POLICY BRIEF FOR ACHIEVING THE 15% BUDGETARY ALLOCATION TO HEALTH IN AFRICA: FULFILLING THE 2001 ABUJA DECLARATION current concerns 2-011

 

16 September 2025  current concerns 2-011

POLICY BRIEF FOR ACHIEVING THE 15% BUDGETARY ALLOCATION TO HEALTH IN AFRICA: FULFILLING THE 2001 ABUJA DECLARATION

-by Dr. Uzodinma Adirieje / +2348034725905 (WhatsApp) / EMAIL: druzoadirieje2015@gmail.com

 CEO/Programmes Director, Afrihealth Optonet Association (AHOA) – CSOs Network and Think-tank

follow Dr. Uzodinma Adirieje on Facebook by clicking on this link <https://www.facebook.com/uzoadirieje> to receive more posts. 

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I. BACKGROUND

In April 2001, African Union (AU) member states met in Abuja, Nigeria, and collectively committed to allocating at least 15% of their annual national budgets to the health sector. This landmark agreement, known as the Abuja Declaration, was designed to strengthen health systems, improve healthcare delivery, and address Africa’s heavy disease burden, particularly HIV/AIDS, malaria, tuberculosis, and other communicable and non-communicable diseases. Two decades later, progress has been uneven, with only a handful of countries achieving or sustaining the 15% allocation. Many African states still spend less than 8% of their budgets on health, leaving millions without access to quality and affordable healthcare. The persistent underfunding of health has contributed to weak infrastructure, inadequate human resources, shortages of essential medicines, and dependence on external aid. These gaps were further exposed during the COVID-19 pandemic, which highlighted the urgency of investing in resilient health systems. Achieving the 15% target is therefore central to advancing Universal Health Coverage (UHC), improving maternal and child health, reducing preventable deaths, and meeting the Sustainable Development Goals (SDGs). A renewed policy focus is required to translate the Abuja Declaration into actionable national strategies, ensuring sustainable domestic financing for health in Africa.

 

II. IMPLEMENTATION ACROSS COUNTRIES

Although several African countries including Nigeria that hosted this meeting, have failed to progress in proportionate budgetary allocation to health, some African countries have shown evidence of good and progressive governance, in implementing the agreement. Rwanda has proven that this goal is achievable, as she has consistently invested over 15% in health, enabling near-universal health insurance. Ethiopia’s Health Extension Program has expanded cost-effective primary health care (PHC) nationwide. Botswana has prioritized HIV/AIDS spending, achieving one of Africa’s strongest HIV responses. Unfortunately, many of the countries including Ghana and South Africa have resorted to introducing new taxes and or increasing existing ones. While Ghana introduced a health insurance levy (2.5% VAT) to sustainably finance its NHIS, South Africa used sugar tax raised over R2 billion (2018–2020), showing potential of earmarked taxes. But these taxes further impoverish the citizens.

 

III. POLICY RECOMMENDATIONS

a. Political Will and Legal Backing: Enshrine the Abuja target into national laws, health financing strategies, and strengthen parliamentary and citizen oversight of budget allocations.

b. Expand Domestic Revenue: Broaden tax bases and improve collection efficiency, introduce earmarked health taxes (e.g., on alcohol, tobacco, sugary drinks), and tackle illicit financial flows, corruption, and tax evasion.

c. Improve Spending Efficiency: Strengthen public financial management and transparent procurement, and prioritize Primary Health Care (PHC) for equitable, cost-effective outcomes.

d. Strengthen Partnerships: Align donor support with national health plans, and explore innovative financing tools (diaspora bonds, solidarity levies).

e. Invest in Systems and Workforce: Expand health workforce training and retention, and upgrade infrastructure and integrate digital health innovations.

f. Regional Accountability and Peer Learning: Use AU’s Africa Scorecard on Domestic Financing for Health to track and compare progress, and share best practices among countries making progress.

g. Citizen and Civil Society Engagement: Foster community-led advocacy to demand Abuja commitment fulfillment, and promote open budget platforms for transparency and accountability.

 

However, using taxes on daily needs and consumer goods (like VAT on food, basic utilities, or other essential items) can disproportionately hurt low-income households. However, the Abuja 15% health financing target can still be achieved without such regressive and impoverishing measures.

 

IV. ELIMINATING POVERTY AND ACHIEVING ‘SDGs’ THROUGH NON-TAXING OF DAILY NEEDS AND CONSUMER GOODS TO FINANCE HEALTH SERVICES

Alternatively, it is hereby proposed to enthrone a Policy that embraces the following practical alternatives:

 

a. Improve Efficiency in Current Government Spending

1. Reduce waste and corruption: According to WHO, 20–40% of health resources globally are lost to inefficiencies. Eliminating leakages in procurement, payroll, and infrastructure projects can free significant resources.

2. Reallocate from non-priority sectors: Some African countries spend large shares of their budgets on subsidies, oversized government structures, or defense. Even a 2–3% reallocation could substantially boost health budgets.

b. Leverage Natural Resource and Extractive Revenues

1. Resource rents and royalties: Countries rich in oil, gas, and minerals (e.g., Nigeria, Angola, DRC) can dedicate part of these revenues to health through sovereign wealth or stabilization funds.

2. Transparent resource-for-health agreements: For example, Botswana used diamond revenues to finance a strong HIV/AIDS response.

c. Curb Illicit Financial Flows (IFFs)

1. Africa loses about $88.6 billion annually through tax evasion, trade mis-invoicing, and corruption (UNECA, 2020). Even recovering 10% of IFFs could finance major increases in health budgets without new taxes.

d. Optimize Debt Management and Reallocation

1. Debt swaps for health: Countries can negotiate with creditors to channel debt repayments into health programs (similar to “debt-for-nature swaps”).

2. Reprioritization in borrowing: When borrowing is necessary, governments can earmark a defined share for health infrastructure and workforce expansion.

e. Innovative Non-Tax Financing

1. Diaspora bonds: Mobilize African diaspora communities to invest in bonds whose proceeds are dedicated to health infrastructure. Nigeria and Ethiopia have experimented with diaspora bonds for development projects.

2. Health solidarity levies (non-essential sectors): Instead of taxing food or daily needs, levies could target luxury goods, air tickets, or high-pollution industries. For example, UNITAID’s airline ticket levy has raised over $2 billion globally for health.

3. Public–private partnerships (PPPs): Private sector contributions in infrastructure, technology, and workforce training can reduce the burden on government health budgets.

f. Strengthen Insurance and Risk-Pooling Mechanisms

1. National Health Insurance Schemes (NHIS): Contributions from employers, employees, and government subsidies can mobilize additional funds without taxing essentials. Ghana’s NHIS, funded partly through a small VAT levy plus other streams, shows mixed lessons, but other models can be designed without relying on consumer goods.

2. Community-based health insurance (CBHI): In Rwanda, CBHI has provided near-universal coverage by pooling contributions across households, supplemented by government support.

g. Regional and Multilateral Financing Mechanisms

1. African Union pooled funds: Member states can contribute to a continental health solidarity fund to support weaker systems.

