Stakeholders in Nigeria's healthcare sector have pointed to weak leadership, governance, and management as major obstacles to better health outcomes. This emerged from a series of workshops in Yola, Sokoto, and Ilorin, organised under the UNICEF-led initiative, 'Enhancing Leadership, Governance and Management Capacities (ELGMC)', in collaboration with Development Governance International (DGI). The project focuses on State Primary Health Care Development Agencies (SPHCDAs) in Adamawa, Kwara, and Sokoto states. It aims to improve evidence-based decision-making and the delivery of gender- and adolescent-responsive primary healthcare, including Reproductive, Maternal, Newborn, Child and Adolescent Health plus Nutrition (RMNCAH+N) services, and responses to gender-based violence.
Dr. Emmanuel Emedu, UNICEF Health Specialist and Project Lead, stressed that strong leadership and management are essential for integrating health services into broader state development plans. Adamawa State Deputy Governor and Chairman of the State Primary Health Care Task Force, Prof. Kaletapwa George Farauta, supported the drive for better governance to enhance accountability and service delivery. Kwara State Health Commissioner, Dr. Amina Ahmed El-Imam, highlighted a gap in soft skills despite existing technical expertise. Sokoto State Health Commissioner, Dr. Faruk Umar Abubakar Wurno, endorsed the project's five objectives and pledged state backing. DGI CEO Dr. Gafar Alawode described the initiative as interactive, with upcoming stages including focus group discussions, interviews, data analysis, and capacity-building plans.
The most revealing moment in this initiative is Dr. Amina Ahmed El-Imam's admission that Kwara has technical skills but lacks soft skills in health leadership—this exposes a systemic flaw replicated across many Nigerian public institutions, where expertise does not translate into effective execution.
The ELGMC project's focus on Adamawa, Kwara, and Sokoto reflects a targeted attempt to fix governance at the state level, where primary healthcare delivery often collapses despite federal policies and funding. The fact that UNICEF and DGI are conducting assessments before rolling out capacity plans suggests previous interventions failed by skipping diagnosis and imposing one-size-fits-all solutions.
For ordinary Nigerians, especially women and adolescents in rural areas of these states, improved leadership could mean more reliable access to maternal care, nutrition services, and protection from gender-based violence—services that exist on paper but rarely reach communities.
This initiative fits a broader pattern: external partners identifying gaps in local execution and stepping in to rebuild systems from within, a recurring theme in Nigeria's development landscape where institutional capacity has long been eroded by political turnover and underinvestment.
