The Chief of Staff to the President, Mr. Femi Gbajabiamila, on Thursday urged all three tiers of government to work collectively toward transforming Nigeria’s healthcare system.
Gbajabiamila made the call while delivering a lecture at the College of Medicine, University of Lagos, during the institution’s 63rd Founder’s Day celebration and 18th Horatio Oritsejolomi Thomas Memorial Lecture in Lagos.
The lecture, titled “Transforming Healthcare: The Role of Political Leadership,” highlighted the distinct but complementary responsibilities of the federal, state, and local governments in ensuring effective healthcare delivery.
According to him, while the Federal Government sets national health policies and oversees tertiary institutions, state and local governments carry the greater responsibility of providing accessible and quality healthcare services.
“State governments are primarily responsible for managing secondary healthcare services, including general hospitals and specialist centres,” he said.
Gbajabiamila noted that although primary healthcare coordination officially falls under local governments, many councils lack the capacity and resources to manage these services effectively.
He emphasised the importance of coordination among all levels of government to ensure the effective delivery of basic health services such as immunisation, maternal care, and treatment of common illnesses.
“In the context of healthcare, political leaders have the power to set national and state priorities that place health at the centre of development,” he said.
“One of the truths we must recognise is that too much of the conversation around healthcare policy in Nigeria focuses on the Federal Government, whereas it is the state and local governments that bear the greatest responsibility for ensuring access to quality healthcare.”
Gbajabiamila lamented that Nigeria’s healthcare indicators remain troubling despite significant allocations to the sector by successive governments.
He disclosed that the country still records one of the highest maternal and infant mortality rates in the world—over 512 maternal deaths per 100,000 live births and approximately 54 infant deaths per 1,000 live births.
According to him, less than 10 per cent of Nigerians are covered by health insurance, while the nation’s doctor-to-patient ratio remains far below the World Health Organization’s recommendation, resulting in a life expectancy of just 55 years.
“These statistics are not just numbers; they represent lives lost, families broken, and futures dimmed,” he said. “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 yielded the desired outcomes.”
Gbajabiamila identified poor funding and corruption as major obstacles to an efficient healthcare system and stressed the need for stronger collaboration among all tiers of government.
“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,” he said.
“Such partnerships can enhance resource mobilisation, foster innovation, and ensure that services are responsive to community needs. For example, some states have successfully implemented public-private partnerships where private firms manage public hospitals under performance-based contracts. These arrangements improve efficiency and accountability while maintaining affordability.”
Earlier, the Provost of the College of Medicine, Prof. Ademola Oremosu, commended participants and emphasised that effective healthcare transformation requires political will.
Oremosu decried the concentration of hospitals in urban areas, noting that many Nigerians still lack access to nearby health facilities.
“There should be intentionality in the citing of healthcare facilities, recruitment of healthcare manpower, and in the funding and financing of healthcare,” he said. “We need a system that will improve our maternal mortality rate, infant mortality, and life expectancy.”
The event also featured goodwill messages, fundraising activities, and the presentation of awards to past provosts and distinguished professors for their outstanding contributions to the university.
