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).