2. Leveraging climate and development financing: With the health impacts of climate change rising, African countries can tap Green Climate Fund (GCF) and other multilateral mechanisms to co-finance health resilience.

h. Digitalization and Efficiency Gains

1. Digitizing tax collection, customs, and procurement systems reduces leakage and boosts government revenue without new taxes.

2. e-Health solutions can reduce costs in service delivery, ensuring existing allocations go further.

 

V. CONCLUSION

Achieving the Abuja 15% health budget target does not have to mean burdening ordinary citizens with higher taxes on daily essentials. In the interest of the welfare of the citizens and to truly work towards eliminating poverty, Policies should Reallocate from wasteful expenditures; Harness natural resource wealth; Recover illicit flows; Engage the diaspora and private sector; and Innovate with financing instruments. This approach ensures that health financing is equitable and sustainable, while protecting the poorest households from additional financial strain towards the achievement of the SDGs. The Abuja Declaration remains an urgent call to action. Achieving the 15% target requires political leadership, sustainable financing, efficiency, partnerships, and citizen accountability. Health is an investment in Africa’s future. It is vital for economic growth, resilience, and human development.

 

 

Dr. Uzodinma Adirieje is a seasoned consultant with extensive expertise in global health, climate change, health/community systems strengthening, development planning, project management, Sustainable Development Goals (SDGs), governance, policy advocacy, and monitoring and evaluation (M&E), based in Nigeria. He provides high-level consultancy services to governments, UN agencies, international organizations, NGOs, and development partners across Africa, leveraging over 25 years of multidisciplinary experience across Africa and the Global South. He was the Chair of Nigeria’s national World Malaria Day Committee in 2019; National President and fellow of the Nigerian Association of Evaluators (NAE) during 2019 – 2022; President of the Civil Society Organizations Strategy Group on SDGs in Nigeria (CSOSG); and Chair of the Resource Mobilization sub-committee of Nigeria’s national World Tuberculosis Day Committee in 2025, etc. He’s currently President of the African Network of Civil Society Organizations (ANCSO), and Chair of the Global Consortium of Civil Society on Climate Change and Conference of Parties (GCSCCC).

 

SUSTAINABLE LIVELIHOODS, LOCAL ECONOMY AND YOUTH EMPOWERMENT IN OIL-PRODUCING AREAS OF NIGERIA’S NIGER DELTA REGION current concerns 2-012 [special edition]

17 September 2025  current concerns 2-012 [special edition]

SUSTAINABLE LIVELIHOODS, LOCAL ECONOMY AND YOUTH EMPOWERMENT IN OIL-PRODUCING AREAS OF NIGERIA’S NIGER DELTA REGION

-by Dr. Uzodinma Adirieje / +2348034725905 (WhatsApp) / EMAIL: druzoadirieje2015@gmail.com

 CEO/Programmes Director, Afrihealth Optonet Association (AHOA) – CSOs Network and Think-tank

follow Dr. Uzodinma Adirieje on Facebook by clicking on this link <https://www.facebook.com/uzoadirieje> to receive more posts. 

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I. BACKGROUND

The Niger Delta region of Nigeria, rich in crude oil and gas resources, remains paradoxically one of the most economically marginalized and environmentally degraded areas in the country. Despite its vast contributions to national revenue, oil-producing communities in the region grapple with poverty, unemployment, environmental pollution, and weak infrastructure. This situation is particularly evident in Imo State, one of the oil-producing states in the Niger Delta, where local communities experience widespread ecological damage caused by oil exploration and exploitation, leading to loss of farmlands, fisheries, and traditional livelihoods. The challenges have deepened the dependence of youths on unstable and unsustainable survival strategies, sometimes fueling restiveness, migration, and involvement in illicit activities. To break this cycle, a focus on sustainable livelihoods, strengthening the local economy, and empowering young people is imperative. Sustainable livelihood initiatives can help diversify economic activities beyond oil, promote skills acquisition, and create opportunities in agriculture, renewable energy, small-scale industries, and digital enterprises. By prioritizing youth empowerment, the Niger Delta can transform its oil-endowed communities into hubs of innovation and inclusive development. This approach aligns with global goals of sustainable development, while addressing poverty, unemployment, and environmental sustainability in the Niger Delta.

II. THE CONTEXT AND CORE CHALLENGES
Several structural barriers constrain livelihoods and youth prospects in oil-producing areas, including the following:
a. Environmental damage: Oil spills, contaminated soils and degraded fisheries directly reduce incomes from farming and fishing.
b. Skill mismatches: Young people often lack market-relevant technical and entrepreneurial skills, and many available jobs require formal credentials or relocation.
c. Limited market access: Small enterprises face weak links to markets, poor transport, and irregular supply chains.
d. Dependence and patronage: Short-term cash handouts or irregular corporate social responsibility (CSR) projects can create dependence and fail to build lasting capacity.
e. Gender and age inequalities: Women and youth often have less access to capital, land, and decision-making, despite being vital economic agents.

III. ADDRESSING THESE GAPS REQUIRES INTEGRATED INTERVENTIONS THAT RESTORE NATURAL CAPITAL, DEVELOP HUMAN CAPITAL, AND CATALYSE THE LOCAL PRIVATE SECTOR.
Addressing these gaps require specific, measurable, achievable, realistic, and timebound strategic approaches as underlisted below.

1. Restore and diversify natural-resource-based livelihoods

a. Sustainable fisheries and aquaculture: Where contamination allows, support sustainable fishponds, restocking programs, and training on modern aquaculture techniques to compensate for damaged wild stocks;
b. Climate-smart agriculture and agroforestry: Introduce salt- and hydrocarbon-tolerant cropping systems, soil remediation techniques, and short-cycle high-value crops; pair these with value-chain support for processing and marketing; and
c. Mangrove and coastal restoration linked to livelihoods: Combine mangrove planting with beekeeping, crab fattening, or eco-tourism pilots to create diversified incomes.

2. Market-driven enterprise development
a. Business incubation and coaching: Create local incubators that offer mentorship, business planning, bookkeeping and market research support, with a focus on youth-led enterprises.
b. Access to finance: Facilitate microfinance, revolving loan funds or matched-grant schemes designed for small enterprises and youth entrepreneurs; include financial literacy and savings groups.
c. Value-chain interventions: Build linkages between producers and buyers (processors, aggregators, urban markets) by improving packaging, quality control, and transport logistics.

3. Skills development aligned to local demand
a. Demand-led vocational training: Offer short, modular courses in trades that match local demand—mechanics, solar installation, cold-chain maintenance, ICT, aquaculture management, carpentry and agro-processing.
b. Apprenticeship and internship schemes: Partner with oil companies, local businesses and government to create formal apprenticeships that include stipends and certification.
c. Digital and soft skills: Integrate digital literacy, customer service and entrepreneurship into training so youth can participate in e-commerce, remote freelancing and local business management.

4. Local content, procurement and supplier development
a. Supplier development programs: Help small local firms meet procurement standards and compete for contracts with oil operators and contractors—through quality improvement, certification assistance and contract facilitation.
b. Guaranteed offtake and market guarantees: Where feasible, CSR programs can include social procurement quotas or preferential contracting for qualified local suppliers.

