How Media and Government Can Save Nigeria’s Primary Health Care

Our Founder, Ramatu Ada Ochekliye, Serving as a Rapporteur at the High-Level Health Media Dialogue

Insights from the High-Level Health Media Dialogue with Media Executives in Nigeria

Theme: Escalating Executive and Media Action for Health Accountability and Financing

Date: Thursday, October 23, 2025

Venue: Transcorp Hilton, Abuja

By Ramatu Ada Ochekliye

Across Nigeria, the cracks in the Primary Health Care (PHC) system are often most visible in the faces of ordinary people. In rural communities, mothers still trek long distances to reach clinics that often have no drugs, no midwives, and sometimes no electricity. We captured these realities in our film Ummi, which tells the story of a woman who walked for hours, desperate to find care, only to arrive at health centres without the resources to help her.

In cities, underfunded PHC centres struggle to serve overcrowded populations. The consequences are devastating: preventable deaths of mothers and newborns, children who miss lifesaving vaccines, and families pushed further into poverty by out-of-pocket health expenses. Weak PHC systems mean delayed disease detection, inadequate health education, and broken referral links, failures that ripple upward to undermine the entire healthcare system. In a country where primary health care should be the first point of contact and the strongest safety net, its fragility has become one of Nigeria’s most urgent public health challenges.

So, how do we begin to fix this? The truth is, Nigeria’s challenge is not a lack of technical expertise — we have it. Over the years, we have developed strong, evidence-based policies that identify what our health system, especially primary health care, needs to succeed. Yet, something remains missing. These policies often stay confined to official documents — written in complex language, distant from the everyday realities of the people they are meant to serve. As a result, the media, who are critical partners in shaping national development narratives, are not always equipped or supported to translate these policies into simple, compelling stories that the public can relate to. Without that enabling environment, the bridge between policy and the people remains weak.

This is why journalists, editors, health officials, and policy makers gathered to ask difficult questions about why Nigeria’s Primary Health Care (PHC) system still struggles, and what can be done differently this time.

The High-Level Health Media Dialogue, themed “Escalating Executive and Media Action for Health Accountability and Financing,” was convened under the Advocacy Solutions Project led by EngenderHealth and funded by the Gates Foundation, with implementation partners including the International Society of Media in Public Health (ISMPH), Legislative Initiative for Sustainable Development (LISDEL), Center for Communication and Social Impact (CCSI), and Equily Nigeria Limited.

From the start, one thing was clear: “We must face our fault lines with honesty”

Veteran broadcaster and ISMPH Executive Director, Chief Moji Makanjuola, set the tone. With her signature blend of warmth and conviction, she celebrated the progress Nigeria has made in health reforms, but didn’t mince words about the challenges.

“While we acknowledge the remarkable progress made,” she said, “we must also acknowledge the fault lines in our healthcare systems.”

She reminded everyone that Primary Health Care — the most basic level of healthcare — remains the critical point for achieving Universal Health Coverage (UHC). Yet, she noted, only about 20 percent of Nigeria’s PHC facilities are fully functional. “Primary health care represents the critical point of universal healthcare,” she warned, “and we must not be comfortable with only 20 percent functionality. But I know the government is working on it, and we in the media must continue to hold them accountable.”

When only 20 percent of Primary Health Care centres in Nigeria are fully functional, the cost is measured in statistics, but in the lives of Nigerians seeking healthcare daily. It means that in eight out of ten communities, people are denied the most basic form of healthcare: immunizations, antenatal services, safe deliveries, and early disease detection. It means that mothers give birth without skilled attendants, children die from preventable diseases, and families turn to unqualified providers or delay treatment until it is too late. The ripple effect reaches far beyond the health sector: sick families are less productive, children miss school, and communities lose their economic vitality. A weak PHC system also pushes the burden upward — to overcrowded secondary and tertiary hospitals — stretching limited resources even thinner. In essence, when only a fraction of PHCs work, the promise of Universal Health Coverage becomes an illusion. No country can build a healthy, equitable future on such a fragile foundation. Strengthening PHC functionality is therefore not optional; it is the cornerstone of national survival.

Building Bridges Between Government And The People

The dialogue drew together powerful voices from government officials to editors, United Nations representatives to health advocates, all speaking a shared truth: that without accountability, financing reforms cannot endure.

The Executive Director of the National Primary Health Care Development Agency (NPHCDA), Dr. Muyi Aina, highlighted the government’s ongoing efforts to rebuild trust in the system: from equipping over 500 PHC facilities to retraining 70,000 healthcare providers and reaching three million children through the recent Measles-Rubella campaign. He spoke passionately about reducing zero-dose children — children who have never received a single vaccine — calling it “the clearest indicator of equity in our health system.”

Dr. Zubaida Abubakar of the United Nations Population Fund (UNFPA) brought a gendered perspective, reminding participants that reproductive health and safe childbirth remain central to development. “No woman should die while giving life,” she said. “And no system can claim progress until women have full access to quality reproductive healthcare.”

Representatives of the Nigeria Union of Journalists (NUJ) and the Nigeria Guild of Editors (NGE) challenged their colleagues to not only expose lapses but also spotlight progress. “Our responsibility,” one editor said, “is not just to point fingers — but to show the nation what works and why it matters.”

