UNICEF Tackles Leadership Crisis in Nigeria’s Primary Healthcare

Stakeholders in Nigeria’s health sector have identified a lack of effective leadership and management as the primary obstacle to improving national health outcomes. During a series of workshops in Yola, Sokoto, and Ilorin, experts argued that technical skill is secondary to governance in the quest for a functional system. The UNICEF-led initiative, “Enhancing Leadership, Governance and Management Capacities” (ELGMC), aims to bridge this gap. By focusing on State Primary Health Care Development Agencies, the programme seeks to move beyond mere policy paper to actual practice. If the pilot succeeds in Adamawa, Kwara, and Sokoto, it could provide a blueprint for a nationwide overhaul.

The initiative targets the structural rot that often cripples health service delivery at the grassroots level. Dr Emmanuel Emedu, a UNICEF health specialist, noted that robust management is the only way to integrate health services into broader development agendas. Without a coherent leadership structure, even well-funded programmes often dissipate into inefficiency. The goal is to foster evidence-based planning and financing for maternal and child health. This includes a specific focus on nutrition and addressing gender-based violence within the primary healthcare framework.

Kwara State’s Commissioner for Health, Dr Amina Ahmed El-Imam, observed that the sector suffers from an abundance of technical expertise but a poverty of “soft skills.” Management is not merely about medical knowledge; it is about the efficient allocation of scarce resources. Translating high-level policies into meaningful benefits for the rural poor remains the ultimate challenge. The ELGMC project intends to provide the training necessary to turn doctors and administrators into effective leaders. Accountability and transparency are the expected dividends of this capacity-building exercise.

In Adamawa, Deputy Governor Prof. Kaletapwa George Farauta underscored that leadership is the engine of monitoring and implementation. She believes that strengthening governance will lead to a more resilient and people-oriented system. The collaboration with Development Governance International (DGI) involves a rigorous assessment of existing policy development capacities. This phase includes focus group discussions and data analysis to identify specific administrative weaknesses. Once these gaps are mapped, the project will move into a mentoring and implementation stage.

Sokoto State has also pledged its full support for the five key goals of the initiative. The inclusive nature of the project aims to ensure that state-level actors take full ownership of the reforms. It is often the case in Nigeria that international interventions fail because of a lack of local buy-in. By involving commissioners and agency heads from the onset, UNICEF hopes to create a sustainable management culture. The pilot states will serve as a testing ground for these governance-first interventions.

The optimism surrounding the ELGMC project is tempered by the scale of the task ahead. Nigeria’s primary healthcare system has long been plagued by neglect and fragmented authority. Establishing a unified system of leadership across diverse states requires more than just workshops. However, if these three states can demonstrate improved health metrics through better management, the pressure will mount for others to follow. For the first time, the “how” of healthcare delivery is receiving as much attention as the “what.”