5. Youth leadership, governance and social enterprise
a. Youth councils and incubators: Support youth platforms that can design community projects (waste recycling, solar mini-grids, market cleaning) and access seed funding.
b. Social entrepreneurship: Encourage youth to tackle community problems via sustainable business models—e.g., low-cost sanitation services, renewable energy kiosks, or water vending with quality assurance.

IV. IMPLEMENTATION PRINCIPLES
Implementing sustainable livelihoods, local economy and youth empowerment interventions in the oil-producing areas of Nigeria’s Niger delta region must be based on these minimum specific, measurable, achievable, realistic, and timebound strategic principles.

1. Participatory design: Involve youth, women and traditional leaders in project selection, monitoring and benefit design to ensure relevance and acceptance.
2. Market orientation: Interventions should be validated by market actors (buyers, processors) to avoid training for non-existent jobs.

3. Gender and inclusion: Design finance products and training with gender-sensitive features (flexible hours, childcare support), and actively target women and marginalized youth.
4. Sustainability and transitions: Favor interventions that can be sustained by local institutions—community cooperatives, microfinance groups, and local government—after CSR funding ends.
5. Monitoring and adaptive learning: Use clear KPIs and regular feedback loops so programs can be adjusted based on results.

V. KEY PERFORMANCE INDICATORS (KPIs)
It is advisable to select specific, measurable, achievable, realistic, and timebound strategic KPIs which should include the following:
1. Number of youth trained as a % of eligible youths in the community

2. Proportion of trained youth in employment or self-employment after 6 and 12 months.
3. Number of families reporting increase in average household income in target communities.
4. Number of local supplier contracts awarded to community enterprises.
5. Loan repayment rates for microfinance schemes and number of active savings groups.
6. Number of restored hectares of productive land or functional fishponds established.

VI. RISK MITIGATION AND COMMON PITFALLS
There have been pitfalls identified in achieving sustainable livelihoods, local economy and youth empowerment interventions in oil-producing areas. These are listed below, along with their mitigation measures.
1. Short funding cycles: Avoid one-off activities; design multi-year programs with clear exit strategies that build local ownership.
2. Misaligned incentives: Ensure oil companies’ procurement and HR policies support local hiring and supplier development genuinely, not rhetorically.
3. Environmental recurrence: Livelihood gains will be fragile if pollution continues; tie livelihood programs to concrete environmental remediation commitments.
4. Elite capture: Use transparent selection criteria and community oversight to prevent resources being monopolized by local elites.

VII. PRACTICAL PROJECT IDEAS AND QUICK WINS FOR SUSTAINABLE LIVELIHOODS, LOCAL ECONOMY AND YOUTH EMPOWERMENT IN OIL-PRODUCING AREAS OF NIGERIA’S NIGER DELTA REGION
1. Provide solar-powered cold-storage hubs at landing sites, managed by community youth cooperatives, to reduce post-harvest losses for fish and perishable crops
2. Set up Youth agribusiness incubator including short agronomy courses and starter kits, and guarantee market linkages with urban buyers.
3. Support waste-to-value enterprises that collect plastics and process them into low-cost building blocks or marketable products.
4. Sponsor apprenticeship consortium where oil companies co-fund a pool of apprentices across various trades and guarantee interviews for high performers.

VIII. CONCLUSION
Transforming the Niger Delta’s oil-producing and affected communities from dependence into resilient local economies requires integrated, market-aware and youth-centred programming. When CSR and public policy prioritize skills that match local demand, create reliable access to finance and markets, and restore natural resources that underpin livelihoods, youth can become job creators rather than job seekers. The broad payoffs are reduced poverty, lower conflict risk, healthier communities and lasting economic diversification that benefit both communities, the Niger Delta, Nigeria, and the oil sector’s social license to operate.

Dr. Uzodinma Adirieje is a seasoned consultant with extensive expertise in global health, climate change, health/community systems strengthening, development planning, project management, Sustainable Development Goals (SDGs), governance, policy advocacy, and monitoring and evaluation (M&E), based in Nigeria. He provides high-level consultancy services to governments, UN agencies, international organizations, NGOs, and development partners across Africa, leveraging over 25 years of multidisciplinary experience across Africa and the Global South. He was the Chair of Nigeria’s national World Malaria Day Committee in 2019; National President and fellow of the Nigerian Association of Evaluators (NAE) during 2019 – 2022; President of the Civil Society Organizations Strategy Group on SDGs in Nigeria (CSOSG); and Chair of the Resource Mobilization sub-committee of Nigeria’s national World Tuberculosis Day Committee in 2025, etc. He’s currently President of the African Network of Civil Society Organizations (ANCSO), and Chair of the Global Consortium of Civil Society on Climate Change and Conference of Parties (GCSCCC).

 

 

COMMUNITY HEALTH, SANITATION AND WATER SUPPLY IN OIL-PRODUCING AREAS OF NIGERIA’S NIGER DELTA REGION: FOCUS ON IMO STATE [current concerns 2-010]

 

14 September 2025  current concerns 2-010 [special edition]

COMMUNITY HEALTH, SANITATION AND WATER SUPPLY IN OIL-PRODUCING AREAS OF NIGERIA’S NIGER DELTA REGION: FOCUS ON IMO STATE
-by Dr. Uzodinma Adirieje / +2348034725905 (WhatsApp) / EMAIL: druzoadirieje2015@gmail.com

 CEO/Programmes Director, Afrihealth Optonet Association (AHOA) – CSOs Network and Think-tank

follow Dr. Uzodinma Adirieje on Facebook by clicking on this link <https://www.facebook.com/uzoadirieje> to receive more posts. 

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I. BACKGROUND

Imo State, located within Nigeria’s Niger Delta Belt of the Eastern region, is one of the country’s recognized oil-producing states. Oil exploration in Imo dates back to the late 1970s, with the discovery of petroleum deposits in areas such as Ohaji/Egbema, Oguta, Oru East, and parts of Owerri West. These communities form the state’s primary oil belt and contribute significantly to Nigeria’s crude oil and gas output. Imo State hosts several oil companies, including multinational and indigenous operators, which manage flow stations, oil wells, and gas facilities across the Niger Delta basin. The oil-producing areas of Imo are rich in hydrocarbons and provide a major source of revenue to the state and the federation. However, like other Niger Delta areas, they face challenges of environmental degradation, oil spills, gas flaring, and underdevelopment. Despite producing substantial wealth, the host communities have long called for greater equity in resource allocation, infrastructural development, and environmental remediation. As a member of the Niger Delta Development Commission (NDDC), Imo State is entitled to intervention projects aimed at improving living conditions in its oil communities. The state’s oil-producing areas remain central to both Nigeria’s energy security and Imo State’s economic development, making their sustainable management crucial for long-term prosperity of everyone.

