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Journalism, PR, and Cash for Coverage: Matters Arising

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By Dr. Marcel Mbamalu

 

 

SIMPLE CONTEXTUAL DEFINITIONS

 

Who is a Journalist?

For the purpose of this discussion, a journalist can be described as a  person who collects, writes, photographs, processes, edits, or comments on news or other topical information to the public.

 

A Journalist’s work is called journalism (Wikipedia). A journalist must, in line with professional ethics, be accurate and fair. The journalist seeks Truth and reports it. He must be honest and courageous in gathering, reporting and interpreting information…and should take responsibility for the accuracy of his work (SPJ Code of Ethics, revised September 6, 2014)

 

 

Public Relations/ Practitioner

 

The professional maintenance of a favorable public image by a company, organization, or a famous person. The PR profession ensures a company, or organization or famous person maintains good records in the public eye. The PR practitioner helps people, organizations to gain public acceptance by explaining the aims, objectives, and methods of their organization and by building and maintaining a favorable image     (https://gostudy.net/occupation)

 

Cash for Coverage/ Brown Envelope Journalism

 

Cash for coverage or Brown Envelope Journalism (BEJ) refers to giving monetary inducement to journalists to encourage them to write positive stories, slant, or kill negative ones. Brown envelop as a term was first coined in 1994 after the UK political scandal (cash-for-questions-affair) in which The Guardian alleged that the owner of Harrods department store, Mohammed Al-Fayed, had paid a Member of Parliament in the House of Commons to ask a question using a brown-colored envelope for the transaction.

 

Journalistic parlance Brown Envelope has, over time, been used to describe monetary gifts concealed in brown envelopes and given to journalists during press briefings. In broader terms, Brown Envelope Syndrome (BES) refers to the potentiality of news sources (PR agents and/or their clients) giving, and journalists taking cash at press conferences or in the general course of their duty. It describes the propensity to give and take ‘bribes’ at any point in the value chain of journalistic sourcing and transmission of news content. So, BES as an expression in media practice can conveniently be used interchangeably with Cash for Coverage Syndrome (CFCs).

It’s a “syndrome” in the sense that giving and taking cash in the course of journalistic work manifests symptomatically and can consistently occur in varied but identifiable ways. The brown “envelope” could be in any color shade (white, green, or red), in naked cash or electronic form (bank transfers). Whatever color, form or means, Brown Envelopes, in the words of Dr. C Nwachukwu of the University of Nigeria Nsukka (UNN), represent any “temptation wrapped in money.”

On the whole, the impact of such ‘temptation’ on content creation, presentation and dissemination are real: The Mass Media audience, the ultimate king, are misled; credibility of news content and platform is compromised setting off the stage for perennial confidence crisis between the media platform and its audience. Loss of audience confidence leads to loss of patronage (business)…and jobs.

Imagine what could happen when an individual, group of individuals, politicians or government buys off an entire edition of a newspaper, a day’s program on Radio/Television or the entire Internet space and decides that no one reads, hears or sees a particular content or that they see it in predetermined modes! Worse still, the individual or group(s) could decide to let their ‘trusting’ readers, viewers and listeners see/hear only what’s convenient and let them wallow in darkness. It’s a matter of life and death for the entire information and communication space.

Yet, the audience knows better, always able to isolate the chaff from the kernel. The reason media businesses rise and fall on content, much more on the credibility of the content. Yes, Content is King! Remember Marshall McLuhan’s postulation: “The Medium is the Message.”

 

 

It’s not just Cash

Brown Envelope or Cash For Coverage syndrome is a cankerworm. It’s much more than giving or taking cash. If brown envelopes are meant to conceal inducements (the reason the envelopes are brown, not white, in the first place), then, other forms of gifts or inducements, not manifest in clear cash benefit but whose intention is to influence story slants or to curry the journalist’s friendship/sympathy when critical information is at stake, should also pass for “Brown Envelopes.”

Consider non-cash gifts like holiday trips abroad, free training for journalists, birthday gifts and cakes, etc. Will these seemingly harmless ‘gifts’ influence the journalist’s coverage and slant of stories, especially when they matter to the audience?

