Femi Gbajabiamila, the chief of staff to the president, on Thursday tasked the three tiers of government with ensuring the transformation of the nation’s healthcare system.

Mr Gbajabiamila gave the advice at the College of Medicine, University of Lagos, during the 63rd Founder’s Day celebration and the 18th Horatio Oritsejolomi Thomas Memorial Lecture in Lagos.

He highlighted the respective roles of the three tiers of government in shaping the healthcare system for effective delivery.

Mr Gbajabiamila said while the federal government sets national health policies and oversees tertiary institutions, it was the state and local governments that bear the crucial responsibility of ensuring access to quality healthcare.

“State governments are primarily responsible for managing secondary healthcare services, which include general hospitals and specialist centres,” he said.

Mr Gbajabiamila, who said that coordination of primary healthcare centres was officially under the jurisdiction of local governments, decried  the reality that many local councils lack the capacity and resources to manage these services effectively.

Highlighting the different responsibilities of each government, he stressed the  importance of coordination for basic health services, such as immunisations, maternal care, and treatment of common illnesses.

He noted that proper coordination would make these services accessible to people in both urban and rural areas.

“In the context of healthcare, political leaders have the power to set national and state priorities that place health at the centre of development.

“One of the truths we must consider is the fact that too much of the conversation around healthcare policy in Nigeria centres on the federal government when, in fact, it is the state and local governments that bear the greatest responsibility in ensuring access to quality healthcare,” he said.

He lamented that Nigeria’s healthcare indicators remained very troubling, despite the significant sums allocated to healthcare by successive federal and state governments.

According to him, the country has one of the highest rates of maternal and infant mortality in the world, over 512 maternal deaths per 100,000 live births, and approximately 54 deaths per 1,000 live births. He added that less than 10 per cent of Nigerians were covered by health insurance.

“Our doctor-to-patient ratio remains far below the World Health Organisation recommendation, making our life expectancy just 55 years.

“These statistics are not just numbers; they represent lives lost, families broken, and futures dimmed. Political leadership must confront this reality with urgency and resolve, beginning by admitting that much of what has been done over the years has not delivered the desired outcomes,” Mr Gbajabiamila explained.

Mr Gbajabiamila identified poor funding and corruption as major problems limiting the effectiveness of the healthcare system. He underscored the need for collaboration among the three tiers of government to foster remarkable improvement in the healthcare system.

”Collaboration is key to unlocking this potential. State governments must work closely with the federal government, local councils, civil society organisations, and the private sector. Such partnerships can enhance resource mobilisation, foster innovation, and ensure that services are responsive to community needs.

“For example, public-private partnerships have been successful in some states, where private firms manage public hospitals under performance-based contracts. These arrangements can improve efficiency and accountability while maintaining affordability,” he said.

(NAN)