II. THE SITUATION ON THE GROUND
The above Communities near oil installations in Imo State typically face four interlinked problems:
1. Unsafe water sources: Oil spills, pipeline leaks and poor waste disposal contaminate surface and groundwater. Many households rely on shallow wells, streams, or unprotected boreholes that are vulnerable to hydrocarbon and microbial contamination.
2. Inadequate sanitation: Limited sewerage systems, poorly constructed latrines, open defecation in some riverine areas, and inadequate solid-waste disposal create persistent environmental health risks—breeding grounds for diarrhoeal diseases, cholera, and parasitic infections.
3. Strained health services: Local primary health care facilities are often under-resourced, with gaps in staff, essential drugs, basic diagnostic capacity and maternal/newborn care. Pollution-linked respiratory and skin conditions add to demand, while livelihoods disruptions reduce households’ ability to pay for care.

4. Limited entrepreneurial spaces: The environmental damages resulting from oil explorations constitute immense hindrance to economic activities especially those relating to the ocean/water and land; since the inhabitants are usually and mainly fishers and farmers.
The above factors combine to worsen child morbidity and mortality, raise maternal health risks, and reduce productivity—creating feedback loops of poverty, poor health, and untimely deaths.

III. PRIMARY HEALTH IMPACTS
1. Respiratory problems and eye irritation: Gas flaring and particulate pollution increase the incidence of coughs, chronic bronchitis and eye irritation.
2. Skin conditions and chemical exposure: Contact with oil-contaminated water or soil can cause dermatitis, rashes and, with long-term exposure, more serious health concerns.
3. Maternal and child health risks: Limited emergency obstetric care and poor transport compound pregnancy risks, while contaminated water and poor sanitation contribute to neonatal infections.
4. Water-borne and enteric diseases: Diarrhoea, typhoid, and hepatitis A are common where drinking water is contaminated or sanitation is poor. Frequent diarrhoeal episodes increase malnutrition in children under five.

IV. PROVEN INTERVENTION PACKAGE
Practical, scalable, and sustainable remedial interventions should blend immediate public-health actions with medium-term infrastructure investments and institutional strengthening. Below are some prioritized, community-centred package of interventions.

1. Emergency and short-term measures (0–6 months)
a. Safe-water emergency supplies: Provide potable water via water-trucking where contamination is acute, distribute household water-treatment kits (chlorine, ceramic filters), and supply jerrycans to reduce recontamination.
b. Risk communication and hygiene promotion: Rapid community campaigns on handwashing, safe water storage, boiling/chemical treatment, and avoiding contaminated water bodies. Use local languages and trusted channels (community leaders, health workers).
c. Mobile clinic outreach: Deploy mobile teams to deliver immunizations, treat common infections, manage diarrhoeal disease, and triage severe cases for referral.
d. Vector control and waste clean-up: Remove solid-waste hotspots and perform targeted vector control to reduce diarrhoeal and mosquito-borne disease transmission.

2. Medium-term infrastructure and service strengthening (6–24 months)
a. Protected water supply systems: Drill and protect boreholes to safe depths, install hand pumps or solar-powered submersible pumps with concrete aprons and drainage. Where possible, develop small piped systems with community water committees and metering to ensure sustainability.
b. Household and communal sanitation: Build improved, ventilated pit latrines or ecosan systems in communities and schools; install public latrines in markets and landing sites; establish desludging services and safe fecal sludge management plans.
c. Rehabilitate and equip PHC facilities: Upgrade health centres with water and sanitation facilities, essential medicines, cold chain for vaccines, basic laboratory diagnostics, and maternal care supplies. Train and retain at least two skilled birth attendants per facility.
d. Community health worker (CHW) programme: Expand CHW networks to deliver home-based care, promote sanitation and water safety, perform community surveillance, and link households to PHC services.

3. Long-term resilience and governance (2–5 years)
a. Integrated water resource management: Map and protect key recharge areas and upstream sources; regulate waste disposal and engage oil operators on buffer zones.
b. Capacity building and local finance: Strengthen local government capacity to manage water and sanitation services; set up community maintenance funds and transparent tariffs where feasible.
c. Health system strengthening and surveillance: Implement routine disease surveillance, digital reporting channels, and emergency preparedness plans that include spill-response health protocols.
d. Environmental health monitoring: Regular testing of water, soil and air with publicly available results; community monitors trained to collect basic samples and report anomalies.

4. Community-centred principles, comprising projects work best when they are participatory and locally accountable:
a. Involve communities in design and monitoring: Community Water Committees and Health Committees should help select sites, set tariffs, and monitor service quality.
b. Use local labour and suppliers: Local procurement and labour create livelihood co-benefits and improve acceptance.
c. Transparent grievance redress: Establish simple, well-publicised complaint channels and track response timelines.

V. SELECTING OUR KEY PERFORMANCE INDICATORS TO MEASURE PROGRESS OF THESE INTERVENTIONS:
Professional Monitoring and Evaluation (M&E) is essential for the realization of the noble intentions of the above interventions. Therefore, the following some selected key performance indicators (KPIs) should be considered in monitoring and measuring the success of the respective interventions as appropriate, to ensure good value for moneys spent:
1. % households with access to safe drinking water within 30 minutes.
2. % households with access to an improved sanitation facility not shared with other households.
3. % households with access to an electric power supply for at least 8 hours every day.

4. % children of school age that are attending fulltime schooling.

5. % adults and out-of-school youths who are gainfully employed

6. % women of childbearing age who give birth in health facilities without financial hardship

7. Immunization coverage rate for children under one in targeted communities.
8. Reduction in reported diarrhoeal incidence among children under five (cases per 1,000).
9. Number of functional PHC facilities with piped water and sanitation.

VI. RISK FACTORS AND CAUTIONS
1. Pollution recurrence: Without stronger environmental controls on oil operations, infrastructure investments risk being undermined by future contamination.
2. Affordability: Even modest tariffs can exclude the poorest; cross-subsidies or targeted subsidies may be necessary.
3. Maintenance culture: Technical systems fail when maintenance is neglected; investments must include training, spare parts supply chains, engagement of locals, and governance structures.

VII. CONCISE RECOMMENDATIONS
1. Rapidly conduct a combined WASH and health needs assessment in affected communities to prioritize interventions.
2. Immediately roll out emergency safe-water and hygiene promotion while planning borehole and sanitation projects.
3. Rehabilitate Primary Health Care (PHC) facilities with a focus on maternal/newborn care, basic eye care services, water and sanitation, cold chain, and basic diagnostics.
4. Create multi-stakeholder oversight committees (community, traditional, religious, local government, oil operators, women groups, NGOs) to coordinate response, finance, and monitoring. This will help create a sense of joint ownership, compelling the communities to also protect iol businesses in their localities.
5. Link remediation commitments by operators to community health and development investments—ensure polluter-pays principles and transparent reporting.

VIII. CONCLUSION
Improving community health, sanitation and water supply in Imo State’s oil-producing areas is technically feasible and socially essential. Success requires combining immediate health protection with medium-term investments and stronger governance. When communities, health systems, local government and the oil sector coordinate transparently—and when affected residents are empowered to oversee services—progress in oil exploration activities and health outcomes can be rapid and enduring.

