Health sector stakeholders have warned that insecurity, inadequate manpower, poor funding and weak legal frameworks are slowing efforts to achieve universal health coverage (UHC) in Nigeria.
The concerns were highlighted on Saturday during the fourth annual scientific conference organised by the College of Health Sciences, Usmanu Danfodiyo University, Sokoto (UDUS), where experts discussed ways to improve healthcare access and address workforce challenges.
The conference, themed “Universal Health Coverage in Nigeria: Overcoming Access and Workforce Gaps in the Face of Insecurity,” featured about 120 research presentations and was chaired by Prof. B.B. Shehu.
Sokoto State Commissioner for Health, Faruk Abubakar-Wurno, who spoke at the event, noted that the state was struggling with unequal distribution of healthcare workers, especially between urban and rural primary healthcare centres.
He explained that while some urban facilities have as many as 80 healthcare workers, some rural centres operate with only one staff member, creating challenges in delivering quality services to residents.
To tackle the shortage, Abubakar-Wurno said the state government had introduced a mandatory two-year service programme for health professionals trained through government scholarships, ensuring they work in underserved areas.
He added that Sokoto had provided 500 scholarships for midwifery training, renovated over 160 primary healthcare centres and revived operations in 92 facilities across the state.
According to him, plans were underway to make all 244 primary healthcare centres in the state fully functional before the end of the year.
A former member of the House of Representatives and former Sokoto Health Commissioner, Shehu Balarabe-Kakale, called for constitutional reforms that would recognise healthcare as a fundamental right of Nigerians.
He argued that because healthcare is currently listed as a non-justiciable objective under Chapter Two of the Nigerian Constitution, citizens have limited avenues to demand accountability from government.
Balarabe-Kakale also criticised Nigeria’s failure to meet the 15 per cent health budget target agreed under the 2001 Abuja Declaration, despite increasing healthcare needs.
He stressed that stronger laws, improved funding and long-term commitment were necessary to strengthen the health system and bridge workforce gaps.
On the impact of insecurity, Wamban Isa, Alhaji Nasiru Yahaya-Isa, disclosed that about 40 per cent of primary healthcare centres in Sokoto East were facing serious operational difficulties due to bandit attacks.
He said insecurity had forced many residents to abandon their communities and relocate to safer areas such as Sokoto and Isa, increasing pressure on existing health facilities.
Yahaya-Isa added that displacement had worsened poverty, disrupted agriculture and commercial activities, while contributing to sanitation challenges, including increased cases of open defecation.
He urged governments and development organisations to prioritise healthcare delivery in conflict-affected and hard-to-reach communities.
Representing the Sultan of Sokoto, Alhaji Sa’ad Abubakar, the district head of Wurno, Alhaji Kabiru Cigari, called for innovative solutions to improve healthcare services in insecure areas.
The Director of Planning, Research and Statistics at the National Health Insurance Authority (NHIA), Abubakar Kurfi, outlined measures needed to speed up Nigeria’s progress towards universal health coverage.
Kurfi encouraged governments to utilise local government financial autonomy to increase investment in primary healthcare and expand health insurance coverage.
He also advocated stronger collaboration among federal, state and local governments, evidence-based planning and better strategies for managing the shift from donor-supported health programmes.
He recommended strategic healthcare purchasing, improved accountability, workforce development and greater community involvement in health initiatives.
The Minister of Defence, Gen. Christopher Musa, represented by Col. A.D. Akinyele, said tackling insecurity was essential to achieving sustainable improvements in healthcare delivery.
Musa said resolving security challenges required cooperation between government agencies, communities and other stakeholders through a collective approach.
Earlier, UDUS College of Health Sciences Provost, Abdulganiyu Jimoh, said the conference aimed to encourage partnerships, knowledge sharing and practical solutions to healthcare challenges.
Jimoh noted that insecurity and the migration of professionals abroad, popularly known as “japa”, had worsened shortages in the health workforce, while reaffirming the institution’s commitment to training skilled healthcare professionals and advancing research.