is recommended for vulnerable groups, including pregnant women, children under 5, and foreigners.

Hajiya Rabi’a, a resident of Tudun Yola, said that the mosquitoes prevent her from sleeping at night due to their bites, even when she is in a net.

Treatment for malaria depends on the type of Plasmodium parasite and the severity of the infection. Artemisinin-based combination therapies are currently the most effective treatments for P. falciparum malaria, which is the most dangerous form. Early and proper treatment is essential to prevent severe illness and to help break the cycle of transmission.

The global impact of malaria remains significant. According to the World Health Organisation, Africa accounts for more than 90% of malaria cases and deaths worldwide. Beyond its toll on health, the disease hampers economic development by reducing productivity, increasing healthcare costs, and deepening poverty in affected communities.

Although malaria is both preventable and treatable, it persists due to environmental factors, limited healthcare access, and poverty in many areas. A continuous global effort is essential, combining prevention methods, effective treatment, public education, and ongoing vaccine research. With dedication and coordinated actions, the world can progress towards eradicating malaria and creating healthier, safer communities.

Bashir Abubakar Umar wrote via baabum2002@gmail.com.

By Anas Abbas 

Abuja may soon face a sanitation crisis as contractors responsible for cleaning the city have threatened to suspend operations from September 25 over the non-payment of nine months’ wages.

The Association of FCT Solid Waste and Cleaning Contractors (AFSOWAC), which oversees sanitation services across 44 lots in the capital, raised the alarm in a letter to the Coordinator of the Abuja Metropolitan Management Council.

“Despite our loyalty and sustained service delivery, we have not received payments since January 2025,” the group said. “We have reached a point where passion and commitment alone cannot sustain this essential service. Without payment, we cannot continue.”

According to the association, its members clear more than 1,000 tonnes of refuse daily using over 100 refuse trucks and 60 tippers, while engaging more than 3,000 workers. Many of these workers, it said, depend solely on the job for their livelihoods.

AFSOWAC disclosed that contractors had kept operations afloat by borrowing heavily from banks and informal lenders, but warned that such means had been exhausted. It added that the Abuja Environmental Protection Board (AEPB), which supervises their contracts, had continued issuing daily directives without addressing the financial challenges.

The contractors further lamented the deteriorating state of the Gosa dumpsite, describing it as “deplorable” and urging urgent intervention to improve access roads and equipment.

They also called on the FCT Administration to expedite the procurement process initiated in October 2024 and review payment rates to reflect current economic realities, such as the removal of subsidies and the devaluation of the naira.

The association warned that a strike would trigger a rapid build-up of waste in Abuja, a city renowned for its relative cleanliness, and could expose residents to serious public health risks.

“We can no longer guarantee uninterrupted services in the Federal Capital City without urgent payment,” AFSOWAC cautioned.