Doctors demand public ranking of governors on healthcare performance

Medical professionals are calling for a transparent system that publicly ranks state governors based on their healthcare performance, aiming to enhance accountability and stimulate greater investment in the sector. The proposed system would evaluate state governments using key health indicators such as maternal and child mortality rates, immunisation coverage, primary healthcare effectiveness, and disease control.

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Healthcare failure is not only a federal problem. Many primary healthcare centres are under the state and local governments, but remain abandoned.

Proponents believe that making these rankings public would encourage a healthy competition among states and promote evidence-based policymaking. Professor Afekhide Omoti, President of the Nigeria Medical Association (NMA), emphasized that the burden of healthcare failure should not rest solely on the Federal Government. He highlighted the critical role of state and local governments, many of which oversee primary healthcare centers that often remain neglected.

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States should match federal healthcare interventions, local governments should begin publishing PHC spending reports, governors should be assessed publicly on health outcomes, while federal allocations for health should be tied to measurable performance. Nigeria cannot centralise all blame in Abuja while states neglect frontline healthcare.

Omoti urged relevant government agencies and health institutions to establish clear performance assessment frameworks and regularly publish scorecards detailing state health outcomes. He stated that measuring and publicizing progress is crucial for strengthening health systems and accelerating Nigeria's progress toward universal health coverage. The NMA president also pointed out the impact of dwindling donor funding and inadequate budget releases, stressing the need for states and local governments to fully commit to their residents' healthcare.

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One major problem is that ministries and hospitals receive partial releases long after budgets are passed. We have observed that the problem is no longer only about budget allocation; it is now fundamentally about budget credibility, release efficiency, and accountability.

Furthermore, Omoti called for the enforcement of full and timely budget releases to the healthcare sector. He noted that even with ambitious budget allocations, partial releases, inefficient utilization, or diversion of funds can lead to the continued deterioration of the health sector. The NMA advocates for a shift from symbolic budgeting to enforceable health financing reforms, treating critical healthcare funding with the same priority as debt servicing and national security obligations.

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Critical healthcare funding should be treated like debt servicing and national security obligations.