Nigeria UHC Forum urges stronger commitment to sustain health reforms

By Ojoma Akor

ABUJA — The Nigeria UHC Forum has called for stronger commitment, sustainable financing and greater accountability to ensure that ongoing health sector reforms translate into lasting improvements in healthcare access and outcomes for Nigerians.

The Chair and Co-convener of the Forum, Chief (Mrs) Moji Makanjuola, made the call in Abuja during the civil society- and media-led mid-year review of Nigeria’s health reforms dialogue, organized by the Health Sector Reform Coalition (HSRC) and the Nigeria Universal Health Coverage (UHC) Forum.

Makanjuola said the review should go beyond assessing policies, programs and activities to determine whether the reforms are building a resilient health system capable of sustaining gains and responding to future shocks.

She said the review allowed non-state actors to collectively interrogate the progress of Nigeria’s health transformation agenda in the presence of the country’s chief health policymaker and heads of health Ministries, Departments and Agencies.

“The true measure of reform is not simply what is initiated, but what is institutionalized, sustained and translated into better health outcomes for Nigerians,” she said.

According to her, critical areas requiring attention include leadership, institutional capacity, community ownership, sustainable health financing, accountability, and the health system’s ability to absorb shocks while continuing to deliver essential services.

Makanjuola said the Forum recognized positive shifts in some health indicators, citing findings from the ongoing Gates Foundation-funded Exemplar Analysis Project.

However, she said progress remained uneven across the country, with some states recording stagnant or deteriorating health indicators.

UHC requires political commitment

The UHC Forum chair also described health investment as fundamentally a political decision, saying the Forum would continue working to place health higher on Nigeria’s political agenda.

She disclosed that the Forum developed a citizen-led health agenda during the 2023 election cycle and engaged political parties and candidates at national and state levels through policy dialogues and advocacy.

According to her, the advocacy helped include citizens’ health priorities in the manifestos of key political parties.

With the 2027 elections approaching, Makanjuola said the Forum would again use the electoral policy window to build political support for health.

She announced that the Nigeria UHC Forum, in collaboration with development partners, the Health Sector Reform Coalition (HSRC), and other stakeholders, would organize a stakeholder workshop in October to review the citizen-led health agenda and develop an action plan for the period before, during, and after the elections.

Domestic resources critical

The Coordinating Minister of Health and Social Welfare, Prof. Muhammad Ali Pate, has said Nigeria must gradually move away from dependence on donor funding for health and strengthen domestic financing to sustain critical health programs.

Pate said the changing global funding environment, coupled with competing priorities in donor countries, made it necessary for Nigeria to take greater responsibility for financing its population’s health.

Speaking during an interview session with Chief (Mrs.) Moji Makanjuola, Chair and Co-convener of the Nigeria UHC Forum, at the dialogue, Pate said Nigeria had benefited significantly from bilateral, multilateral and philanthropic support over the past 25 years, particularly in areas such as HIV, immunization and other global health priorities.

However, he said the country could no longer assume that external partners would continue to finance its health needs at the same level.

He added that Nigeria had gradually become dependent on external financing, and that the changing global environment was already putting pressure on donor resources.

According to him, wealthier countries are increasingly directing resources towards defense, conflicts, climate change, migration and domestic challenges, reducing the resources available for international development assistance.

Pate said the pathway out of donor dependency was for the federal, state and local governments to increase domestic investment in health.

He stressed, however, that increased domestic health financing would depend partly on the country’s broader economic and fiscal position.

He said removing the subsidy had created additional revenue for the federal and state governments, which could potentially be channeled toward social sectors such as health and education.

Pate also said improved tax collection, rather than simply increasing taxes, could expand the pool of resources available for government investment.

He noted that Nigeria’s government revenue had historically been low relative to the size of its economy, making improved revenue mobilization essential to financing public services.

Pate further identified reforms to the Basic Health Care Provision Fund and excise taxation as other potential avenues for increasing health resources.

He said expanding health insurance coverage was also important because Nigerians already spend substantial amounts on healthcare out of pocket. Still, those resources are not efficiently pooled to spread health risks.

Pate also explained the rationale behind Nigeria’s Sector-Wide Approach (SWAp), saying it was designed to address fragmentation in the country’s health sector and place government more firmly at the center of coordination and accountability.

The minister also highlighted progress in efforts to expand domestic manufacturing of medicines, medical supplies and other health commodities.

He said investments were being made in the local production of pharmaceutical products, rapid diagnostic tests, medical equipment, intravenous fluids and family planning commodities.

Pate outlines health outcomes to watch by 2027

Asked what measurable results citizens and civil society should use to assess the health reforms over the next year, Pate pointed to reductions in maternal and child mortality, increased skilled birth attendance and immunization coverage, and increased health financing by states.

He said the government was already seeing improvements in some population-level indicators, including maternal health and contraceptive use.

According to Pate, data from a recent population survey covering the 2024–2026 period showed increases in contraceptive use, skilled birth attendance and other indicators.

He cited a reported 17 percent reduction in maternal mortality in some local government areas compared with 2023 and said the government aimed to deepen these gains.

He also pointed to the need for further reductions in child mortality and improved immunization coverage.

Pate stated that sustained implementation of the reforms would be important to achieving these outcomes, particularly given Nigeria’s population size and its impact on continental health indicators.

The minister’s comments come amid calls from civil society and health sector stakeholders for greater accountability in implementing Nigeria’s ongoing health reforms, including stronger domestic financing, improved coordination, and measurable improvements in health outcomes.