 

Dr. Uzodinma Adirieje is a seasoned consultant with extensive expertise in global health, climate change, health/community systems strengthening, development planning, project management, Sustainable Development Goals (SDGs), governance, policy advocacy, and monitoring and evaluation (M&E), based in Nigeria. He provides high-level consultancy services to governments, UN agencies, international organizations, NGOs, and development partners across Africa, leveraging over 25 years of multidisciplinary experience across Africa and the Global South. He was the Chair of Nigeria’s national World Malaria Day Committee in 2019; National President and fellow of the Nigerian Association of Evaluators (NAE) during 2019 – 2022; President of the Civil Society Organizations Strategy Group on SDGs in Nigeria (CSOSG); and Chair of the Resource Mobilization sub-committee of Nigeria’s national World Tuberculosis Day Committee in 2025, etc. He’s currently President of the African Network of Civil Society Organizations (ANCSO), and Chair of the Global Consortium of Civil Society on Climate Change and Conference of Parties (GCSCCC).

 

COMMUNITY ENGAGEMENT, GOVERNANCE AND CONFLICT PREVENTION IN OIL-PRODUCING AREAS OF THE NIGER DELTA REGION, NIGERIA: FOCUS ON IMO STATE {current concerns 2-009 [special edition]}

 12 September 2025

current concerns 2-009 [special edition]

COMMUNITY ENGAGEMENT, GOVERNANCE AND CONFLICT PREVENTION IN OIL-PRODUCING AREAS OF THE NIGER DELTA REGION, NIGERIA: FOCUS ON IMO STATE
-by Dr. Uzodinma Adirieje / +2348034725905 (WhatsApp) / EMAIL: druzoadirieje2015@gmail.com

  follow Dr. Uzodinma Adirieje on Facebook by clicking on this link <https://www.facebook.com/uzoadirieje> to receive more posts. 

'Like' and comment on my posts to receive other people's responses.

BACKROUND

Imo State, located in the southeast region of Nigeria, is one of the country’s recognized oil-producing States, contributing to the national economy through petroleum exploration and production. With reserves located mainly in communities within Ohaji/Egbema, Oguta, and Owerri West local government areas, the state plays a strategic role in Nigeria’s energy sector. Crude oil and natural gas deposits in these areas have attracted both multinational and indigenous oil companies, making Imo part of the Niger Delta oil belt. Despite its relatively smaller output compared to states like Rivers, Delta, or Akwa Ibom, Imo’s oil resources remain vital for federal revenue allocation through the derivation principle. However, the benefits of oil production have been accompanied by challenges, including environmental degradation, youth unemployment, and underdevelopment in host communities. This dual reality underscores the importance of sustainable resource management and Corporate Social Responsibility (CSR) initiatives to improve livelihoods and foster stability.

 

Although oil production in Imo State has brought jobs and revenue, it has also amplified tensions between communities, operators and the State. Local grievances often centre on environmental damage, perceived inequitable benefits, lack of transparency in community–company dealings, and responses to illegal oil activities. When these grievances are unmanaged they can escalate into protests, youth militancy or clashes with security forces — as seen in several Imo communities — with damaging social and economic consequences.

This article explains the root causes of conflict in Imo’s oil-bearing areas, outlines practical principles for community engagement and good governance, and presents an actionable conflict-prevention framework that companies, State/local governments and communities can adopt.

WHY CONFLICT ARISES: THE CORE DRIVERS
1. Environmental harm and livelihoods loss: Oil spills, gas flaring and illegal refining damage fisheries, farmlands and water — the foundation of many local livelihoods. When the environmental damage persists, frustration grows and trust in operators erodes. Lessons from other Niger Delta sites show how environmental disasters can produce long-term grievances if remediation is slow or opaque;
2. Perceived exclusion from benefits: Communities frequently report that jobs, contracts and CSR projects bypass local people or are captured by elites, fuelling anger—especially among youth who see few legitimate pathways to income;
3. Weak, non-transparent community agreements: Memoranda of understanding (MOUs) or community development agreements that are vague, poorly publicised or unenforceable create a sense that promises are negotiable rather than binding;
4. Poor grievance handling and slow redress: When complaints about pollution or projects are ignored or handled opaquely, escalation becomes likely; and
5. Criminality and security responses: Illegal refining, oil theft and associated crime provoke harsh security responses. Clashes between youths and security forces (as reported in Izombe and other locations) worsen cycles of violence and mistrust.



NEED FOR CONSTRUCTIVE COMMUNITY ENGAGEMENT AND GOVERNANCE
Good practice rests on a handful of interlocking principles namely:
a. Participation and inclusion: Engagement must include women, youth, minority groups and traditional leaders. Decisions that affect access to land, water or jobs should not be made by a narrow leadership clique alone.
b. Transparency and information access: Environmental baselines, incident reports, remediation plans and procurement opportunities should be publicly accessible in local languages and through community channels.
c. Accountability and enforceability: Agreements should have measurable deliverables, third-party verification and clear sanctions if parties fail to deliver.
d. Local ownership and capacity building: Communities should receive skills and institutional support (e.g., to run water systems, supplier associations, or grievance panels) so benefits persist beyond project funding.
e. Conflict-sensitive programming: Projects must be designed to avoid inadvertently exacerbating inequalities (for instance, favouring one village over another) and include conflict-mitigation measures from the outset.
These principles are grounded in the academic and practical literature on oil-sector community relations and have been distilled from multiple Niger Delta case studies.

AN OPERATIONAL FRAMEWORK FOR CONFLICT PREVENTION (SIX PILLARS)
1. Participatory baseline and risk mapping: Jointly map who depends on which natural resources, historic grievances, hotspots of illegal activity and social fault-lines. This shared picture guides prioritisation and reduces suspicion.
2. Negotiated, public Community Development Agreements (CDAs): Replace secretive MOUs with CDAs that specify: scope of projects; timelines; procurement and hiring quotas; environmental remediation commitments; monitoring arrangements; and dispute-resolution steps. CDAs should be registered with local government and made publicly available.
3. Robust grievance redress mechanism (GRM): Design a multi-tier GRM: (a) community-level intake (trusted local agents), (b) company-level response team with fixed SLAs, and (c) independent arbitration/appeal (NGO or ombudsperson). Track grievances publicly (number, category, resolution time, outcome) to build confidence.
4. Community monitoring and independent verification: Train and equip local monitors to collect basic environmental and service-delivery data; complement them with independent technical audits. Community data should be published alongside company/regulator data to improve transparency and co-learning.
5. Local content, livelihoods and youth inclusion: Tie community benefits to verified environmental performance (e.g., release funds for community projects only after third-party confirmation of cleanup). Prioritise youth apprenticeships, supplier development and social enterprises to offer legitimate economic options that reduce susceptibility to criminality.
6. Conflict-sensitive security arrangements: Where security forces are present, establish clear rules of engagement, independent civilian oversight and community liaison officers. Avoid heavy-handed responses; invest instead in policing that protects communities and targets criminality while respecting human rights.

