Скачать или смотреть Strengthening Health Governance, Fostering Collaboration, and Ensuring Accountability

On July 10, 2025, Dr. Jemchang Fabong of Nextier Health brought together two of Nigeria’s key health system thinkers, Dr. Gafar Alawode (Development Governance International) and Dr. Abubakar Kurfi (National Health Insurance Authority), for a robust conversation on fixing the core of Nigeria’s failing health system: governance.

The speakers didn’t mince words. Nigeria faces a staggering 28% of global maternal deaths, and the real tragedy isn’t just the deaths, it’s that no one is acting like it’s an emergency.

Dr. Gafar reframed governance not as a bureaucratic checklist, but as the operating system of the health system. He laid out six areas Nigeria struggles with: weak leadership, inconsistent policies, poor institutional structures, lack of coordination, minimal accountability, and ignorance of political realities. The result? Data that should spark reform gets ignored. Facilities are mismanaged. Healthcare workers are absent. The system is on autopilot.
Dr. Kurfi focused on health financing. He emphasised that the shift from NHIS to NHIA is meaningful only if policies translate into services for real people, especially the poor, pregnant women, and children. But insurance is meaningless without quality care. You can’t hand someone a card and call it coverage when clinics lack drugs, staff, or electricity.

Both agreed that data governance is the bedrock of reform. Nigeria can’t even agree on its population size, which is a foundational figure for planning. This chaos affects everything from funding to tracking results. The Basic Health Care Provision Fund, designed to support PHCs, often allocates funds based on guesses, not evidence.

Yet, there are glimmers of hope. One state used workforce data to fix its staffing imbalance, converting redundant admin staff into clinical support roles. Another program offers pregnant women free C-sections and automatic health insurance enrolment, a great idea that hinges on functioning data systems.

The panel also tackled community accountability. While public oversight is key, it’s often weak or manipulated. Dr. Gafar warned against over-romanticising community structures, noting that local leaders sometimes collude in fraud. Instead, he suggested more thoughtful community engagement, with well-trained, motivated members and real incentives.

Another gap is coordination across sectors. Ministries and agencies often work in silos. However, the Nigeria Centre for Disease Control’s leadership during COVID-19, uniting health, agriculture, finance, and more, showed that multisectoral collaboration is possible when accountability is clear and progress is tracked.

The message was clear: universal health coverage isn’t just about more funding or programs — it’s about fixing the system. It requires consistent leadership that sees beyond political cycles, institutions that are transparent and functional, and a financing system where money translates to services that work. Data must be trusted, timely, and used to make decisions. Most importantly, it requires everyday Nigerians to be informed, engaged, and unafraid to demand the care they deserve.

This isn’t just about health, it’s about development, equity, and dignity. Dr. Gafar concluded, “We cannot afford to outsource our development vision. Nigeria must define, own, and be held accountable for it.”