Youth, women demand inclusion in Nigeria’s health financing decisions
Dr. Muhammad Ali Pate, Coordinating Minister of Health and Social Welfare, Nigeria
Young people and grassroots women leaders have decried their continued exclusion from Nigeria’s health financing decision-making processes, demanding statutory inclusion and participatory budgeting to ensure resources truly reflect citizens’ needs and priorities.
They made the call on Monday during the National Health Financing Policy Dialogue themed “Reimagining the Future of Health Financing in Nigeria,” organised by the National Health Insurance Authority (NHIA) in collaboration with development partners.
The dialogue aims to reimagine health financing models that ensure healthcare is more equitable, sustainable, and accessible, especially as African nations face mounting fiscal pressure.
Mr. Seniye Michael, a youth representative from DEAN’s Youth-led Initiative, noted that young people, who constituted more than 50 percent of Nigeria’s population, remained significantly underrepresented in key health policy platforms.
He added that in spite of facing an unemployment rate of about 53 percent, youth voices were largely absent from critical health decision-making spaces in the country. He cited bodies such as the National Health Insurance Authority (NHIA) and the Basic Health Care Provision Fund (BHCPF) as examples where young people have minimal or no representation.
“In Nigeria, citizens are often excluded from allocation processes. Leaders assume our needs, spend on our behalf, and shut us out. Youth inclusion must be statutory, not just symbolic,” Michael stressed.
He proposed establishing a Youth Health Access Fund, contributions pooled by young people to directly finance their healthcare, ensuring accountability, strengthening ownership, and minimising fund diversion within the public health system.
Grassroots women leaders also raised concerns.
Mrs. Hauwa Adamu, Leader of Wives of Traditional Rulers, said women and children remained the most vulnerable in the absence of robust, inclusive, and accountable healthcare systems.
“Policies are often written for us without us. Women’s lived experiences must inform advocacy, design, and implementation. When women understand health financing, their voices become powerful instruments of change,” she said.
Dr. Aminu Magashi, Coordinator of the Africa Health Budget Network (AHBN), warned that mere symbolic invitations were inadequate. He urged that inclusion be institutionalised in policy design and health budgeting processes.
“Without intentional reforms, health financing will remain disconnected from the realities of Nigeria’s majority, especially youth, women, and the vulnerable,” Magashi said, calling for practical engagement and legislative support for reform.
He advocated stronger collaboration among civil society, lawmakers, and policymakers to advance a Legislative Health Agenda that ensures national health financing priorities lead to improved and measurable service delivery outcomes.
Dr. Gafar Alawode, CEO of DGI Consult, described health as a “holistic health economy” employing more than 800,000 Nigerians and contributing significantly to economic development through healthcare service delivery and job creation.
Alawode said the Legislative Health Agenda provided a framework that aligned appropriation, oversight, and legislation with jointly identified health priorities of government and civil society to enhance transparency and accountability.
“Health financing should not just seek more funds. It must also ensure existing allocations are well spent. Shared priorities guide planning, appropriation, and oversight to maximise outcomes,” he said.
He stressed the need for civil society to be engaged from policy design through to evaluation, warning that fragmented advocacy undermined impact. He said a pooled and strategic approach would improve results.
Alawode revealed that a citizen perception survey was currently underway to assess the implementation of government health policies at the grassroots level, with feedback to guide future reforms and interventions.
On innovation, he highlighted the importance of digital tools in reducing inefficiencies, citing technology’s role in exposing ghost workers and enabling real-time tracking of Basic Health Care Provision Fund disbursements.
“With a single click, you can view what a facility received, how it was spent, and service utilisation. But we lack an institutional framework for digital health at federal and state levels.”
Chief Moji Makanjuola, Chair of the Nigeria UHC Forum, stressed the media’s role in simplifying technical health financing issues for everyday Nigerians and serving as a watchdog to ensure accountability.
“The media must move beyond quoting speeches. Follow the money, track allocations and outcomes. Don’t give out grinding machines. Buy health insurance for your communities instead,” Makanjuola said.
She called for capacity building for journalists to effectively interpret health budgets and financing mechanisms, urging coverage that extended beyond events to expose gaps and showcase impact at the community level.
The dialogue ended with a consensus that a vibrant media, informed civil society, and committed legislature are essential to building a transparent, inclusive, and effective health financing system.
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