PRACTICAL MEASURES AND QUICK WINS
a. Public incident dashboards: A simple online (and print) dashboard of spills, remediation status and GRM cases helps counter rumours and shows progress.

b. Joint rapid response teams: Community representatives embedded in company response teams speed containment and reassure locals.
c. Community trust funds with transparent disbursement: Funds for schools, clinics or water systems should have community committees and published accounts.
d. Local arbitration panels: A panel combining respected community figures, a neutral NGO and a legal expert can deliver faster, culturally appropriate dispute resolution.

MONITORING, INDICATORS AND ADAPTIVE LEARNING
Track key performance indicators (KPIs) such as number of grievances filed and resolved within agreed timeframes, percent of Community Development Assistance [CDA] commitments fulfilled, youth employment rates in local contracts, and measures of community trust (periodic perception surveys). Use quarterly multi-stakeholder review meetings to adjust interventions based on evidence.

CHALLENGES AND MITIGATIONS
1. Elite capture: Use transparent selection criteria for project beneficiaries and rotate committee membership.
2. Capacity gaps: Invest in training for community committees and local governments.
3. Political interference: Anchor CDAs in local government records and, where possible, national regulations to reduce unilateral override.
4. Ongoing environmental damage: Link community benefits explicitly to verifiable remediation milestones so improvements are conditional on environmental performance.

CONCLUSION
Preventing and resolving conflict in Nigeria’s Niger Delta Belt including Imo State’s oil-producing communities is less about one-off payments and more about building durable systems of participation, transparency and accountability. When communities are partners — not passive recipients — and when agreements are public, measurable and honoured/enforced, the risk of violent escalation falls sharply. The alternative is a repeating cycle of damage, grievance, protest and repression that harms both people and the long-term interests of the oil sector. Practical, well-designed community engagement and governance mechanisms can turn oil revenues into inclusive development for all, rather than a source of fracture for some.

 

Dr. Uzodinma Adirieje is a seasoned consultant with extensive expertise in global health, climate change, health/community systems strengthening, development planning, project management, Sustainable Development Goals (SDGs), governance, policy advocacy, and monitoring and evaluation (M&E), based in Nigeria. He provides high-level consultancy services to governments, UN agencies, international organizations, NGOs, and development partners across Africa, leveraging over 25 years of multidisciplinary experience across Africa and the Global South. He was the Chair of Nigeria’s national World Malaria Day Committee in 2019; National President and fellow of the Nigerian Association of Evaluators (NAE) during 2019 – 2022; President of the Civil Society Organizations Strategy Group on SDGs in Nigeria (CSOSG); and Chair of the Resource Mobilization sub-committee of Nigeria’s national World Tuberculosis Day Committee in 2025, etc. He’s currently President of the African Network of Civil Society Organizations (ANCSO), and Chair of the Global Consortium of Civil Society on Climate Change and Conference of Parties (GCSCCC).

 

NIGERIA’S 2027 PRESIDENTIAL PAIRINGS: EXPLORING THE TINUBU/SHETTIMA, OBI/DATTI, ATIKU/OBI, JONATHAN/KWANKWASO CANDIDACY OPTIONS [friday Blues 1-007]

 12 September 2025

friday Blues 1-007

NIGERIA’S 2027 PRESIDENTIAL PAIRINGS: EXPLORING THE TINUBU/SHETTIMA, OBI/DATTI, ATIKU/OBI, JONATHAN/KWANKWASO CANDIDACY OPTIONS
- by Noble Dr. Uzodinma Adirieje (KSJI)

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EMAIL: druzoadirieje2015@gmail.com

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This article is also available at the following link

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This week, I’m looking at Nigeria's 2027 potential Presidential Pairings. With the 2027 presidential contest still two years away, Nigeria’s political chessboard is already crowded. Four ticket permutations—Tinubu/Shettima, Obi/Datti, Atiku/Obi, and Jonathan/Kwankwaso—capture contrasting strategies: incumbency and continuity, youthful reformism coupled with experienced partners, broad opposition coalitions, and a nostalgic-plus-regional balancing act. Each pairing has strengths, glaring weaknesses, and varying plausibility as a real campaign force.

Tinubu/Shettima: incumbency, continuity, and the politics of risk
President Bola Tinubu’s All Progressives Congress (APC) moved early: party stakeholders publicly endorsed Tinubu for a 2027 re-run, signaling that the ruling formation intends to trade on incumbency and continuity. Incumbent campaigns benefit from party machinery, state-level influence, and the ability to point to economic choices—such as subsidy removal and currency reforms—as bold (if painful) reform programs.

But Tinubu/Shettima face real headwinds. The administration’s reforms, while drawing investor praise, have sharpened cost-of-living pressures and kept insecurity near the top of voter grievances—material vulnerabilities that opposition narratives will exploit. Internally, the Shettima vice-presidential question has provoked unease in some APC quarters: regional actors and critics have publicly debated whether the ticket’s religious and geographic optics are optimal, producing friction ahead of a demanding re-election campaign.

Obi/Datti: youth appeal meets technocratic steadiness — but is it unified?
The Peter Obi phenomenon in 2023 reshaped voter expectations: his messaging energized urban youth and parts of the South-East. Pairing Obi with Datti Baba-Ahmed (often called simply “Datti”)—the senator and 2023 running mate who has been publicly associated with Obi’s movement—would attempt to combine Obi’s political brand with a partner seen as disciplined and policy-oriented. Datti himself has commented on his relationship with Obi and signalled openness but has also criticized some coalition moves—suggesting he will not be an automatic or uncritical partner.

The biggest question for an Obi/Datti ticket is institutional muscle. Obi’s strongest energy has been grassroots and youth-driven; converting enthusiasm into nationwide party structure and inter-regional coalitions requires compromises that risk diluting his brand. Additionally, Labour Party internal dynamics and the jockeying of other opposition platforms could complicate who legally fields a joint ticket or which party becomes home to their ambitions.

Atiku/Obi: a fusion that could unsettle the status quo — if egos and logistics align
A formal Atiku Abubakar–Peter Obi arrangement would be one of the most consequential opposition alignments: Atiku brings decades of national political networks and PDP experience; Obi brings populist legitimacy among young, urban voters. Recent reporting shows opposition leaders are exploring coalitions designed to prevent a rout by the ruling party, with bodies such as the African Democratic Congress (ADC) serving as potential umbrellas.

Yet coalitions are messy. Obi has repeatedly insisted on his independence in different contexts, and Atiku is a tenacious contender with his own base—melding two strong personalities and ambitions into a single, functioning ticket requires careful negotiation over leadership, policy platform, and party structure. If they solve the “who leads and why” puzzle and present a clear economic and security alternative to voters, their union could be electorally potent; if not, it risks fragmentation that advantages the incumbent.

Jonathan/Kwankwaso: symbolic balance and the limits of comeback politics
A Goodluck Jonathan–Rabiu Kwankwaso ticket evokes an older generation of leaders attempting to reassert relevance through cross-regional alliances: Jonathan’s South-South base and statesman image; Kwankwaso’s appeal among certain Northern constituencies and the “Kwankwasiya” movement. Speculation and informal talks have circulated about such a collaboration, and Jonathan’s name frequently surfaces in rumor and discourse about a potential comeback.