“The Health Of Mothers Reflects The Health Of The Nation”

In his remarks, Uche Amaonwu, Country Director of the Gates Foundation, Nigeria, drew the link between health and governance. “The health of our mothers,” he said, “is the mirror of our national conscience. If mothers continue to die, then we have failed to govern well.”

He described the media as “accountability partners” who give context to numbers and budgets, translating policies into human stories. He emphasized that good journalism can be as critical to saving lives as any medical intervention.

The Governor of Kaduna State captured attention when he outlined his administration’s reforms: over 200 revitalized PHC facilities, 120 neonatal centers (with 90 fully upgraded), and the establishment of the Kaduna State Centre for Disease Control and Kaduna State Emergency and Ambulance Services, which now offer free 48-hour emergency care.

Perhaps the most touching moment came when he announced that nursing and midwifery students would now pay 30 percent less in tuition — a move to retain local talent and slow the brain drain. “Health,” he said firmly, “is a right, not a privilege. And equity must remain our compass.”

A Call To Collaboration

The dialogue’s high point came when Professor Muhammad Ali Pate, Coordinating Minister of Health and Social Services, took the stage. Calm but firm, he addressed both policymakers and journalists directly.

“Fixing health is a political choice,” he said. “We can spend our time blaming each other, or we can focus on building together. Our people deserve solutions, not excuses.”

He acknowledged Nigeria’s fiscal limitations — a low revenue-to-Gross Domestic Product (GDP) ratio that has constrained progress — but assured participants that new reforms were opening up fiscal space for health. He commended states expanding PHC coverage, especially those improving workforce recruitment and service delivery.

But his biggest message was about inclusion: “We must engage citizens to follow what is being done. Accountability cannot be a closed conversation.”

Contributions from Kaduna, Lagos, and Kano States showcased varied progress:

• Kaduna earmarked ₦1 billion for its Health Scheme, beginning with pensioners and civil servants.
  
  

• Lagos announced its health budget had risen to 12 percent, with a goal of 14 percent by 2026, alongside a new 1,200-bed tertiary hospital.
  
  

• Kano reaffirmed that its health allocation now exceeds 16 percent — a signal of political will for better outcomes.

At the community level, Honourable Bello Lawal of the Association of Local Governments of Nigeria (ALGON) reminded the media that PHC delivery starts and often fails at the local government level. “We welcome scrutiny,” he said. “It keeps us honest.”

Former President of the National Association of Women Journalists (NAWOJ), Ladi Bala, declared, “The diversion of health funds is not mismanagement — it is mass murder. And we must call it what it is.”

In one of the most inspiring sessions, Professor Desmond Okocha called for deeper integration of media in health advocacy. “We must stop treating journalists as outsiders,” he said. “They are part of the health ecosystem.” He urged government and development partners to engage the media from the design stage of policies, not just during implementation. He also called for the inclusion of Health Communication as a core module in journalism schools. “When the media are informed, they become unstoppable,” he said to loud applause.

Honouring Champions, Affirming Hope

The day closed with recognition for those driving reform.

• Professor Muhammad Ali Pate received an award as Champion for Promoting the Renewed Hope Agenda in the Health Sector.
  
  

• The Governors of Kaduna, Kano, and Lagos States were honoured as PHC Champions for prioritizing health financing and service delivery.

In his closing remarks, Dr. Ahmad Abdulwahab of the Nigeria Governors’ Forum (NGF) revealed that the 36 states collectively budgeted ₦2.3 trillion for health in 2025 — up from ₦520 billion in 2023 — with 29 percent channelled toward PHC. He stressed, however, that “budgets are only promises; progress is measured by what is released and what reaches the people.”

Towards A Healthier Nigeria

One thing was clear: this dialogue was a commitment, a reaffirmation that Nigeria’s path to Universal Health Coverage begins with honesty, collaboration, and the courage to tell the truth.

“Health is not an expense,” Makanjuola had said earlier. “It is an investment in our humanity.”

If Nigeria is to turn its health statistics into real stories of survival and progress, the government and the media must move beyond parallel efforts and begin to work in true partnership. Policies and budgets alone cannot save lives unless they are understood, embraced, and demanded by the people they are meant to serve. And that understanding can only come through clear, compassionate communication, through stories that connect policy to the pain and the hope within our communities.

The government holds the power to enact reforms, but the media holds the power to humanise them. Together, they can build a bridge between technical language and lived experience, one where every Nigerian can see how health decisions made in Abuja affect the mother in Gwoza, the child in Badagry, or the farmer in Akure.

At Shades of Us, we have seen the impact of this bridge firsthand. Through our Mobile Cinema project, we take stories like Ummi into underserved communities, using film, conversation, and empathy to translate policies into everyday language. When people see themselves in these stories, policy stops being abstract; it becomes personal, actionable, and urgent.

For Nigeria’s health indices to improve, collaboration is non-negotiable. The government must continue to reform with transparency, and the media must continue to tell the truth with courage. Only then can our words — and our actions — begin to heal a nation in need of care.