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The VAT Struggle : Lessons for the North

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By: Sani Danaudi Mohammed

The current VAT struggle between the Federal Government and two states in the South, Rivers and Lagos, is sending strong signals to the slumbering North. Obviously, they, the northern states, have abandoned the agriculture sector which could put the region on a global radar as a formidable exporter of cash crops to the international community. At the state level, the North is unfortunate to find itself under different clueless regimes. The governors’ overdependence on the federal allocations has finally forced the region to its knees, begging for alms to survive. It is incontestable that most states in the northern region would be completely on their knees should Rivers and Lagos States succeed in accomplishing their noble dream of becoming revenue collectors.

The term ‘VAT’, Value Added Tax, is a consumption tax that is being exploited by many developed and developing countries to great advantage. In any clime where consumption is key, VAT cannot be evaded. The truth of the matter is that the economic development and growth of any nation depends on its government’s ability to generate adequate revenue in order to effectively provide various infrastructural facilities and amenities to meet the growing needs of its population. Success in meeting its population’s needs enables a nation to maintain its pride of place among the global comity of nations. Proceeds from VAT have brought about wonders of socio-economic progress and infrastructure development in America, United Kingdom and France, to mention but a few.

Nyesom Ezenwo Wike, the Rivers State governor, is currently taking the bull by the horn. A trained lawyer cum economist and former Minister of Education, the iconoclastic Wike, by his resilient stance on making VAT count in Rivers State, seems to have jarred some of his counterparts in other Nigerian states from sleep. And such stance has the potential of phasing out unproductivity on the part of many state governors who contribute little or nothing to the federation account. It is also capable of discouraging mediocre individuals with knowledge deficit on how economy works from contesting political leadership positions like governorship. With the development in Rivers, the installation of VAT will increase the blessings already existence in the oil-rich state. but Rivers State is not alone in this radical but promising move. The Lagos State governor, Babajide Samwo-Olu, has followed suit with the signing, into the law, a bill that will empower the State of Excellency to collect its VAT. This move will, no doubt, justify the sustained clamour for the replacement of economically tactless state gobernors with enterprising and visionary ones who have the will to generate productive ideas as well as translate such to resources for the overall good and interest of their people. Leadership, it must be stressed, is not a walk in the park. It entails responsibility. And to be responsible, a leader must be constructively creative.

In Nigeria, tax collection has become practically impossible, given the uninspiring reality that both the tax collectors and the tax payers share different sentiments in relation to VAT. The current global oil glut has adversely affected the revenue generation status of Nigeria. The over 60% drop in oil price to less than $40 per barrel was unanticipated by President Buhari-led government. And this has resulted in over 80% fall in the yield (spread) per barrel of oil produced in Nigeria. This markedly steep decline in the country’s revenue accounted for the 2016 budget deficit of over N2trillion, An untoward development like this has precipitated the continuous devaluation of the Naira, while the Gross Domestic Product( GDP) growth is slow, inflow of foreign direct investment has been cut down, bringing about rising inflation and growing unemployment.

The FG has put a stop on capital projects while allocation to the states of the federation has reduced. This has resulted in the inability of many state governments in the nation to honour the social contract (between them and the populace) which constrains their provision of necessary infrastructural facilities and pay workers’ salaries ranging as and when due. It is, therefore, very clear that there is the need to diversify the revenue base of the nation, and VAT is the panacea. As a major revenue source of advanced nations of the world, VAT is not well exploited to great advantage the Nigerian government.

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Section 46 of the VAT Act introduces new definitions for animal feed and commercial aircraft spare parts and components. The definition of goods and services has been reviewed, as animal feed now refers to any raw, semi-processed or processed product which is fed to domesticated and other animals raised and slaughtered for human consumption as beef, goat, lamb, pork, chicken, fish and other kinds of meat. Such feed is also given to animals cultivated and raised for the production of milk or eggs as well as other sources of protein and nutrients useful to humans. Commercial aircraft spare parts and components, according the review, now refer to engines, propellers, radio apparatus, instruments, appliances, furnishing, parts of any of the foregoing, and generally any other article of whatever description maintained for installation in a commercial aircraft in substitution for parts or articles removed. All forms of tangible properties, movable or immovable, but which do not include land and building, money or securities.