But on plausibility, this pairing looks the most speculative. Jonathan has publicly denied planning an active presidential bid in recent fact-checks and media reports, and Kwankwaso has faced organizational and party setbacks that complicate efforts to mount a credible nationwide campaign. In short: name recognition exists, but institutional readiness and clear intent are weaker than in the other permutations.

What the permutations tell us about 2027
Three themes cut across these options. First, coalition-building will be decisive: Nigeria’s size and diversity mean no single region or demographic can deliver victory alone. Second, performance politics—how voters judge the economy, security, and governance—will shape whether incumbency is a liability or an advantage. Third, institutional anchors matter: personal brands are influential, but party machines, legal nominations, and internal unity determine whether a promising pairing becomes an effective campaign.

About 18 months to this crucial election, Tinubu/Shettima currently have the clearest path to fielding a ticket due to party endorsement and incumbency, but they are vulnerable to economic discontent and intra-party debates. Obi/Datti or Atiku/Obi could produce the most dynamic opposition ticket if they reconcile leadership and party mechanics. Jonathan/Kwankwaso, while intriguing on paper, is the least certain unless both figures decisively commit and secure platforms that can mobilize across the federation.

As 2027 draws closer, expect alliances, denials, endorsements, and legal manoeuvres to intensify. For observers and voters alike, the key question will be whether these permutations generate coherent policy visions for a country wrestling with deep economic and security challenges—or whether they remain contests of personalities and patronage.

Noble Dr. Uzodinma Adirieje is a distinguished and multidimensional communicator whose work as a writer, columnist, blogger, reviewer, editor, and author bridges the intersections of global health, sustainable development, human rights, climate justice, and governance. He holds a number of chieftaincy titles including ‘High Chief Ugwumba I of Amaruru’, and ‘Ahaejiejemba Ndigbo Lagos State’.

 

IMPERATIVE OF UNIVERSAL HEALTH COVERAGE FOR THE ACHIEVEMENT OF THE SUSTAINABLE DEVELOPMENT GOALS AND AFRICA’S AGENDA 2063 (2) [current concerns 2-008]

 

current concerns 2-008

IMPERATIVE OF UNIVERSAL HEALTH COVERAGE FOR THE ACHIEVEMENT OF THE SUSTAINABLE DEVELOPMENT GOALS AND AFRICA’S AGENDA 2063 (2)

-by Dr. Uzodinma Adirieje / +2348034725905 (WhatsApp) / druzoadirieje2015@gmail.com

  follow Dr. Uzodinma Adirieje on Facebook by clicking on this link <https://www.facebook.com/uzoadirieje> to receive more posts. 

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VI. The Economic and Social Case for UHC

a. Human capital and growth: Health investments yield high social and economic returns by increasing labour productivity, educational attainment, and innovation.

b. Financial risk protection: Prepayment and pooling reduce catastrophic expenditures and prevent poverty traps.

c. Efficiency: PHC-led systems reduce avoidable hospitalizations, lower costs, and improve continuity of care.

d. Resilience: Health systems capable of maintaining essential services during epidemics, conflicts, and climate shocks protect lives and livelihoods.

 

VII. Pathways to UHC: Core Building Blocks

The following pathways constitute the core building block for effective UHC systems:

a. Service Coverage via Strong PHC regimes that define a national essential health benefits package with explicit cost-effectiveness, equity, and fiscal realism criteria; expand community health platforms (CHWs, outreach, school health) with supportive supervision and reliable supply chains; integrate RMNCAH, NCD prevention and care, mental health, rehabilitation, palliative care, and SRHR into PHC; and embed public health functions (surveillance, immunization, vector control, WASH linkages) within PHC.

b. Financial Protection and Progressive Financing regimes that reduce OOP shares by expanding prepaid, pooled financing: social health insurance, tax-funded schemes, or hybrid models; improve domestic resource mobilization: earmarked sin taxes (tobacco, alcohol, sugary drinks), efficiency in tax collection, and reprioritization of public budgets; enhance pooling and equity: merge or align fragmented schemes; subsidize premiums for the poor and vulnerable; and implement strategic purchasing: capitation and diagnosis-related payments for PHC and hospitals; pay-for-quality with safeguards for equity.

c. Quality of Care and Patient Safety regimes that encompass national quality strategies, accreditation and licensing, and continuous quality improvement; safety culture around infection prevention and control, pharmacovigilance, and respectful care; person-centeredness that promote shared decision-making, grievance redress, and client satisfaction tracking;

d. Numbers, Skills, and Distribution of Health Workforce that scale up training and task sharing, expand midwifery, nursing, pharmacy, and allied cadres; incentivize rural and hard-to-reach deployment: housing, hardship allowances, career pathways; and protect and motivate workers: fair pay, safe workplaces, mental health support, and continuous professional development.

e. Medicines, Vaccines, Diagnostics, and Supply Chains that strengthen procurement transparency, and adopt pooled procurement mechanisms; support local manufacturing and regional value chains under AfCFTA; enforce regulatory standards through AMA; and implement real-time logistics management information systems to prevent stock-outs and wastage.

f. Digital Health and Data Systems characterized by interoperable, privacy-preserving electronic health records; client registries and unique IDs; data for decision-making using routine HMIS, civil registration and vital statistics, geospatial analytics, and AI-assisted forecasting; and telehealth and mHealth to extend reach, continuity, and self-care.

g. Governance, Accountability, and Community Engagement paradigm with clear stewardship roles across national and subnational levels, and legal frameworks for UHC; transparent budgeting, public expenditure reviews, and citizen-led social accountability; community participation in priority-setting and monitoring inclusive of health committees, CSOs/NGOs, faith-based organizations, and professional associations.

 

VIII. Cross-Cutting Priorities for Africa

There are cross-cutting priority areas to realize the important place of UHC in achieving the SDGs and Africa Agenda 2063. These include, in no particular order of priority, the following:

a.  Gender Equality, SRHR, and Ending GBV to ensure that SRHR and GBV services are in the essential benefits package with removal of user fees that deter uptake; and to expand adolescent-friendly services by engaging men and boys, protecting bodily autonomy, and promoting consent.

b. Humanitarian, Fragile, and Conflict Settings by promoting UHC-in-fragility approaches using mobile clinics, public–private partnerships, and health-worker protection; maintaining immunization and essential services during crises, by integrating refugees and IDPs equitably.

c. Climate-Resilient and Planetary Health Systems by recognizing and addressing the climate-and-health interface through climate-informed planning, early warning systems, heat-health action plans, and vector surveillance; and greener health facilities using energy efficiency, renewable power, and climate-smart supply chains.

d. One Health and Antimicrobial Resistance (AMR) to integrate human, animal, and environmental health surveillance; and enhance stewardship through optimizing antimicrobial use; strengthen laboratory networks/referrals, and enforce infection prevention and control.

