Nigeria’s efforts to improve the health of women and children are increasingly confronting a challenge that cannot be solved by more medicines, equipment or funding alone: weak leadership and management systems capable of turning health investments into results. That challenge is now the focus of a major intervention by the United Nations Children’s Fund (UNICEF) and Development Governance International (DGI) Consult, which is targeting leadership, governance and management gaps in Adamawa, Kwara and Sokoto States to help protect gains recorded in reproductive, maternal, newborn, child and adolescent health and nutrition (RMNCAH+N).
The intervention is significant because baseline assessments across key health institutions in the three states identified gaps in planning and implementation, coordination, supportive supervision, data use, workforce management and other aspects of health-sector governance. The concern is straightforward: health systems can have policies, programmes and technical expertise on paper, yet fail to deliver their full impact when leadership is weak, resources are poorly managed and accountability is fragmented. It is this gap between having health interventions and delivering results that the Enhancing Leadership, Governance and Management Capacities (ELGMC) Project is seeking to close.
Implemented by DGI Consult as part of the European Union-funded Strengthening Access to Reproductive and Adolescent Health (SARAH) Project, the initiative is jointly implemented by UNICEF and the United Nations Population Fund (UNFPA) in the three states. Following the baseline assessments, UNICEF and DGI Consult recently completed state-level capacity-strengthening workshops that brought together senior government officials, health-institution heads, programme managers, local government representatives, development partners and other stakeholders. Rather than treating leadership as an administrative skill separate from healthcare delivery, the programme places it at the heart of improving health outcomes.
UNICEF Health Systems Specialist, Dr. Emmanuel Emedo, captured the rationale succinctly. ‘It is important that health professionals understand how to lead because when we lead better, we deliver better results. Technical expertise alone is not enough for effective and efficient healthcare delivery,’ he said. For Emedo, the challenge becomes particularly important as health professionals assume leadership responsibilities and governments take greater ownership of programmes amid changes in the global development financing environment.
The implication is that Nigeria’s health sector must increasingly learn to do more with the resources available to it-and that requires competent managers who can plan strategically, coordinate programmes, manage finances, deploy human resources efficiently and use data to make decisions. The workshops therefore focused on strategic planning, coordination, results-based management, financial management, human resources for health, resource optimisation and data-driven decision-making.
Participants also developed shared RMNCAH+N visions and explored results frameworks designed to translate priorities into measurable targets and strengthen accountability. In Kwara, where stakeholders acknowledged significant progress in maternal and child health, the emphasis was particularly on protecting those gains while confronting persistent weaknesses in governance, resource management and service delivery. The Commissioner for Health, Dr. Amina El-Imam, acknowledged the support of UNICEF and development partners but stressed the need to sustain progress while addressing existing gaps.
The Executive Secretary of the Kwara State Primary Health Care Development Agency, Prof. Nusirat Elelu, similarly identified the management capacity of health workers, especially officers-in-charge of facilities, as critical to translating the state’s health ambitions into results. That focus on local governments and facilities is important because this is where health policies ultimately become-or fail to become-services. For a pregnant woman, the quality of leadership may be reflected in whether a primary healthcare centre has the personnel, supplies and referral arrangements needed when complications arise.
For a newborn, it may determine whether essential care is available on time. For a child or adolescent, it may influence whether services are adequately planned, staffed and monitored. In that sense, governance is not an abstract bureaucratic concept. It can determine whether people receive care when they need it.
DGI Consult’s Chief Executive Officer, Dr. Gafar Alawode, said the ELGMC Project was deliberately designed to go beyond conventional training. ‘A lot of people have trained as professionals in the health sector, but many have not had formal training in leadership. This programme is problem-solving and competency-based,’ he said. According to him, the objective is to equip health leaders with the competencies and systems required to identify problems, strengthen institutions and optimise available resources. ‘It is not just about conducting a training. It is about developing competent leaders and managers who can solve critical problems in the health sector, strengthen systems, optimise available resources, and ultimately improve access to quality healthcare,’ Alawode said.
That distinction could determine whether the intervention produces lasting results. Nigeria has no shortage of health policies, strategies, programmes or development interventions. The more difficult task is ensuring that these initiatives survive beyond workshops and are consistently implemented at state, local government and facility levels.
The ELGMC Project is taking leadership development beyond the training room by strengthening coordination, accountability and planning across Adamawa, Kwara and Sokoto states. Mentoring, technical support, action trackers and results frameworks are helping RMNCAH+N teams improve implementation and prepare stronger 2027 plans. The next phase will extend these efforts to local governments and health facilities through cascade training, expenditure reviews, financial modelling and performance dashboards. A Leadership Fellowship and Community of Practice will deepen peer learning and mentorship. Ultimately, the measure of success will be whether stronger leadership translates into better planning, efficient resource use, accountability and improved health services for women, children and adolescents.