Academy of Medical Sciences Reels Out Measures to Achieve Universal Health Coverage in Nigeria

The Academy of Medical Sciences has reaffirmed its readiness to partner with federal and state authorities towards achieving Universal Health Coverage in Nigeria, working alongside relevant public health institutions to drive the execution of strategic directives.

The Academy says achieving the UHC in Nigeria requires sustained executive leadership, strategic fiscal allocation, and multi-sectoral governance coordination.

Consequently, the Academy recommended three high-level policy measures, comprising the fulfillment of health financing commitments, operationalization of statutory frameworks, and the enforcement of institutionalized accountability mechanisms.

The Academy said annual health sector budgetary allocations should be progressively scaled toward the fifteen percent baseline established by the 2001 Abuja Declaration to ensure sustainable financing for UHC.

It also called for the fast-tracking of comprehensive implementation and enforcement of all statutory provisions under the National Health Act, 2014, with emphasis on the Basic Health Care Provision Fund.

Finally, the Academy of Medica Sciences called for the establishment of a Presidential Oversight and Monitoring Committee to track national progress across key health indicators, specifically health workforce expansion, maternal mortality reduction, and biosecurity preparedness.

The recommendations were contained in a communique from the AMS’ Maiden Biennial Presidential Colloquium, with the theme: “Nigeria’s Health at a Crossroad: Confronting Workforce Shortages, Epidemic Risks, and Maternal Mortality”.

According to the document jointly signed by the President of the Academy, Emeritus Professor OSATO FRANK GIWA-OSAGIE, and the Secretary of the Academy, Professor Mayowa Owolabi, the MSA recommended the enforcement of competitive remuneration schemes and flexible post-retirement contracts, as well as non-financial incentives, such as improved workplace safety standards, as part of measures to discourage the brain drain syndrome affecting the health sector.

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THE MAIDEN BIENNIAL PRESIDENTIAL COLLOQUIUM - NIGERIA’S HEALTH AT A CROSSROAD: Confronting Workforce Shortages, Epidemic Risks, and Maternal Mortality

PREAMBLE

The Academy of Medical Sciences (ACADMEDS), formerly the Academy of Medicine Specialties of Nigeria, is an independent, non-profit organization dedicated to providing objective guidance on public health, medical education, research, and healthcare policy.

Advancing its core mission to foster excellence across medical education and translational research, ACADMEDS hosted its Maiden Biennial Presidential Colloquium on Thursday, 30 July, 2026, at the Old Great Hall, College of Medicine, University of Lagos, Idi-Araba, Lagos. The event convened academic leaders, healthcare professionals, policymakers, and the public.

The Academy's President, Emeritus Professor Osato Frank Giwa-Osagie, FAMedS, OON, delivered the keynote address titled: "Nigeria’s Health at a Crossroad: Confronting Workforce Shortages, Epidemic Risks, and Maternal Mortality." His presentation drew commendation from the Governor of Lagos State, His Excellency Babajide Sanwo-Olu, represented by Dr. Oludayo Olajide, Permanent Secretary of the Lagos State Ministry of Health. Following the keynote, a panel of distinguished experts led technical presentations and discussions across four strategic thematic areas:

1. Addressing Health Workforce Challenges in Nigeria – Distinguished Professor Akin Osibogun, FAMedS
2. Combating Maternal Mortality: Current Realities and Strategic Imperatives – Professor Adetokunbo O. Fabamwo, FAMedS
3. Epidemics and Pandemics: The Nigerian Experience and Preparedness – Dr. Jide Idris.
4. Optimizing Rapid Response: Mechanisms for Health Emergencies – Professor Obinna Onwujekwe, FAMedS

​ SUMMARY OF KEY ISSUES

1. Health Workforce Challenges (Human Resources for Health - HRH)

1. Critical Supply Deficit: Human Resources for Health (HRH) remain the foundational determinant of health system performance and outcomes (WHO). Although the African continent bears 24% of the global disease burden, it commands access to merely 3% of the global health workforce.
2. Geographic Disparities and Systemic Retention Barriers: Over 70% of practicing medical practitioners in Nigeria are concentrated within five urbanized administrative zones (Lagos, FCT, Rivers, Kano, and Kaduna), leaving rural populations disproportionately underserved. This distribution crisis is exacerbated by non-commensurate remuneration, inadequate healthcare infrastructure, structural policy misalignment between the Ministries of Education and Health and accelerated international physician emigration ("brain drain").

2. Maternal Mortality

1. Epidemiological Burden of Maternal Mortality: Nigeria accounts for approximately 28% of global maternal deaths, driven predominantly by preventable direct obstetric complications, including severe postpartum hemorrhage, pre-eclampsia/eclampsia, and obstructed labor. The mortality is concentrated in northern Nigeria and compounded by poor uptake of family planning and lack of independent medical decision making by women of child-bearing age.
2. Structural Determinants: Key systemic drivers include catastrophic out-of-pocket health expenditure, sub-optimal referral logistics between primary and tertiary care tiers, poor Antenatal Care (ANC) utilization, and a pronounced deficit of skilled birth attendants at the primary care level.

