Lagos, Nigeria: Chief of Staff Femi Gbajabiamila has underscored the critical responsibility of governments in driving healthcare transformation across Nigeria.
He emphasised that sustainable progress hinges on strategic investment, policy innovation, and collaborative leadership to ensure accessible, quality care for all citizens.
Gbajabiamila, also the Guest Speaker, also advised the College of Medicine, University of Lagos, at the 63rd Founder’s Day celebration and the 18th Horatio Oritsejolomi Thomas Memorial Lecture in Lagos.
The theme of the lecture was: “Transforming Healthcare: The Role of Political Leadership.”
He highlighted the respective roles of the three tiers of government – the local, state and Federal Government in shaping the healthcare system for effective delivery.
Gbajabiamila said while the Federal Government sets national health policies and oversees tertiary institutions, it is the state and local governments that bear the crucial responsibility of ensuring access to quality healthcare.
“State governments are primarily responsible for managing secondary healthcare services, which include general hospitals and specialist centres,” he said.
Gbajabiamila, who said that coordination of Primary Healthcare Centres (PHCs) was officially under the jurisdiction of local governments, decried the reality that many local councils lack the capacity and resources to manage these services effectively.
Emphasising the different responsibilities of each government, he stressed the importance of coordination for basic health services, such as immunisations, maternal care, and treatment of common illnesses.
He noted that proper coordination would make these services accessible to people in both urban and rural areas.
“In the context of healthcare, political leaders have the power to set national and state priorities that place health at the centre of development.
“One of the truths we must consider is the fact that too much of the conversation around healthcare policy in Nigeria centres on the Federal Government when, in fact, it is the state and local governments that bear the greatest responsibility in ensuring access to quality healthcare,” he said.
He lamented that Nigeria’s healthcare indicators remained very troubling, despite the significant sums allocated to healthcare by successive federal and state governments.
According to him, the country has one of the highest rates of maternal and infant mortality in the world – over 512 maternal deaths per 100,000 live births and approximately 54 deaths per 1,000 live births.
He added that less than 10 per cent of Nigerians were covered by health insurance.
“Our doctor-to-patient ratio remains far below the World Health Organisation recommendation, making our life expectancy just 55 years.
“These statistics are not just numbers; they represent lives lost, families broken, and futures dimmed. Political leadership must confront this reality with urgency and resolve, beginning by admitting that much of what has been done over the years has not delivered the desired outcomes.
Gbajabiamila identified poor funding and corruption as major problems limiting the effectiveness of the healthcare system.
He underscored the need for collaboration among the three tiers of government to foster remarkable improvement in the healthcare system.
” Collaboration is key to unlocking this potential. State governments must work closely with the federal government, local councils, civil society organisations and the private sector.
“Such partnerships can enhance resource mobilisation, foster innovation, and ensure that services are responsive to community needs.
“For example, public-private partnerships have been successful in some states, where private firms manage public hospitals under performance-based contracts.
“These arrangements can improve efficiency and accountability while maintaining affordability,” he said.
Earlier, the College Provost, Prof. Ademola Oremosu, praised all the participants, saying that governments could transform the healthcare system if they had the “political will”.
Oremosu decried that health facilities were often far from people, as most hospitals were situated in urban areas.
He emphasised the need for intentionality in the selection of healthcare facilities, ensuring services are closer to the people who need them.
According to him, the three levels of government play a role in shaping healthcare, noting that local and state governments need to be more responsive.
“One of the problems is that healthcare facilities are often far away from the people.
“So, there should be intentionality in the citing of healthcare facilities, in the recruiting of healthcare workforce and in the funding and financing of healthcare.
“We need a healthcare system that will improve our indices in the maternal mortality rate, infant mortality and life expectancy,” Oremosu said.
