Civic Society Organisations (CSOs) under the Health Sector Reform Coalition have called for timely release of health budgets, stronger accountability for the Basic Health Care Provision Fund (BHCPF), transparent tracking of funds, expanded health insurance and improved financial protection for Nigerians.

]They also raised concerns over high out-of-pocket spending, fragmented health financing and continued dependence on external funding.

The Chair and Co-convener of the Nigeria Universal Health Coverage (UHC) Forum, Moji Makanjuola, said health must be placed firmly on the political agenda ahead of next year’s elections.

Makanjuola recalled that the forum engaged political parties and candidates during the 2023 elections through a citizen-led health agenda, which influenced health priorities in the manifestos of key parties.

She said the forum would convene a stakeholder workshop to review the agenda and develop an advocacy plan for the period before, during and after the elections.

She added that progress remained uneven, with evidence from the Gates Foundation-funded Exemplar Analysis Project showing “pockets of positive shifts” in some states, while others remained stagnant or deteriorated.

Also speaking at a CSO/media-led mid-year review of Nigeria’s health sector reforms in Abuja, Chairperson of the Health Sector Reform Coalition, Dr Muhammed Lecky, commended the reforms but said their success would depend on translating policy gains into functional primary healthcare services and measurable improvements in citizens’ lives.

Lecky urged government to use functional PHCs, rather than the number of renovated facilities, as a key measure of reform. He said such centres should have adequate health workers, essential medicines, basic diagnostics, electricity, water, infection-prevention systems, referral arrangements and maternal and child health services.

He said the Health Sector Renewal Investment Initiative and Sector-Wide Approach (SWAp) provided an important framework for coordinating federal and state governments, LGAs, development partners and communities.

However, Lecky warned that the gains must be institutionalised, adequately financed and targeted at underserved populations.

Citing the Nigeria Demographic and Health Survey 2023–24, he noted that although 79 per cent of women received antenatal care from skilled providers, only 43 per cent had four or more visits. Only 50 per cent of births were assisted by skilled providers, while 39 per cent of children aged 12–23 months were fully vaccinated with basic antigens.

He added that 14 per cent of children received no vaccinations, while 40 per cent of under-fives were stunted, including 21 per cent severely stunted. Modern contraceptive use among married women stood at 15 per cent, with 21 per cent reporting unmet need for family planning.

Lecky called for greater investment in health workers, including timely payment, rural incentives, safer working conditions, training and career progression.

Drawing lessons from the SCAPP project implemented by BudgIT and HSRC across Kaduna State’s 23 local councils, he said community participation should become a stronger pillar of health reform.

He also proposed a National Health Act Alignment and Implementation Matrix to identify policy overlaps and gaps, clarify responsibilities, harmonise guidelines, set timelines and provide for public reporting.

Minister of Health and Social Welfare, Prof. Muhammad Pate, said government was working to increase resources for healthcare and strengthen regulatory and professional institutions responsible for service quality and financing.

He identified medical supplies and infrastructure as priorities, stressing that sustained investment at federal, state and local government levels was required.

Pate cautioned that years of deterioration in the health sector could not be reversed overnight, saying reform would take time.

He also urged development partners to support Nigeria in ways that strengthen local capacity rather than create parallel systems.

The minister said stronger governance, accountability, adequate resources, institutions and community participation would be necessary to achieve lasting improvements, adding that CSOs remained important in identifying gaps and providing feedback on government policies and programmes.