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Important gifts are no longer in brown envelopes; they are now in white ‘vessels’ to accomplish saintly ‘missions.’ If good journalism practice is anchored on Truth, Fairness, and Balance for credible information, education, and entertainment of the audience, any good gesture that seeks to influence good content creation and delivery is a cankerworm.

 

Cash for coverage Vs Journalism/PR Ethics

Journalism and Public Relations are complementary professions that profess truth and abhor distortion of information/communication. Cash for news coverage defies this basic principle. Among professionals, there is a general understanding that BES is very bad for good PR practice, much worse for good Journalism; it’s an unethical practice based on journalism and PR professional ethics. The Society for Professional Journalists (SPJ) has a Code of Ethics for members, the NUJ and Press Council also have a code of ethics, all aligning with good practice bordering on truthful, courageous, fairyland patriotic news reporting devoid of inducement. Yet, does the syndrome fester?

 

WHAT DOES IT MEAN TO ASK FOR CASH BEFORE COVERAGE?

 

Asking for gratification can be covert (complaints about distance and cost of transportation etc) or overt (declaring what it would cost to attend a press conference and/or to publish content therefrom). What do we make of previous scandals?

Reasons for BES among journalists and PR practitioners (What they say)

 

 

Issues about African culture of gift-giving

 

 

Nigerians believe in giving and receiving gifts formally and informally. Many say this is one of the major reasons why it’s difficult to tackle this in Nigeria.

 

Issues about PR &Journalism ideology

 

 

Do quacks truly exist in journalism and PR practice? Who truly is a journalist; the one who can write and speak impeccable English or the one who is trained, grounded, and certified on the basics of good journalism? Should Journalism and PR be different from other key professions like Medicine and Law? Can I, as a journalist be hired by a law firm to defend a client in court simply because I could argue very well? Can a good Television analyst perform a surgery on a patient because he does so with words? Not cast in iron, but these and many more are issues that perhaps, could rub off on efforts to find answers to questions under discussion. How many journalists and PR ‘agents’ ended up becoming who they are today because they could not find jobs in their disciplines after graduation?

 

Issues about Training and Retraining:

 

 

Knowledge and competence breed self-confidence and self-respect. Good retraining programs for certified members of a given profession help to engender self-confidence and mutual respect; hence, they will respect the code of ethics and overcome ‘temptations wrapped in money,’ especially in a fragile economy.

 

Issues about preaching professionalism in a fragile economy:

 

Is       Nigeria really among the poorest of the poorest countries? Does it have 20% (10.5 million) of the world’s out-of-school children? How many media organizations in Africa will survive the next 10 years? How many newspapers have an average of 200,000 print-run daily? How many of them have an average of five pages of adverts per day to stay afloat? What is the average take-home pay of Nigerian journalists? How media organizations in Nigeria pay salaries as and when due? Can we work to create saints in hell? How many oases of plenteous integrity can we find in a desert of need?

 

Yet, I see light at the end of the tunnel. There are a few Josephs, a few Daniels, a few Shedrack, Meshack, and Abadenego left!

 

On the PR side, do practitioners face pressure from employers and clients (PR)?

 

 

 

SOLUTIONS

 

Clear identity or ideology for PR and Journalism

 

Improvement in training and retraining, remuneration and reward for excellence

 

The salience of the recent unbundling of Mass Communication courses in universities to the rescue?

 

Possible redefinition of the bounds of gift-giving; must the latitude be expanded to realistically reflect certain nuances? For instance, why do patients pay for hospital cards and for drugs, yet the doctor collects separate consultation fees, nurses ask for money to buy syringes. Hospital bills still come afterward???

 

 

Are journalists tying themselves up at a time market realities are getting grimmer?

 

Public-funded BBC, CNN, and GOOGLE take adverts even from Nigerian firms and they take sides in news coverage using genres that are neither hard news, nor Feature/ opinion, but all combined in non-clear-cut reporting called ADVOCACY NEWS, which is news with explicable bias.

 

Former Minister appointed Adviser center of Journalism 

THEORETICAL UNDERPINNINGS

 

 

Social Responsibility Theory: This presupposes that the media, in discharging its critical functions, acts in social interest and for the good of the society.  Reporting dispassionately…against business logic and profit motives. In the light of current realities, the big question: Is there a more professional way to commoditize news? There are different, just like there are varied products in other professions like Law and Medicine, etc.