3. Epidemic Preparedness and Biosecurity

1. Vulnerability to Outbreaks: Recurrent endemic infectious disease outbreaks—including Lassa fever, cholera, and viral hemorrhagic fevers—underscore persistent vulnerabilities in national biosecurity and outbreak containment frameworks.
2. Operational Bottlenecks: Systemic deficiencies include fragmented inter-agency coordination, sub-optimal Infection Prevention and Control (IPC) implementation, limited diagnostic/laboratory infrastructure, and delayed real-time epidemiological surveillance capability.

4. Emergency Response Architecture

1. Structural Delays: Sluggish emergency capital mobilization, administrative rigidity, weak multi-sectoral linkages, and an over-reliance on ad-hoc, reactive interventions severely impede the velocity and efficacy of public health emergency responses.

STRATEGIC RECOMMENDATIONS

To mitigate these systemic vulnerabilities, the colloquium articulated the following strategic directives:

1. Transform Health Workforce Production and Retention

1. Implement the COBMES Model: Upgrade designated General Hospitals nationwide to serve as accredited clinical training centers for medical students under the Community-Oriented-Based Medical Education System (COBMES) framework, thereby scaling training capacity and output.
2. Inter-Ministerial Governance Alignment: Establish an institutional joint planning interface between the Federal Ministry of Health (the primary employing authority) and the Federal Ministry of Education (the regulating/producing authority) to harmonize human capital supply with national health system demands.
3. Institutionalize Retention Packages: Enforce competitive remuneration schemes, including universal implementation of the Consolidated Medical Salary Structure (CONMESS) for academic clinical staff, and introduce non-financial incentives (e.g., subsidized housing/mortgage schemes, improved workplace safety standards, and flexible post-retirement contracts for expert clinicians).
4. Targeted HRH Financing: Capitalize a dedicated HRH fund leveraging an estimated additional $2.80 per capita annually ($540 million per annum) to expand pre-service training infrastructure, fund educational subsidies, and accelerate public sector recruitment.

2. Optimize Maternal and Child Healthcare Systems

1. Scale Emergency Obstetric and Newborn Care (EmONC): Standardize Primary Healthcare (PHC) facilities by deploying essential life-saving technologies, including Non-Pneumatic Anti-Shock Garments (NASG), Uterine Balloon Tamponades (UBT), misoprostol, and magnesium sulfate, supported by integrated emergency transfer protocols.
2. Workforce Deployment and Universal Access: Guarantee equitable distribution of certified midwives to hard-to-reach areas while establishing universal point-of-care subsidies for essential maternal and child health services. The Abiye model from Ondo State which reduced maternal mortality by 85%, should be adopted nationwide.
3. Strengthen Hemovigilance and Blood Banking Systems: Establish regional, functional blood supply networks to ensure rapid, safe blood access for managing postpartum hemorrhage. Blood donation by the husband was an effective solution.

3. Fortify National Health Security Infrastructure

1. Institutional Enhancement of NCDC: Secure predictable, multi-year funding and expand operational capacity for the Nigeria Centre for Disease Control and Prevention (NCDC) and state-level Public Health Emergency Operations Centers (PHEOCs).
2. Surveillance and Diagnostic Capacity: Invest in domestic genomic surveillance, decentralized biosafety laboratory networks, and community-level early warning systems to accelerate outbreak detection and response.
3. Pay attention to the growing burden of non-communicable diseases: Improve surveillance, prevention, acute care and rehabilitation services for non-communicable diseases.

4. Operationalize Emergency Response Architecture

1. Operationalize the One Health Platform: Fully institutionalize a multi-sectoral One Health framework integrating human, animal, and environmental health surveillance bodies for unified emergency action.
2. Ring-Fenced Contingency Funding: Establish an autonomous National Health Emergency Reserve Fund to permit immediate financial disbursement during acute health crises.
3. Deployment Readiness: Train and maintain permanent, state-level Rapid Response Teams (RRTs) configured for immediate strategic deployment.

CALL TO ACTION AND INSTITUTIONAL COMMITMENT

Achieving Universal Health Coverage (UHC) in Nigeria requires sustained executive leadership, strategic fiscal allocation, and multi-sectoral governance coordination. The Academy of Medical Sciences reaffirms its institutional readiness to partner with federal and state authorities, alongside relevant public health institutions, to drive the execution of these strategic directives.

Consequently, the Academy urges the Federal Government and key policy stakeholders to implement the following high-level policy measures:

1. Fulfill Health Financing Commitments: Progressively scale annual health sector budgetary allocations toward the 15% baseline established by the 2001 Abuja Declaration to ensure sustainable financing for UHC.
2. Operationalize Statutory Frameworks: Fast-track the comprehensive implementation and enforcement of all statutory provisions under the National Health Act (2014), with emphasis on the Basic Health Care Provision Fund (BHCPF).
3. Institutionalize Accountability Mechanisms: Establish a Presidential Oversight and Monitoring Committee to rigorously track national progress across key health indicators, specifically health workforce expansion, maternal mortality reduction, and biosecurity preparedness.

Emeritus Professor Osato Frank Giwa-Osagie, FAMedS, OON

President, Academy of Medical Sciences

Professor Mayowa Owolabi, FAMedS, DSc

Secretary, Academy of Medical Sciences