Stakeholders in Nigeria’s health sector have identified insecurity, workforce shortages, inadequate funding and weak constitutional backing as major obstacles to achieving universal health coverage (UHC) across the country.

The concerns were raised on Saturday at the fourth annual scientific conference organised by the College of Health Sciences, Usmanu Danfodiyo University, Sokoto (UDUS), where experts explored solutions to healthcare access and workforce challenges.

The conference, themed “Universal Health Coverage in Nigeria: Overcoming Access and Workforce Gaps in the Face of Insecurity,” featured about 120 scholarly papers and was chaired by renowned scholar, Prof. B.B. Shehu.

Speaking at the event, Sokoto State Commissioner for Health, Faruk Abubakar-Wurno, said the state faced an uneven distribution of healthcare workers, particularly between urban and rural primary healthcare facilities.

He said some urban primary healthcare centres (PHCs) had up to 80 personnel, while certain rural facilities operated with only one health worker, affecting service delivery and healthcare access.

Mr Abubakar-Wurno said the state government introduced a two-year compulsory service policy for health professionals trained through state scholarships to address persistent workforce shortages in underserved communities.

He added that the government had awarded 500 scholarships for midwifery training, renovated more than 160 PHCs and restored services in 92 centres across the state.

According to him, efforts were ongoing to ensure that all 244 PHCs in Sokoto become fully functional before the end of the year to improve healthcare delivery.

A former House of Representatives member and former Sokoto Health Commissioner, Shehu Balarabe-Kakale, called for constitutional reforms to make healthcare a fundamental right of every Nigerian.

Mr Balarabe-Kakale said healthcare remained a non-justiciable socio-economic objective under chapter two of the constitution, limiting accountability and weakening commitments to healthcare funding and service delivery.

He lamented that Nigeria had consistently fallen short of the 15 per cent health budget allocation target contained in the 2001 Abuja Declaration in spite of growing healthcare demands.

According to him, stronger legislation and sustained funding remain essential for achieving universal health coverage and addressing critical workforce shortages across the health sector.

Speaking on insecurity, the Wamban Isa, Alhaji Nasiru Yahaya-Isa, said about 40 per cent of PHCs in Sokoto East faced severe operational difficulties due to persistent bandit attacks.

Mr Yahaya-Isa said many health facilities, schools and communities had been abandoned as residents relocated to safer towns, including Sokoto and Isa, placing pressure on existing services.

He said the displacement had deepened poverty, disrupted farming and commercial activities and contributed to poor sanitation practices, including increased cases of open defecation.

Mr Yahaya-Isa urged governments and development partners to prioritise healthcare delivery in hard-to-reach and conflict-affected communities to ensure equitable access to essential services.

The Sultan of Sokoto, Alhaji Sa’ad Abubakar, represented by the district head of Wurno, Alhaji Kabiru Cigari, emphasised the need for innovative approaches to healthcare delivery in insecure communities.

In his keynote address, the director of planning, research and statistics at the National Health Insurance Authority (NHIA), Abubakar Kurfi, outlined strategies for accelerating universal health coverage in Nigeria.

Mr Kurfi urged governments to leverage local government financial autonomy to increase funding for primary healthcare services and expand access to health insurance coverage nationwide.

He also advocated stronger coordination among tiers of government, evidence-based policymaking and strategic planning to manage the transition from donor-funded health programmes.

According to him, governments should adopt strategic purchasing of health services, strengthen accountability mechanisms, invest in workforce development and promote community ownership of health programmes.

The Minister of Defence, Gen. Christopher Musa, linked insecurity directly to healthcare challenges, saying sustainable improvements in health coverage would depend on restoring peace and stability.

Represented by Col. A.D. Akinyele, Mr Musa emphasised that addressing insecurity required a whole-of-society approach involving government institutions, communities and other critical stakeholders.

Earlier, the Provost of the College of Health Sciences, UDUS, Abdulganiyu Jimoh, said the conference was designed to promote collaboration, knowledge sharing and practical solutions.

Mr Jimoh said insecurity and the “japa” phenomenon had worsened workforce shortages, while reaffirming the college’s commitment to producing skilled health professionals and advancing medical research.

(NAN)