Tinubu Enlists Traditional Leaders in Primary Healthcare Monitoring Campaign
Nigerian President Bola Tinubu has called on traditional and religious leaders to assume responsibility for monitoring primary healthcare facilities in their communities as part of efforts to combat preventable diseases.
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Nigerian President Bola Tinubu has mobilized traditional and religious leaders to take active roles in monitoring primary healthcare delivery, marking a shift toward community-based oversight of disease prevention programs.
The directive, issued during an engagement with traditional rulers and faith leaders, tasks community authorities with assessing the functionality of primary healthcare centers within their jurisdictions. According to the Peoples Gazette, Tinubu emphasized that combating preventable diseases extends beyond government responsibility to include traditional institutions.
This approach aligns with established public health frameworks that recognize traditional leaders as critical intermediaries between health systems and communities. The World Health Organization's primary healthcare model identifies community engagement as essential for achieving universal health coverage, particularly in settings where formal health infrastructure faces capacity constraints.
Healthcare Access Challenges
Nigeria's primary healthcare system serves as the first contact point for approximately 70 percent of the population, yet faces persistent challenges in service delivery. The 2023 Nigeria Demographic and Health Survey documented significant gaps in facility functionality, with only 28 percent of primary health centers meeting minimum service readiness standards.
Preventable diseases continue to drive morbidity and mortality across Nigeria. Data from the Nigeria Centre for Disease Control shows that vaccine-preventable diseases, including measles, diphtheria, and yellow fever, accounted for substantial disease burden in 2024. Malaria remains the leading cause of outpatient visits, responsible for 27 percent of consultations at primary health facilities according to the National Malaria Elimination Programme.
The engagement with traditional leaders represents an attempt to address supervision gaps in Nigeria's three-tiered health system, where primary healthcare falls under local government authority. Traditional rulers maintain significant influence in community health-seeking behavior, particularly in rural areas where 52 percent of the population resides.
Community Oversight Model
The proposed monitoring framework builds on existing community health governance structures. Nigeria's Ward Development Committees, established under the National Primary Health Care Development Agency, already include traditional and religious leaders among their membership. These committees are mandated to oversee facility operations, supply chain management, and staff attendance.
Similar community-based oversight models have shown measurable impact in other African contexts. A 2022 study published in BMJ Global Health examining community health committees in Kenya found that facilities with active community oversight demonstrated 34 percent higher immunization coverage and 41 percent better antenatal care attendance compared to facilities without such mechanisms.
Religious leaders have proven particularly effective in health communication campaigns. During Nigeria's 2023 polio eradication drive, engagement with Islamic scholars in northern states contributed to a 23 percent increase in vaccine acceptance, according to WHO AFRO data. Faith-based networks reach populations that formal health messaging often fails to engage effectively.
Implementation Questions
The success of Tinubu's initiative depends on several operational factors. Traditional leaders require clear monitoring protocols, reporting mechanisms, and channels for escalating identified deficiencies. Without structured frameworks, community oversight risks becoming ceremonial rather than functional.
Health workforce shortages present another constraint. Nigeria's physician density stands at 4 per 10,000 population, well below the WHO threshold of 23 health workers per 10,000 required for essential service delivery. Even with enhanced monitoring, primary health centers cannot deliver services without adequate staffing, essential medicines, and functional equipment.
Financing remains the fundamental challenge. Nigeria allocates approximately 3.9 percent of its budget to health, significantly below the Abuja Declaration target of 15 percent. Primary healthcare receives the smallest share within this allocation, limiting the resources available for facility maintenance, supply procurement, and workforce retention.
The Federal Ministry of Health has not yet released detailed guidelines on how traditional leaders will conduct monitoring activities or how their findings will integrate into existing health management information systems. These operational details will determine whether the initiative translates into measurable improvements in primary healthcare functionality.
As Nigeria advances toward universal health coverage under its National Health Act, community engagement mechanisms will require sustained investment beyond initial mobilization. The effectiveness of traditional leader involvement in health facility oversight will become apparent in coming months through routine health indicators including immunization coverage, antenatal attendance, and facility delivery rates.