 

 

Media Economics: Media as a going concern and profit-oriented theory in a competitive stressful market, driven more by corporate support than by audience clientele.

 

Four-way PR Model: Sensationalism, Full Information, Symmetry, and Asymmetry. GRUNIG and HUNT 1984)

 

 

 

CONCLUSION: The Big Question

Is cash for coverage a case of professional anomaly that has become a culture, or a case of inevitable industry reality that needs some professional rethinking/adjustment? If technology is, indeed, changing many things, to what extent can it be allowed to change social laws?

Dr Marcel Mbamalu, is the News Editor of The Guardian, presented this at The Jacksonites Biweekly Webinar on August 2, 2020

Opinion

Muhuyi and the Fight for Kano’s Future-Ismail Auwal

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By Ismail Auwal

I knew Muhuyi Magaji Rimin Gado had capacity. His work at Kano’s Public Complaints and Anti-Corruption Commission had established that much. But watching the pace of his present assignment, I have had to revise my expectations upward. I did not imagine he would bring this much energy to the task.
The operations have kept coming: arrests, investigations and court proceedings. Alongside them are plans for rehabilitation and skills training. What has emerged is a public official taking responsibility for an assignment whose consequences reach far beyond his office and into the homes and neighbourhoods of Kano.
Within 45 days, the task force reportedly conducted more than 200 raids and secured more than 200 convictions, with four mobile courts handling the cases. Those figures remain reported results. They nevertheless describe an early pace of enforcement that deserves attention, and the leadership sustaining it deserves recognition.
Consider the work behind an operation. Information arrives and must be assessed. Someone decides what requires investigation and brings the relevant agencies together. Officers are deployed, evidence is gathered and records are prepared. After an arrest, the responsibility continues through the preparation and handling of a case.
Maintaining that effort across repeated operations requires organisation and follow-through. This is where Muhuyi’s energy becomes significant. He has taken on a responsibility that demands sustained attention, and the accounts emerging from Kano suggest he is giving the assignment precisely that.
The arrests sit at the centre of this effort because they make government action visible. For residents who have reported suspected criminal activity, an operation can show that their information reached someone prepared to respond. It can begin to restore a connection between public complaints and public action.
That connection matters. When people believe a complaint will go nowhere, they may stop making it. They find ways to live around the problem, avoid certain places or carry their concerns privately. An institution that responds gives them a reason to participate again and demonstrates that their knowledge of their community has value.
Muhuyi’s task force has an opportunity to strengthen that relationship with every operation properly investigated and every case properly followed. His leadership deserves commendation for pursuing the work through institutions, bringing enforcement and court proceedings into the same understanding of public responsibility.
For Kano, the stakes are personal. A family dealing with harmful drug use may find its plans gradually displaced by the next crisis. Schooling is interrupted, money intended for other needs goes towards seeking help, and relationships come under strain. Parents try to understand what is happening while worrying about what might happen next.
These are the lives behind the assignment. A response that reaches them can change what they expect from government. It can provide somewhere to seek assistance and a reason to believe that the burden they have been carrying is receiving attention beyond the household.
That is why I have followed Muhuyi’s work with growing interest. The task force is addressing a problem whose effects can spread through generations. Protecting a young person’s opportunity to learn, work and contribute has consequences for an entire family. It also influences the kind of Kano that will emerge in the years ahead.
Muhuyi brings experience suited to these demands. At the Public Complaints and Anti-Corruption Commission, he worked where citizens’ grievances met the machinery of government. Complaints had to be received, records examined and investigations pursued. Public expectations had to be translated into administrative and legal action.
His contribution included work on the institution itself. In April 2025, the commission published an account of commendations from the Civil Society Legislative Advocacy Centre. CISLAC recognised developments under his leadership, including an anticorruption strategy, operating guidelines for government institutions and offices across Kano’s 44 local government areas.
There is substance in that record. Extending an institution’s presence makes it easier for people to approach it. Establishing procedures gives staff a framework for handling complaints. Setting a strategy helps work continue across competing demands. These are foundations on which visible results depend.
For a resident seeking assistance, the difference can be practical: an office within reach, a process that can be understood and an official assigned to follow the matter. Such arrangements give public service a form people can use. Muhuyi’s experience developing them is an asset to his present responsibility.