Our northern governors must begin to see government and governance beyond addressing gatherings and making public speeches, Political leaders in Nigeria have, for decades, been riding on the coat tails of family privileges to acquire wealth by faulting, on many occasions, our Constitution. It is obvious that politics in Nigeria is now becoming a business of the weak-minded individuals who lack the vision to see beyond their noses to create ideas and innovations to generate income for infrastructure developments and create jobs. We all witnessed the plight of states’ legislations across the country, which mandates payment of huge amount of money to former governors and their deputies to the detriment of the electorate.

Since there is pegged monthly allocation coming from the federal purse which is not determined by the amount contributed by the federation states, many governors are more than lazy in contributing to the pool of fund expected to be shared at the month end. But they are quick to claim glory for voting figures during general elections. Indeed, it high time every state government learnt to steer its population towards contributing resources for the development of the state. We read from our archives about how the late Premier of the defunct Northern Region, Sardauna of Sokoto and his counterpart in the Western Region, the late Obafemi Awolowo exploited this capability to great advantage in building very solid economic and educational structures which still remain the pride of the country.

The founding fathers of Nigeria were never this lazy. While Nigeria operated regional system of government, it became healthy competition among regional leaders, striving for development of their respective regions and people. While multiple streams of income generation were initiated, no one went to bed and wait for monthly allocations as the case is now. On a personal note, I see Wike and Nasir El-Rufai as the most radical political leaders in this country. The late Maitama Sule (Dan Masanin Kano) described such breed of politicians as responsible rascals because they are exactly the crop of leaders Nigeria needs now. They have been courageous to speak and implement policies and programmes which they consider right for their states and people, no matter whom their decisions may hurt.

On arriving Kaduna from Abuja on Saturday for a function, I, while passing through the busy Mando express way, saw young men. They were well dressed in uniform. And I kept wondering whether or not they were security agencies. Little did I realize that they were officers of Kaduna State Transport and Environmental Law Enforcement Agency (KASTELEA). This is one of the sundry initiatives boldly taken by Kaduna State to take the youths off the street. The major bye-product of this radical move is the emergence of a new Kaduna State under El-Rufai’s watch. It is true that Wike and El-Rufai are pacesetters while others follow. This is because they have set standards in terms of revenue generation. The cities of Kaduna and Port Harcourt currently wear a new look, as flyovers are beautifully scattered all over just because these two states are able to develop capacity for finding an alternative method of revenue generation rather than rely always on the federation account.

According to the available records of internally generated revenue (IGR) in the 36 States of the Federation in the year 2020, Lagos State topped the list, followed by Rivers, Delta, Ogun and Kaduna States. These states generated more than what other 31 states generated as IGR combined, which is why other states are financially dependent on the federation account where they account for 50% , 35% to local governments while the Federal Government is left with only 15% of the generated revenue.

In conclusion, it is evident that, should the governors of Rivers and Lagos States succeed in their plight then, like Governor Inuwa Yahaya of Gombe State said, many states will collapse. It is not time for begging for alms but this is critical time for the northern states that are left behind to begin to think about the constructive ways to improve on their internally generated revenue. Otherwise, the sinking ship will spare no one. Though, the Appellate Court has ordered for the stay of execution of the earlier judgment secured by the Governors of Rivers and Lagos States with respect to the signing, into law, the bill that will empower the state governments to collect VAT, the wounds are not yet healed. Anyone accusing Wike or Sanwo-Olu on this needs urgent reorientation. Otherwise, he or she can be said to share the same lazy mindset with the of the northern Political elites in question.

Sani Danaudi Mohammed
National President,
Arewa Youths Advocate for Peace and Unity Initiative, Writes from Bauchi.

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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