Thought Leadership

Minister of Health for Nigeria: A Job Description

….if I was looking…this is what I would be looking for:

With the Ministry of Finance and the Attorney Generals Office, the Ministry of Health belongs to a small group of ministries that are unique in the specificity of its functions. Health and health services involves complexities that are extremely difficult to understand in detail by people outside the health professions.

The next minister should come from one of the health professions.

Many in the health profession spend their careers managing individual patients. Few have had any managerial experience beyond their clinical teams. Few receive any management training. They are rarely trained to think strategically, to plan, set objectives, execute projects, monitor milestones, manage budgets, and manage people. Nigerians could not identify with any objectives of the MOH in the past years because none has been communicated to them. Our tertiary hospitals are all managed as single entities by clinicians with no managerial experience either, no surprise none of them attracts the confidence of Nigerians. A vast number of health parastatals are fiefdoms of incompetence that have hardly affected the lives of Nigerians apart from maybe NAFDAC.

The next minister should have proven managerial experience or/and training and be able to see the link between health and development.

Most health professionals spend their careers thinking about the health of individual patients. Since most of them come from teaching hospital settings, they tend to think of health as the health care of those that make it to teaching hospitals. This is the thinking behind the investment of billions of dollars in procuring extremely expensive equipment for teaching hospitals, which on rare occasions that they do work, cannot be afforded by most; a completely flawed investment. How many lives has the £10M MRI saved?

The next minister should have experience or/and training in thinking about health in population terms. I.e. what will be the most efficient way to invest the resources available for health to benefit the most people?

The Ministry of Health is probably the best placed ministry to attract funds well in excess of its federal allocation from partner agencies and bodies. With Nigeria’s 140 million people, there will not be any significant impact on global health programmes without Nigeria’s engagement. The world needs us, but we have to always remember that it is in our peoples’ best interest to attract resources for health and health care to Nigeria.

The next minister needs to be competent, confident, articulate, result oriented and able to deal with international partners.

Finally…the Minister of Health can be the most thankless position. Health indicators do not change over night in best of times. Many of the things that affect health are outside the remit of the Ministry of Health. Healthy people do not make the news! There are a lot of temptations to cut corners, to seek quick solutions, to compromise. Any compromise will lead to people dieing.

Integrity is the single most important quality absolutely required of the next Minister of Health.

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

By Chikwe Ihekweazu

Chikwe Ihekweazu is an epidemiologist and consultant public health physician. He is the Editor of Nigeria Health Watch, and the Managing Partner of EpiAfric (, 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.

6 replies on “Minister of Health for Nigeria: A Job Description”

Good blog, you forgot to add that the next Minister of Health should look to put into place some sort of regulatory body that ALL doctors, medical professionals etc are accountable to. In the UK, the GMC (General Medical Council) has the powers to suspend the licenses of medical professionals for incompetence….in Nigeria, many doctors (not all) only seem accountable to themselves. We hear far too many stories of medical negligence and the patient is powerless. When a young and perfectly healthly woman bleeds to death in child birth (most often due to the doctor’s incompetence/inexperience)….the family is left to pick up the shattered pieces of their lives……

There is a book titled “Strategic Concept for Managing Healthcare in Nigeria” which I will recommend that every Nigerian read.

The primary ‘person specification’ for a Minister is that the person must be politically astute and have extensive leadership qualities. Second is that the person can come from any walk of life but must have good understanding of the social trends, economic status of the country, understanding of health factors that contribute to health services development, good health and inequalities to accessibility and affordability by all the populace

He/she must be able to network, analyse information, use research evidence to make informed decision about healthcare policies.

Very importantly he/she must be able to appoint people with health services management qualifications, training and experience that can take strategic approach for aligning the concept of quality, productivity and cost effectiveness and efficiency both in clinical outcomes of services delivery and financial management.

The specific roles for health professionals include National and State Chief Medical Officers, Chief Nursing Officers etc. Hospitals and specific healthcare institutions must be led managerially by qualified managers. Management is a career separate from medical, nursing, pharmacy, engineering careers. This is the difference between the other parts of the world and Nigeria / Africa.

Trained managers and trained clinicians have different views to development of healthcare services and patients’ care. They are united in making the system work better for the society and by this there can be checks and balances.

Apart from the above the blog I am responding to is one that addresses the issue of leadership position of Nigeria’s healthcare industry.

David Eboh

In the UK, the GMC (General Medical Council) has the powers to suspend the licenses of medical professionals for incompetence….in Nigeria, many doctors (not all) only seem accountable to themselves. We hear far too many stories of medical negligence and the patient is powerless.

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