The commission’s engagement with CISLAC also involved cooperation on asset tracking and recovery. That experience points to another quality relevant to the task force: understanding that institutions can accomplish more when they combine expertise and establish clear arrangements for working together.
Drug enforcement brings together responsibilities held by different bodies. Reporting on the task force’s maiden meeting described participation by the NDLEA, police, Department of State Services and other public institutions. Their involvement provides a basis for coordinated work, while leadership keeps that cooperation active after the meeting ends.
Information must move to those able to assess it. Evidence must reach those preparing proceedings. Responsibilities must be understood well enough to prevent a case from losing momentum between institutions. Muhuyi’s role is to help make these connections work, and the reported activity gives reason to recognise his commitment.
Governor Abba Kabir Yusuf also deserves credit for establishing the platform and giving the assignment political backing. Placing an experienced official at its head was a consequential decision. Muhuyi’s response has given that decision operational meaning through the task force’s reported activities and developing partnerships.
The governor’s support and the chairman’s drive can reinforce each other. Public backing enables institutions to commit resources, while operational leadership directs those resources towards the work. Kano benefits when both remain focused on the people the assignment is meant to serve.
The effort has attracted recognition from other institutions. Reports of an August visit said the NDLEA’s Zone 5 Command named Muhuyi a War Against Drug Abuse ambassador, citing cooperation, awareness and community mobilisation. In September, the North-West Development Commission also commended the task force and expressed interest in collaboration.
Such recognition can open opportunities for assistance and shared expertise. It also encourages the personnel carrying out the work. Officers, investigators and administrative staff all contribute to the results associated with a chairman’s name. Their effort deserves recognition alongside the leadership coordinating it.
The ambition to help people rebuild their lives after enforcement is equally important. Muhuyi has reportedly outlined plans for skills training reaching 10,000 people, with a role envisaged for the Kiru Reformation Centre. That number is a proposed target, and its direction is encouraging: rehabilitation has a place in how he understands the assignment.
A young person returning home may need treatment, an opportunity to resume education or help acquiring a skill. The family may also need guidance. Recovery can involve a series of steps, each requiring someone to remain involved after the immediate crisis has passed.
Including rehabilitation recognises that public responsibility continues through those steps. It gives the campaign a purpose that families can understand: helping a person regain the ability to participate in everyday life. That ambition deserves support because its benefits can extend well beyond the individual receiving assistance.
A young person who resumes school recovers an opportunity to prepare for adulthood. Someone who acquires a useful skill has a basis for pursuing a livelihood. A household that receives help can begin making plans again. Through these changes, an intervention becomes an investment in Kano’s future.
The support of religious scholars, Friday mosque imams and Hisbah can strengthen this effort. These institutions have relationships with communities that government agencies can work alongside. Their participation can encourage discussion, prevention and assistance in places where families already seek guidance.
Muhuyi deserves credit for leading an assignment that is developing these connections. Public engagement helps build the cooperation on which sustained progress depends. Families need to know where to seek help, and communities need to understand how they can contribute to protecting young people.
The task force’s developing approach brings these responsibilities into the same conversation. Operations address suspected offences, court proceedings carry cases forward, rehabilitation plans look towards recovery, and community partnerships create opportunities for prevention and support. Together, they provide a basis for recognising the leadership behind the effort.
I have followed Muhuyi’s work with an existing appreciation of his capacity. What I now appreciate more fully is his willingness to apply it with urgency. He has brought energy to an assignment that requires people to keep showing up, keep coordinating and keep following the work. That commitment deserves commendation.
Kano’s future will be shaped partly by what happens to its young people today. Every opportunity preserved, every family assisted and every community able to obtain a response contributes to that future. Muhuyi has taken on a responsibility that reaches directly into those possibilities.
The arrests have made the effort visible, and his leadership is giving it momentum. With sustained support, the work can leave its strongest record in the lives of people who find a way forward: young people returning to education and employment, families receiving assistance and communities gaining confidence in the institutions serving them.

