League Table for Health Outcomes – waking up our governors


In case you missed it an important event took place in Abuja early this month.

The Minister of Health, Prof. Babatunde Osotimehin, called a Presidential Summit with all our State Governors around the the theme;


This is not a coincidental title! The general perception is that apart from a few exceptions, most State Governors in Nigeria have abdicated their responsibility for the health of their people. Also with most people worried about electricity, roads and other basic requirements for a decent life, not a lot of political pressure is brought to bear on our state governments around the state of our health. This is the reason why the Governor of Adamawa State is bringing in our friends from Germany to build a state-of-the-art hospital while health workers were on strike for most of the year and the state was ravaged outbreaks of cholera...(yes..really!).

The summit was timely and in a technical meeting that preceded the meeting the Minister made a most critical assessment of the situation when he said:

“….the  state of the health system is  unacceptable, and incapable of delivering general health care services to 140 million Nigerians”

Then our Minister of Health, led a delegation including his Minister of State and the Directors of all the parastatals and key officers in the Ministry  to the National Economic Council meeting. This is a meeting including all the Governors and chaired by our Vice President.

The Vice President chaired the meeting and our governors were shown part of a documentary on the health situation in Nigeria (you will be surprised how little they would know and see riding around in their convoys of bullet proof jeeps). Our governors were shown a presentation on the health situation in Nigeria – and about the planning process underway to address Nigeria ‘s health situation. Every Governor was given a summary of the proceedings around the new national strategic framework that they have been working on AND most politically powerful, they received  league tables … ranking states… in their performance on health indicators from the recent DHS…powerful! The data they received is official and culled from the 2008 Demographic Health Survey which the National Population Commission will be disseminating publicly on the 23rd of November here in Abuja.

We gather that there was a discussion between the Governors and the Minister and our Governors all praised the Minister.  They acknowledged his passion and drive, and the way in which states had been brought into the planning process.  But when it came to putting their money where their mouths are – i.e the declaration of commitment was for Governors to sign up to incrementally increase their health budgets toward 15%….they bickered and came up with ingenious excuses.

The responsibility for the provision of health for our people is lies mostly in the hands of our state governors. Whether any of them will see health as a priority remains to be seen.  Building hospitals will not be enough for our health, even if it is enough for the egos of our governors.

But they our our governors! In a federal state like ours…there is no greater power in the polity to affect the lives of our people as in the hands of our governors. This power can be used as is it is being done in Lagos State…or in contrast as in Abia State.


Never doubt that a small group of thoughtful committed people can change the world; indeed it is the only thing that ever has…Margaret Mead

Chikwe Ihekweazu is an epidemiologist and consultant public health physician. He is the Editor of Nigeria Health Watch, and the Managing Partner of EpiAfric (www.epiafric.com), which provides expertise in public health research and advisory services, health communication and professional development. He previously held leadership roles at the South African National Institute for Communicable Diseases and the UK's Health Protection Agency. Chikwe has undertaken several short term consultancies for the World Health Organisation, mainly in response to major outbreaks. He is a TED Fellow and co-curator of TEDxEuston.

Discussion1 Comment

  1. Our people still believe in edifice. For them it is better to be treated and die in a magnificent building with MRI and no Doctor than to be seen in a health centre or GP surgery with a highly skilled and experienced Healthcare professional as this will not be very good for the obituary ads.

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