By David Lawani, Abuja
Civil society organisations have challenged the Federal Government to translate its health sector reforms into measurable improvements in healthcare delivery, even as the Coordinating Minister of Health and Social Welfare, Prof. Muhammad Ali Pate, defended the administration’s record and called for continuity.
The Health Sector Reform Coalition (HSRC) said the success of the reforms should no longer be measured by policies launched, facilities renovated or funds allocated, but by their impact on ordinary Nigerians.
Chairperson of the coalition, Dr Muhammed Lecky, spoke during a mid-term assessment of the Federal Government’s health reform programme in Abuja.
Lecky acknowledged progress under the current administration but said the gains must be protected, institutionalised and converted into measurable outcomes, particularly for underserved communities.
The coalition said the current reform agenda, including the Health Sector Renewal Investment Initiative and the Sector-Wide Approach (SWAp), provided an opportunity to address longstanding fragmentation in the health sector.
It noted that the framework brought the Federal Government, states, local governments, development partners and communities around shared priorities.
However, the organisations warned that improved coordination must ultimately be reflected in the quality of care available to Nigerians at the point of service.
They particularly urged the government to move beyond counting renovated primary healthcare centres and determine whether such facilities were actually functional.
According to the coalition, functional primary healthcare centres require adequate health workers, essential medicines, basic diagnostic services, water, infection-prevention systems, referral arrangements and maternal and child health services.
The CSOs also identified high out-of-pocket expenditure, delayed release of funds, fragmented financing and dependence on external funding as major threats to effective healthcare delivery.
“Health financing should therefore be judged not only by what is allocated, but by what reaches the frontline and what services those resources produce,” the organisations stated.
The coalition’s concerns were reinforced by health indicators cited from the Nigeria Demographic and Health Survey (NDHS) 2023–24.
The CSOs noted that although 79 per cent of women received antenatal care from a skilled provider, only 43 per cent had four or more antenatal visits.
They also reported that only 50 per cent of live births were assisted by skilled providers, while just 39 per cent of children aged 12–23 months were fully vaccinated with basic antigens.
The organisations further noted that 14 per cent of children in the age group had received no vaccinations.
On nutrition, they said about 40 per cent of children under five were stunted, including 21 per cent who were severely stunted.
The coalition argued that the figures showed the need to measure reform by outcomes rather than administrative milestones.
It also warned that national averages could conceal serious inequalities in poorer communities, remote rural areas and among populations facing barriers to healthcare.
Responding to the concerns, Pate said the administration was recording tangible improvements, and that continuity was necessary to consolidate the gains.
The minister said a reported 10 per cent reduction in maternal mortality had been recorded in participating local government areas compared with 2023.
He said the government was targeting further reductions in maternal and neonatal mortality by 2027, alongside improved skilled birth attendance, immunisation coverage and availability of resources for healthcare delivery at the state level.
“We know that the work of this administration in the last three years is tangible and is showing impact at the population level,” Pate said.
He identified continuity as critical to sustaining the reforms, warning that abandoning initiatives already underway could result in delays and loss of momentum.
“In my mind, the single most important outcome that we should aim for by this time in 2027 is having President Bola Tinubu in his position to continue the reforms. Because he’s invested so much, he’s laid the foundation,” Pate said.
The minister also highlighted changes in health sector governance, saying the Federal Government and states were now working through aligned operational plans, quarterly performance dialogues and joint annual reviews.
He said the new approach placed government at the centre of health-sector coordination while requiring development partners to align their interventions with national priorities and greater transparency.
“We have objectives that are aligned, even if how we reach them is different in Bayelsa than in Zamfara,” Pate said.
According to him, the government was strengthening monitoring and evaluation through quarterly performance reviews with states, while a joint annual review would be conducted in November.
Pate also pointed to the State of Health of the Nation Report as a mechanism for tracking progress and giving Nigerians clearer information about activities and outcomes across the sector.
Another area highlighted by the minister was domestic production of pharmaceuticals, medical equipment and other healthcare commodities.
He said expanding local manufacturing would reduce Nigeria’s dependence on imports, create jobs, limit exposure to foreign exchange pressures and potentially lower the cost of medicines.
Pate disclosed that the government was supporting skills development for young Nigerians seeking employment in the pharmaceutical and manufacturing sectors.
He said about 2,000 young Nigerians had been trained through Empower Academy, a Swiss academy, to acquire practical skills required by the industry.
Meanwhile, Chairman and Co-convener of the Nigeria Universal Health Coverage Forum, Chief (Mrs.) Moji Makanjuola, said civil society would continue to monitor the implementation of health reforms and promote evidence-based accountability.
Makanjuola said the media had a critical role in helping citizens understand health policies and demanding accountability from government.
She urged journalists to strengthen evidence-based reporting on healthcare financing, service delivery, equity and access to quality care.
She said the Nigeria UHC Forum and HSRC would use the 2027 electoral cycle to push healthcare higher on the political agenda and secure commitments from political parties and candidates.
Makanjuola also disclosed plans for a stakeholder workshop in October to review the citizen-led health agenda and develop an action plan to be implemented before, during and after the 2027 elections.
The competing positions have placed the focus of Nigeria’s health reform agenda on whether policy changes, increased coordination and investments can translate into sustained improvements in healthcare delivery, particularly for vulnerable communities.