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Opinion

Dry Taps Gone, Kano Flows Again: The Abba Yusuf Water Comeback By Abba Anwar

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By Abba Anwar

It is evidently clear and on record to understand that Kano thirsty decade is ending, as how His Excellency the Governor of Kano State, Eng Abba Kabir Yusuf is turning 95 years of ruin into a N21.3 Billion revival. This is leadership, commitment, display of patriotic political will and understanding of complexities and peculiarities of human existence.

What Kano is experiencing now, in terms of redirecting the water industry into human face, calls for global gist and account. For example in Cape Town, they called perennial shortage of water Day Zero – the day the taps would run dry.

In Flint, Michigan, history tells us that it was a lead poisoning crisis that shocked America. While in Kano, Africa’s most populous city, situated in Northern Nigeria, it was slower, quieter, and more painful. Very pathetic and heartbreaking, for over ten years, the taps simply stopped. No announcement. No Day Zero. Just air.

The history of Kano water sector reveals that the city needs 700 million litres of water every single day to survive. Until last year, it was getting less than 300 million. A deficit of 400 million litres. That is not a shortage; it is a systemic collapse. Mothers woke up at 4 a.m. to queue at boreholes. Children trekked kilometres with jerry cans. Industries shut down. Cholera whispered in the background.

Identification of problem didn’t match with problem diagnosis. For years, successive administrations applied plaster to a cancer. The current administration of Governor Yusuf has chosen to perform open-heart surgery. A better and neater option. Surgical operation not plaster application. Which catches and punches the right button.
And the heart is now beating again as the Governor means business and genuine service delivery.

Kano’s 95-year-old legacy, which I term as The Soul of a City, is a deliberate presentation for proper
understanding of the magnitude of what is happening now. Hence we must understand what was lost.

Kano’s water story did not start yesterday. It started in 1927, when the British colonial administration, under Emir Abdullahi Bayero, broke ground for what would become the first waterworks in Northern Nigeria – the Challawa Water Works. Completed in 1930, with a modest 20 million litres per day, it was an engineering marvel of its time. It supplied Dorayi, Kabuga, Kofar Fanfo, Jan Bulo, Rijiyar Zaki, and even the Army Barracks in Janguza. It ran non-stop for 86 years.

Then came its younger brothers. The Old Tamburawa in 1986 – 9.6 million litres, later upgraded to 20 million. Then the New Tamburawa, a behemoth with a 150 million litre per day capacity. And anchoring them all, the legendary Goron Dutse reservoirs – five massive underground and surface reservoirs built between 1930 and 1974, with a combined storage of over 40 million litres. They were the lungs of Kano’s distribution.

By whatever standard and estimation this was a system built by visionaries, with clearly defined vision. But it was, unfortunately, killed by neglect. Year in year out all the donkey years witnessed terrifying reality when city’s lifeline was utterly and irresponsibly looted.

To tell my reader that, that experience was worrying our Governor deeply even before he came on board, before he took the oath of office on May 29, 2023, he set up a powerful Committee of Experts to look into the perennial nature of the water industry. Immediately after he came on board his engineers gave him a report on water that read like a war zone assessment.

Since then, when I discussed the concern with a friend from Darmanawa he quickly commended the effort and called for public support of the entire process and procedures.

It was fundamentally clear that in Challawa, the scene was “pathetic and disheartening,” in the official words of the Ministry. Out of six giant industrial generating sets that power the entire plant when the national grid fails, only two were limping. Water Works No. 1 and No. 2 were dead. No. 3 was gasping at 30% capacity. A call for action at whatever rate.

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Worse than decay was destruction. Raw water pumps were gone. Electrical starters ripped from control rooms. Underground electrical facilities stolen. And in an act that shocked even veteran engineers, a 15-kilometre, 15.6 kilometre underground transmission pipeline – the artery that feeds Challawa – was excavated and stolen. Not vandalised. Stolen. Some individuals even walked into the premises claiming the federal government had sold the waterworks to them. A brazen dishonesty of the highest order.

At Goron Dutse, the story was even more symbolic. The reservoirs that had quenched Kano for nearly a century had not received a single drop of water for over ten years. Ten years! They were dry, cracked, and filled with silt. As bad as economies during conventional wars. Abandonment amid need for attention.

