Repositioning Nigeria’s health sector requires moving from fragmented, reactive interventions to system-wide reform anchored on governance, financing, and accountability.
First, health workforce stability must be prioritised. Recurrent strikes are symptoms of deeper issues, poor remuneration structures, unclear career progression, unsafe working conditions, and weak social dialogue.
Government must institutionalise structured engagement with health professional bodies, backed by enforceable collective agreements and predictable funding.
The integration of states like Lagos into the National Health Workforce Registry is a critical step, as real-time data allows for better planning, equitable deployment, and targeted incentives to address workforce gaps.
Second, sustainable financing is non-negotiable. While increased allocations, such as the N32.8 billion Basic Health Care Provision Fund releases, the proposed N42.18 billion for vulnerable populations, and mandatory national health insurance, are encouraging, funding must translate into outcomes.
This requires strengthening purchasing systems, enforcing performance-based disbursement, and improving last- mile delivery. The National Health Insurance Authority’s reforms to reduce out-of- pocket spending and sanction erring providers show that financing and accountability must go hand in hand.
