Insecurity, workforce shortage threaten universal health coverage — Stakeholders

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Stakeholders in Nigeria’s health sector have warned that persistent insecurity, an acute shortage of healthcare workers, inadequate funding and weak constitutional provisions for healthcare are major obstacles to achieving Universal Health Coverage in the country.

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The stakeholders made the observation on Saturday during the 4th Annual Scientific Conference of the College of Health Sciences, Usmanu Danfodiyo University, Sokoto (UDUS), themed: “Universal Health Coverage in Nigeria: Overcoming Access and Workforce Gap in the Face of Insecurity.”

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They stressed that unless the challenges are urgently addressed through sustained investment, stronger policies and improved security, millions of Nigerians, particularly those in rural and conflict-affected communities, would continue to face limited access to quality healthcare.

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Speaking at the conference, Sokoto State Commissioner for Health, Dr. Faruk Abubakar, disclosed that the state government had introduced a two-year compulsory service policy for health professionals trained on state scholarships to bridge the widening manpower gap.

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He revealed that the distribution of health workers across the state remained uneven.

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“Some primary healthcare centres in urban areas have as many as 80 health workers, while some facilities in rural communities are managed by only one health worker. This imbalance must be corrected if we are to provide equitable healthcare services,” he said.

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The commissioner said the administration had awarded 500 scholarships for the training of midwives, renovated more than 160 primary healthcare centres, restored services in 92 facilities, and expressed confidence that all 244 PHCs in the state would become fully operational before the end of the year.

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Former member of the House of Representatives, Dr. Shehu Kakale, called for constitutional reforms to make healthcare a fundamental right for every Nigerian.

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According to him, healthcare remains a non-justiciable socio-economic objective under Chapter Two of the 1999 Constitution, making it difficult to hold governments accountable for healthcare delivery.

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“Health should be recognised as a fundamental right of every Nigerian. Without constitutional backing and adequate legislation, achieving universal health coverage will remain difficult,” he said.

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Kakale also lamented Nigeria’s failure to meet the 2001 Abuja Declaration, under which African countries agreed to allocate at least 15 per cent of their annual national budgets to the health sector.

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He noted that sustained financing remained critical to expanding healthcare access and addressing workforce shortages.

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Highlighting the effect of insecurity on healthcare delivery, Wamban Isa and Alhaji Nasiru Yahya Isa said nearly 40 per cent of primary healthcare centres across Sokoto East were facing serious operational challenges due to persistent bandit attacks.

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“Many health facilities, schools and entire communities have been abandoned as people flee to safer areas such as Sokoto and Isa. This has overstretched available health services and worsened poverty and sanitation challenges,” he said.

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He appealed to governments and development partners to prioritise healthcare delivery in conflict-affected communities to ensure that vulnerable populations were not left behind.

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Representing the Sultan of Sokoto, Alhaji Muhammad Alhassan, the Sarkin Sudan and District Head of Wurno, also stressed the need for innovative strategies to extend healthcare services to underserved communities affected by insecurity.

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Delivering the keynote address, Dr. Kurfi Abubakar, Director of Planning, Research and Statistics at the National Health Insurance Authority (NHIA), urged governments at all levels to take advantage of the financial autonomy of local governments to strengthen primary healthcare and expand health insurance coverage.

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He also advocated stronger collaboration between federal and state governments, increased use of data for policymaking, improved accountability mechanisms and strategic purchasing of health services to maximise limited resources.

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According to him, continuous investment in healthcare workers and greater community participation would be essential to sustaining healthcare programmes, particularly as donor support continues to decline globally.

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Representing the Minister of Defence, Colonel A. O. Akingbemila, conveyed the minister’s message that insecurity remained a major threat to the nation’s healthcare system.

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The minister, General Christopher Musa, said lasting improvements in universal health coverage would only be possible when peace and security were restored across the country.

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He stressed that tackling insecurity required a whole-of-society approach involving governments, security agencies, traditional institutions, civil society organisations and local communities.

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Earlier, the Provost of the College of Health Sciences, UDUS, Professor Abdulganiyu Jimoh, said the annual conference was organised to encourage collaboration among health professionals, policymakers and researchers in developing practical solutions to Nigeria’s healthcare challenges.

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He observed that insecurity and the growing wave of migration of health professionals, popularly known as the “japa” syndrome, had further depleted the country’s healthcare workforce.

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Jimoh reaffirmed the college’s commitment to producing highly skilled health professionals while advancing medical research and specialist services, including kidney transplant programmes.

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Nigeria continues to face significant challenges in achieving Universal Health Coverage despite several policy initiatives. According to health experts, shortages of skilled healthcare workers, poor funding, insecurity and the migration of medical professionals abroad have weakened healthcare delivery, particularly in rural communities.

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The Federal Government has repeatedly identified strengthening primary healthcare, expanding health insurance coverage and improving health workforce retention as key strategies for achieving universal access to quality healthcare.

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