The total cost of decay was put at over N30 billion. An administration in the past had spent N5.6 billion in just 11 months for “maintenance” but it was maintenance without a soul. As pipes were not replaced, reservoirs were not desilted, pumps were not procured. The result? Tamburawa, designed for 150 million litres, was doing 27%. Challawa, designed for 220 million, was doing less than 30%. Together, they should produce 370 million litres. They were producing less than 90 million.

To revive just Challawa, an official told journalists that the state would need $3.5 million, later revised to over $10 million, because the 1930-era machines have to be custom-built in Europe on demand. They are not on any shelf in the world.

This is the rot Governor Yusuf inherited. To me, Governor Yusuf’s political will is doctrinal with no match in sight. Unmatched political will. It is glaring for all to know that great cities are not revived by press releases. They are revived by political will. This is where His Excellency separates himself from every administration in the last decade.

He did not send a committee. He went himself. Since from the start of the good re-engineering touch of the water facilities. For example just yesterday, he and his able Deputy H.E. Murtala Sule Garo alongside other top government functionaries visited water projects that are almost ready for good operations.

In a now-famous inspection tour, Governor Yusuf, in rain boots, walked the length of Challawa and Tamburawa with engineers from CGC Nigeria Limited and CCECC Nigeria Limited – the same Chinese engineering giants building Africa’s biggest dams and railways. He saw the leaking pipes. He saw the obsolete clarifiers. He saw the dead high-lift pumps. And there, on the spot, he made a decision that will define his legacy.

He approved without any hesitation, the sum of N21.29 billion. Wow! the single largest water investment in Kano in 15 years. Leadership by example. Viva our dear Governor Viva.

Not N21.89 billion in rumour. N21.29 billion in signed contracts. With N9.9 billion to CGC Nigeria Limited for the total rehabilitation of Tamburawa Water Treatment Plant and its raw water pump station. The sum of N11.39 billion to CCECC Nigeria Limited for the rehabilitation of Challawa Raw Water Pump Station, its treatment plant, and the total restoration of the Goron Dutse reservoirs. Action! Action!! Action!!!

This is not rehabilitation on paper. This is what is happening on the ground right now, as confirmed by Dr. Dahiru Muhammad Hashim, Acting Commissioner for Water Resources, Environment and Climate Change. That:

1. The critical 15.6-kilometre transmission line to Goron Dutse has been restored with modern ductile steel pipes, replacing the 1970s asbestos pipes that were poisoning the system.

2. Goron Dutse reservoirs have been fully desilted and repaired.

3. Clarifiers, filtration units, manifolds, and high-lift pumps have been restored.

4. Ten high-capacity 110-kilowatt pumps have been procured.

5. A full test run was completed in mid-September.

And beyond the metropolis, the Governor is doing what no one did – reviving the dead. Nine out of Kano’s 19 dormant regional water schemes are under restoration. Guzugu in Kabo is flowing. Joda in Gabasawa is flowing. Wudil Waterworks, dead for years, is alive. For the first time, rural Kano is part of the water equation. Government for all sections of the state.

On September 21, 2026, the Ministry officially announced: expanded distribution of potable water would commence within few days to come. All are waiting patiently Your Excellency Sir!

Why Kano must attract global communities? From London to Lagos, water is politics. The UN says water scarcity will displace 700 million people by 2030. What Governor Yusuf has done is a case study in how to reverse it without World Bank loans, without privatising your heritage.

He did not outsource the problem. He funded the solution. He did not blame the past. He fixed the future. Sometime in the past I spoke to Malam Musa in Tarauni, he was lamenting all over. When asked again, now, he simply smiles that Governor Yusuf is on the top of the situation. This is courageous.

When the taps in Kofar Mata sputter and then gush, when a child in Dala drinks from the tap for the first time in his life, when Goron Dutse reservoirs hold water again after a 10-year drought, Kano will not just be celebrating water. Kano will be celebrating a Governor who proved that a 95-year-old dream, buried under silt, stolen pipes, and failed promises, can still flow.

That is not just governance. That is unmatched and unwavering political will in action.

KANO FLOWS AGAIN UNDER GOVERNOR YUSUF!

Viva Kano. Viva Abba Gida-Gida.

