Health sector leaders and policymakers on Thursday outlined urgent steps Nigeria must take to strengthen primary healthcare (PHC) delivery and mobilise sustainable financing in a rapidly shifting post-aid environment.
They spoke at the 2025 National Health Dialogue hosted by PREMIUM TIMES in partnership with the Centre for Journalism Innovation and Development (CJID), with support from the Gates Foundation.
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The forum brought together government officials, global health experts, civil society actors and journalists under the theme: “Evidence, Innovation, and Financing for a Healthier Nigeria.”
The real cost of PHC
A panel moderated by Tolulope Aderelu-Balogun of News Central featured the Executive Secretary of the Kaduna State Primary Health Care Board, Bello Jamoh; Executive Secretary of the Kwara SPHCDA, Nusirat Elelu; CEO of Nisa Premier Hospital, Ibrahim Wada; Editor-in-Chief of the African Journal of Health Economics, Obinna Onwujekwe; and PREMIUM TIMES Health Editor, Nike Adebowale-Tambe.
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The session examined the “Real Cost of Primary Healthcare: Examining the State of PHC Delivery at the Sub-National Level.”
Mr Jamoh said Kaduna State now replaces retiring health workers immediately to prevent service disruption. He noted that the state manages 260 PHCs, “with more than 200 fully functional,” and is building “generation-to-generation health capacity” through strong supervision and community engagement.
Mrs Elelu said Kwara is revitalising at least one fully functional PHC per LGA and has recruited “over 1,000 health workers this year.”
She added that upgraded PHCs now run 24-hour services supported by security personnel, perimeter fencing and staff quarters. The state, she said, is also strengthening equitable distribution, digital capacity and emergency response.
Mr Wada underscored the role of investigative journalism in improving health accountability, noting that despite troubling public health indices, private-sector contributions and public–private partnerships offer hope for better outcomes.
Speaking on the media’s role, Mrs Adebowale-Tambe said many health workers are afraid to share information because of job insecurity. She highlighted the impact of visual storytelling: “The documentary shown today made the crisis feel more real. Faces and suffering were visible.”
She urged newsrooms to collaborate more, citing global cross-border projects such as the Panama Papers and Pandora Papers.
Addressing PHC security concerns, Mrs Elelu said protection levels differ by community risk but insisted that all upgraded PHCs in Kwara “must have dedicated security personnel” to operate round-the-clock.
Mr Jamoh said sustainable PHC development requires balancing political priorities with technical needs. Kaduna, he said, aims to reduce maternal mortality by 25–30 per cent in two years through improved labour management, emergency response training, and strengthened reproductive health care.
Financing health in a post-aid era
A second panel moderated by Enitan Tejuoso of the Presidential Initiative for Unlocking the Healthcare Value Chain (PVAC) featured Charles Doherty of the Ekiti Health Insurance Scheme; Uchenna Igbokwe, CEO of Solina Centre; Amina Dorayi, senior country director at Pathfinder International; and Biobele Davidson, Strengthening Health Systems lead at BudgIt.
Mr Igbokwe warned that Nigeria’s heavy dependence on external funding for immunisation and other public health programmes is unsustainable. He called for expanded mandatory health insurance, an increase in the Basic Health Care Provision Fund from one to two per cent, and more strategic private-sector participation.
Ms Dorayi said Nigeria must “build a sovereign health system” by reducing reliance on aid. She proposed that every state ministry dedicate one per cent of its budget to a community-managed health trust fund. She also emphasised preventive care, lifestyle modification, clear health communication, and treating women’s health as a “state of emergency.”
Mr Doherty said Nigeria must move from rhetoric to action, noting that out-of-pocket spending remains above 70 per cent, while most states allocate less than five per cent of their budgets to health—far below the Abuja Declaration target. He added that donor funds “often get lost in logistics,” with up to 65 per cent spent on overheads rather than services.
Ms Davidson highlighted the need for community ownership, transparency and digital accountability tools such as the PHC Tracker. She said decisions must “reflect the voices of those affected” and called for stronger budget credibility and data-driven planning.
Mr Igbokwe added that Nigeria must cultivate “millions of local health champions,” citing the Community Women’s Orientation Network, which trains young women who already deliver vaccines house-to-house to serve as community health educators.
Federal government commitments
Earlier, the Minister of Health and Social Welfare, Muhammad Pate, said the federal government is working to secure the highest health budget in Nigeria’s history, curb wasteful spending and strengthen accountability.
READ ALSO: Health ministry, ICPC sign agreement to boost transparency in PHCs
He said decades of underinvestment, weak governance and unclear responsibilities have denied Nigerians reliable healthcare.
The 2025 Dialogue
The dialogue also featured a fireside chat with Mr Pate, alongside remarks from the NPHCDA Director-General, Muyi Aina; the NACA Director-General, Temitope Ilori; and several state health commissioners.
A dedicated session on state-level financing priorities for 2026 featured presentations from the Permanent Secretary of the Abia State Ministry of Health, Ifeyinwa Blossom; the Jigawa State Commissioner for Health, Muhammad Kainuwa; and the Katsina State Commissioner for Health, Musa Funtua.
The event also showcased outstanding health journalism by PUNCH Newspaper, community health engagement strategies by Nigeria Health Watch, and health innovation exhibitions by DRO Health, HelpMum and Dobic Health.
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