By Emmanuella Oghenetega
As healthcare challenges evolve, refining methodology has become a necessity; this includes Improving the established rules, procedures, and systematic approach used in healthcare research, delivery, and quality improvement to make them more effective, accurate, patient-centered, and efficient.
To this course, the Federal Ministry of Health and Social Welfare, in collaboration with its MDAs, state governments, development partners, the private sector, traditional and religious institutions, civil society and academia, convened the 2025 Health Sector Joint Annual Review (JAR) in Abuja.
The three-day Review assessed national and subnational performance under the Sector-Wide Approach (SWAp) and realigned collective action to accelerate delivery of the Nigeria Health Sector Renewal Investment Initiative (NHSRII) and progress towards Universal Health Coverage (UHC).
During the course of the review, Key observations were made, of which included; Governance & Accountability
The signing of the Universal Health Coverage (UHC) Compact Addendum, which strengthens mutual accountability across federal, state, LGA, private sector, and traditional institutions. However, operationalisation at the subnational level remains uneven, as fewer than half of states have fully functional coordination platforms, and alignment to One Plan/One Budget processes varies significantly across zones.
Therefore, the ICC review highlighted the need for technically sound targets and consistent use of validated data sources to avoid performance distortion.
As regards Maternal & Newborn Health, a 17% reduction in maternal mortality in early-implementing Local Government areas and improving trends in neonatal mortality across participating states. However, only 32% of assessed facilities meet minimum readiness criteria, and blood availability remains a binding constraint in multiple states.
Pertaining the functionality of the Primary Health Care (PHC) and its Service Readiness; it was observed that the PHC revitalisation efforts have raised functionality scores in several zones, with increases in 24-hour service availability, electricity reliability, and WASH standards.
However, critical gaps persist: staffing deficits remain acute, especially in rural LGAs, commodity stockouts and limited CEmONC capacity continue to undermine service quality.
In terms of Health Financing & Financial Resilience, it was observed that domestic financing through the Basic Health Care Provision Fund (BHCPF) and State Health Insurance Schemes expanded, with over 2.4 million vulnerable Nigerians enrolled and improvements in claims processing. However, external funding declines and delayed budget releases present risks to essential programmes.
Vaccine financing discussions, highlighted the need for predictable counterpart contributions and improved budget execution at both federal and state levels.
In the area of data and evidence for decision-making, it was observed that routine use of available platforms at state and LGA levels remains inconsistent, with varying levels of data validation, completeness, and timeliness—limiting full-sector accountability.
Market-Shaping & Local Production
Reforms under the Presidential Value Chain Initiative continue to gain momentum, with new MoUs signed with local manufacturers and over 40 private sector entities engaged in expanding pharmaceutical and diagnostics production. Early wins are visible in syringes, PPE, and select commodities. Sustained industrial policies, regulatory clarity, and guaranteed demand mechanisms will be essential to scaling local production and reducing dependency on imports.
In the case of Integrity, Transparency & Systems Strengthening across the BHCPF, immunization financing, and PHC operations, data quality improvement and anti-fraud controls remain critical, observations of cases of ghost workers, irregular payments, double expenditures, and weak fiscal tracking were highlighted.
Making it imperative to strengthen digital financial management systems, enforce compliance with treasury guidelines, and institutionalise routine audits which are central to building public trust.
Other observations included Sexual & Reproductive Health (SRH), and Immunization, of which for immunization, a
mixed performance in the implementation of the Gavi accountability framework (across core programmatic and especially the vaccine financing indicators) was observed, due to tight fiscal realities.
Intent on resolving some of these impeding observation, resolution were made in line with international commitments on donor coordination and the shift to supporting government priorities by supporting government ownership and using national systems.
The meeting resolved to strengthen stakeholder coordination for improved health service delivery, ensuring alignment with the commitments outlined in the compact. This includes; Operationalizing the Universal Health Coverage Compact Addendum by the first quarter (Q1) 2026 through a co-created implementation framework with clear Ask-and-Offer commitments and a robust tracking mechanism.
Adopting of biometric verification across all Primary Healthcares and health-insurance platforms to eliminate ghost workers, strengthen attendance management, and enhance HRH transparency and performance, drawing from the Gombe model. (To formalize these, at the National Council on Health (NCH) at the NCH, Gombe to present a case study of Biometric registration for potential review and adoption for scale up; and also a memo to be reviewed on the standardized certification pathway for medical officers to safely perform emergency obstetric procedures).
Strengthening of integrity, transparency, and fiduciary controls by rolling out digital expenditure-tracking and biometric attendance across all BHCPF-supported facilities by third quarter (Q3) of 2026, supported by empowered oversight committees.
Improvement in the data quality and use for action by implementing robust quality assessment plans, optimizing DHIS2, and strengthening data culture and management practices across levels
Advance HRH reforms by establishing a National HRH program, and explore deployment of new cadres of the future health workforce aligned with Nigeria’s emerging service-delivery priorities and long-term economic ambitions including value chain optimization, regulation, and management.
Accelerate and scale the Maternal and Newborn Mortality Reduction Innovation and Initiatives (MAMII) programme nationally; close the financing gap through domestic resource mobilization and private sector resource pooling, strengthen SBBC and community engagement, and expand to new LGAs guided by mini-DHS data, with full scale-up of MPCDSR and referral systems by Q4 2026.
Improve the access to and quality of Sexual and Reproductive Health (SRH), through policy domestication, sustainable financing, community engagement, and stakeholder collaboration.
Deployment and scaling up of the Primary Health Care financial management systems and exploring linkages with financial institutions to improve real-time visibility, and mitigate fiduciary risks.
Expansion of health insurance coverage and equity programmes by enforcing employer insurance mandates for all organizations engaging with government, scaling equity schemes, digitizing enrollment and claims, and enrolling 5 million Nigerians, including 1 million additional vulnerable persons, by end-2026.
The advancement of local manufacturing and supply-chain resilience by operationalizing Medipool, incentivizing private-sector investment, and transitioning at least 20 priority commodities to local production with five new manufacturing plants operational by 2026.
Strengthening both State and LGA delivery systems to improve readiness, responsiveness, and accountability in the following areas: at the State-level resource mobilization, focal accountability, and performance tracking, ensuring LGA structures are fully aligned with NHSRII priorities; Emergency response capacity, by scaling NEMSAS and RESMAT and ensuring all PHCs meet minimum readiness standards for CEmONC and timely referral; Inter-agency collaboration across NPHCDA, NHIA, NCDC, NMEP, NAFDAC and other key actors to strengthen integrated service delivery and facility readiness and; Accountability for Drug Revolving Funds (DRFs) to eliminate leakages, curb corruption, and ensure uninterrupted access to essential medicines.
The final resolve being, that as part of resource pooling, mutual accountability and transparency from the portfolio review, the stakeholders will; Institute data-guided monitoring and fund allocation guided by periodic resource mapping, National health accounts, and public expenditure review at national level; as well as State Resource Mapping and State health accounts; Support strengthening of the public expenditure framework review – World Bank; Establish iterative joint updates beyond the joint annual review for partners to adjust programming and reallocate resources proactively; Optimize state level investments, particularly to unlock HOPE PHC incentives and strengthen frontline service delivery – All Development Partners and; Advance a government co-financing arrangement with bilateral partners
ISSUED this 14th day of November 2025 in Abuja.
The event was chaired by the Coordinating Minister of Health and Social Welfare Prof. Muhammad Ali Pate, alongside Dr Iziaq Adekunle Salako, Minister of State for Health.