Anwar writes from Kano
Tuesday, 29th September, 2026

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Opinion

The Tinubu Health Reset: A Consultant Examines Nigeria’s Healthcare Reforms

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By Dr. Usman Muhammad Shanawa

For decades, Nigeria’s healthcare system has faced a familiar set of challenges: inadequate infrastructure, limited access to specialised medical services, weak primary healthcare facilities, shortages of healthcare personnel and the rising financial burden of treatment on ordinary Nigerians.

Against this backdrop, the Federal Government under President Bola Ahmed Tinubu has pursued interventions across different levels of the healthcare system, ranging from primary healthcare and general hospitals to specialised tertiary facilities, digital health, emergency care and healthcare financing.

For Dr. Usman Muhammad Shanawa, a Consultant Obstetrician and Gynaecologist and specialist in Gynaecological Oncology with more than two decades of experience in clinical practice and healthcare management, the interventions deserve to be examined as part of a broader attempt to strengthen Nigeria’s healthcare architecture.

Dr. Shanawa’s assessment moves across the three levels of healthcare delivery, ranging from primary, secondary and tertiary, while drawing particular attention to diagnostics, maternal healthcare, hospital infrastructure, health insurance and the growing role of technology.

For him, the real significance of healthcare reform lies not simply in the announcement of new projects, but in whether the changes improve access to quality medical care for Nigerians.

*Zamfara: A local window into the reforms*
Dr. Shanawa’s assessment begins from Zamfara State, where he says federal support and collaboration with state authorities have provided a local perspective on the changing healthcare landscape.

He recalled that financial constraints had historically affected the implementation of several healthcare projects at the state level.

According to him, increased federal financial support and policy interventions under the Tinubu administration created room for renewed investment, with 2025 emerging as a particularly significant period for healthcare development in the state.

He views the experience as an illustration of how government intervention can translate into improved access to healthcare when funding, policy and implementation converge.

*At the top: Expanding tertiary healthcare*
At the apex of Nigeria’s healthcare system are tertiary institutions, where patients with complex medical conditions are expected to receive specialised treatment and advanced diagnostic services.

Yet these institutions have historically faced technological and infrastructural gaps.

Dr. Shanawa identifies improved diagnostic capacity as one of the areas requiring sustained attention.

He points to technologies such as Computerised Tomography (CT) scanners and Magnetic Resonance Imaging (MRI) as critical tools for modern medical practice.

For a specialist in gynaecological oncology, the issue carries particular weight.

Cancer care, he explains, depends heavily on timely and accurate diagnosis. The availability of sophisticated diagnostic and oncology services closer to patients can reduce the need for long-distance travel in search of specialised treatment.

He also points to the development of oncology facilities in states such as Katsina, Enugu and Edo as examples of efforts to expand specialised cancer services beyond traditional medical centres.

The broader implication, in his assessment, is that advanced healthcare should not remain concentrated in only a few locations.

*The missing link: Strengthening secondary healthcare*
Between the primary healthcare centre and the highly specialised tertiary hospital lies another crucial layer, that is the secondary healthcare.

For Dr. Shanawa, general and state hospitals remain an indispensable part of the healthcare chain.

These facilities often receive patients referred from primary healthcare centres and provide services beyond the capacity of frontline facilities, while also serving as important points for emergency treatment.

He particularly highlights emergency obstetric care.

For women experiencing complications during pregnancy or childbirth, he argues, the availability of properly equipped secondary hospitals and effective referral systems can be critical.

This makes the strengthening of general hospitals more than an infrastructure issue. It is also a question of how quickly the healthcare system can respond when lives are at risk.

*Primary healthcare: Rebuilding from the foundation*
If tertiary healthcare represents the peak of the system, primary healthcare is its foundation.

And this, according to Dr. Shanawa, is where one of the most important aspects of the current reforms lies.

Nigeria’s healthcare system has historically been characterised by patients bypassing weak or poorly equipped primary healthcare centres and seeking treatment directly at secondary and tertiary institutions.

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The result has been pressure on higher-level hospitals, with facilities already handling complicated cases also having to deal with conditions that could have been managed closer to patients’ communities.

Dr. Shanawa sees the renewed emphasis on primary healthcare as an attempt to reverse this pattern.