 

IX. Financing UHC: Making It Affordable and Sustainable

Financing is at the core of spreading the benefits UHC, including the adherence to minimum of 15% annual budgets to Health, as agreed by African countries during the African Union’s meeting in Abuja, Nigeria in 2001. To this end, efforts must be made towards budget reprioritization to meet or move toward continental and global health financing benchmarks; use of innovative financing such as solidarity levies, diaspora bonds, results-based financing, blended finance for infrastructure; promoting efficiency gains by reducing waste, leveraging generic medicines, adopting cost-effective technologies, and improving provider payment methods; as well as development cooperation aligned with national plans, and transition strategies for countries moving to higher income categories.

….. to be continued

 

Dr. Uzodinma Adirieje is a seasoned consultant with extensive expertise in global health, climate change, health/community systems strengthening, development planning, project management, Sustainable Development Goals (SDGs), governance, policy advocacy, and monitoring and evaluation (M&E), based in Nigeria. He provides high-level consultancy services to governments, UN agencies, international organizations, NGOs, and development partners across Africa, leveraging over 25 years of multidisciplinary experience across Africa and the Global South. He was the Chair of Nigeria’s national World Malaria Day Committee in 2019; National President and fellow of the Nigerian Association of Evaluators (NAE) during 2019 – 2022; President of the Civil Society Organizations Strategy Group on SDGs in Nigeria (CSOSG); and Chair of the Resource Mobilization sub-committee of Nigeria’s national World Tuberculosis Day Committee in 2025, etc. He’s currently President of the African Network of Civil Society Organizations (ANCSO), and Chair of the Global Consortium of Civil Society on Climate Change and Conference of Parties (GCSCCC).

 

REFLECTIONS ON CIVIL SOCIETY SPOTLIGHT AT THE 2025 NIGERIA NATIONAL HEALTH FINANCING DIALOGUE current concerns 2-007 (special edition)

 

current concerns 2-007 (special edition)

REFLECTIONS ON CIVIL SOCIETY SPOTLIGHT AT THE 2025 NIGERIA NATIONAL HEALTH FINANCING DIALOGUE

-by Dr. Uzodinma Adirieje / +2347015530362 (WhatsApp) / druzoadirieje2015@gmail.com

CEO/PD, Afrihealth Optonet Association (AHOA) – CSOs Network and Think-tank

 

A highlight of the 2025 Nigeria National Health Financing Dialogue held in Abuja, Nigeria during 1 – 4 September 2025, was the active participation of civil society organizations, including the Afrihealth Optonet Association (AHOA)—a pan-African and global South network of NGOs, CBOs, academic/research institutions, and professional associations working across health, environment, climate change, and sustainable development.

During the sessions, AHOA’s Leadership and AHOA Fellows, with other civil society participants, ensured that citizens’ voices and grassroots realities were not sidelined in what could otherwise have been a technocratic conversation. Their interventions and interactions with other participants were anchored around five key contributions:

1. Community Accountability in Financing
AHOA drew from its track record of implementing community-based oversight and social accountability tools. It advocated models where health facility committees and civil society groups track fund releases under the Basic Health Care Provision Fund (BHCPF), ensuring that every naira released is reflected in medicines, staff salaries, or service delivery at the last mile.

2. Social and Behaviour Change Communication (SBCC)
AHOA and other CSO representatives highlighted how SBCC approaches, tested in climate and health programmes, can be adapted to promote citizens’ buy-in to health insurance schemes, improve understanding of entitlements, and encourage the reduction of harmful out-of-pocket payments (OOP).

3. Climate–Health Financing Nexus
With Nigeria facing rising health threats from environmental degradation and climate shocks, AHOA pushed for integration of climate financing mechanisms into health sector planning. Their position was clear: climate vulnerability and health financing must be treated as interconnected, not parallel, agendas.

4. Equity and Vulnerable Populations
AHOA emphasized inclusion—calling for financing models that prioritize women, children, persons with disabilities, and populations in fragile, rural, and climate-affected settings. Their advocacy stressed that UHC cannot be achieved if financing instruments neglect the poorest and most vulnerable Nigerians.

5. Engagement with the media

AHOA also engaged the media throughout its released statement on the current concerns 2-005 (special edition) – ‘THE IMPERATIVE OF THE 2025 NATIONAL HEALTH FINANCING DIALOGUE IN NIGERIA’, which its representatives translated as technical discourse and citizen-friendly narratives in interactions with participants. This visibility was critical in broadening national awareness that health financing reform is not just a budgetary issue but a human rights and equity imperative.

Meeting our Expectations: From Dialogue to Delivery

The Abuja Dialogue achieved what many such gatherings do not: it created a shared vocabulary and hopefully, a time-bounded to-do list. It reframed health financing as state capability and national competitiveness—not just a technical problem to outsource to consultants. And it located Nigeria within a wider African wave of reforms that are increasingly sceptical of narrow contributory models and more interested in the hard work of pooling and purchasing for equity.

For me as a civil society actor, one of the most significant lessons was that inclusive participation works. By engaging civil society voices like Afrihealth Optonet Association (AHOA), alongside policymakers, donors, and private sector leaders—the Dialogue broadened its legitimacy and deepened its potential for real change. Financing reforms will only succeed if Nigerians, especially those at the grassroots, feel the difference through reduced out-of-pocket spending, improved facility conditions, and accessible, quality care.

It is my considered opinion that if we do the following three things with discipline, Nigeria can bend the curve within the next five years:

(1) pool smarter by consolidating and subsidizing coverage for the poor while enforcing portability;

(2) purchase strategically by paying for value at both primary and secondary care levels and publishing the results; and

(3) protect fiscal space by tying every new naira to measurable service gains and by de-risking private capital for essential health enablers, especially power and supply chains.

The Dialogue in Abuja has set the compass. The real test—beginning the morning after—is whether budgets, provider contracts, community monitoring systems, and facility dashboards start to look different. As the lights dimmed on the final day, there was a palpable sense that Nigeria is ready to graduate from talk-shops and pilot projects, to real evidence-based target-driven performance. The work ahead will be demanding. But if the spirit that was generally exhibited during this Dialogue endures namely pragmatic, inclusive, and relentlessly execution-minded, this writer is optimistic that —“Reimagining the Future of Health Financing in Nigeria” will give way to “Delivered Future of Health Financing in Nigeria”, and millions of Nigerians will feel the difference not in communiqués, but in quality care that is accessible, affordable, available, and worthy.

 

Dr. Uzodinma Adirieje is a seasoned consultant with extensive expertise in global health, climate change, health/community systems strengthening, development planning, project management, sustainable development goals (SDGs), governance, policy advocacy, and monitoring and evaluation (M&E). He provides high-level consultancy services to governments, UN agencies, international organizations, NGOs, and development partners across Africa, leveraging over 25 years of multidisciplinary experience across Africa and the Global South. He was the Chair of Nigeria’s national World Malaria Day Committee in 2019; National President and fellow of the Nigerian Association of Evaluators (NAE) during 2019 – 2022; President of the Civil Society Organizations Strategy Group on SDGs in Nigeria (CSOSG); and Chair of the Resource Mobilization sub-committee of Nigeria’s national World Tuberculosis Day Committee in 2025, etc. He’s currently President of the African Network of Civil Society Organizations (ANCSO), and Chair of the Global Consortium of Civil Society on Climate Change and Conference of Parties (GCSCCC).