He argues that strengthening the base of the healthcare pyramid while maintaining improvements at the tertiary level is essential to creating a more functional system.

The Federal Government has reported the deployment of National Health Fellows and Public Financial Management Officers across all 774 local government areas under the health-sector renewal programme, alongside the revitalisation of primary healthcare facilities in priority areas.

For Dr. Shanawa, the importance of such interventions lies in bringing healthcare closer to the people before illnesses become more complicated.

*Maternal mortality: The doctor’s particular concern*
For an obstetrician, the discussion inevitably returns to maternal health.

Dr. Shanawa describes maternal mortality as one of Nigeria’s most persistent public-health challenges, one that has affected generations of Nigerian women.

He argues that strengthening primary healthcare, improving referral systems, expanding the frontline health workforce and ensuring access to emergency obstetric care are essential to addressing pregnancy-related complications.

The Federal Ministry of Health has reported improvements in maternal and newborn health indicators in areas targeted under its intervention programmes.

For Dr. Shanawa, however, the importance of such interventions ultimately comes down to whether a pregnant woman can obtain appropriate care at the time she needs it.

The journey from pregnancy to safe delivery, he suggests, depends on the strength of the entire healthcare chain, from community-level services to emergency and specialist hospitals.

Healthcare needs people, not just buildings
Infrastructure may be the visible face of healthcare investment, but Dr. Shanawa stresses that facilities cannot function without the professionals who operate them.

Doctors, nurses, midwives, community health workers, laboratory scientists, pharmacists and other healthcare professionals are central to translating infrastructure and equipment into actual medical services.

The Federal Government has reported recruitment and retraining initiatives for frontline and community-based health workers as part of its health-sector renewal efforts.

But recruitment is only one part of the challenge.

For the reforms to be sustained, healthcare workers must also be retained, properly deployed and supported with the equipment and working environment required to provide quality care.

*The cost of getting sick*
Another dimension of Nigeria’s healthcare challenge is affordability.

For many families, the question is not only whether a hospital exists, but whether they can afford the treatment available there.

Dr. Shanawa therefore places health insurance and healthcare financing alongside infrastructure and medical technology in his assessment of the reforms.

He points to the Basic Health Care Provision Fund and broader efforts to expand health insurance coverage as mechanisms that could reduce the financial burden on patients.

The Federal Ministry of Health has reported significant increases in health insurance enrolment, while also acknowledging that out-of-pocket expenditure remains high.

This presents one of the central tests for healthcare reform: expanding services while ensuring that the people who need those services are not priced out of the system.

Healthcare goes digital
The transformation is also taking place beyond hospital walls.

Digital health and electronic medical records are increasingly becoming part of the effort to modernise Nigeria’s healthcare system.

Dr. Shanawa highlights electronic medical records and health-information exchange systems as important tools for improving the management and continuity of patient care.

The Federal Government’s Nigeria Digital in Health Initiative is intended to improve interoperability between healthcare facilities and facilitate the secure sharing of health information.

For a healthcare system spread across a vast country, better digital connectivity could help bridge some of the gaps between facilities and levels of care.

Measuring the Tinubu health reset
For Dr. Shanawa, the ultimate measure of healthcare reform is not the number of projects announced or facilities commissioned.

It is what happens to the patient.

Can a woman access skilled care when she needs it?

Can a patient obtain an accurate diagnosis without travelling hundreds of kilometres?

Can an emergency case receive timely treatment?

Can a family afford the cost of care?

Can healthcare professionals work with the equipment, personnel and systems they require?

These questions bring the debate back to the heart of healthcare delivery.

The Federal Government has reported progress across areas including infrastructure, digital health, primary healthcare, workforce development and maternal-health interventions.

But sustaining such gains will require continued financing, effective implementation, maintenance of infrastructure, retention of skilled professionals and stronger coordination among federal, state and local authorities.

For Dr. Shanawa, Nigeria’s healthcare system cannot be transformed by focusing on only one level.

The primary healthcare centre, the general hospital and the specialist tertiary institution must function as parts of the same system.

That, ultimately, is the test of the health reset, and whether the reforms can move beyond policy and infrastructure to create a healthcare system in which quality, affordable and accessible medical care is closer to the Nigerian who needs it most.

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