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Stakeholders say poor healthcare coordination leaves patients to navigate care alone

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Poor coordination across Nigeria’s healthcare system leaves patients and their families navigating referrals, carrying medical records between facilities, and repeatedly explaining their medical histories as they seek treatment.

Addressing these gaps was a central focus of discussions at the 2026 Health Equity Conference, where stakeholders called for stronger referral systems, improved information sharing and clearer responsibility for patients as they move between healthcare providers.

Speaking at the conference, Yemi Ajao, Chief Executive Officer of OneBarrow International Limited, said patients should not have to navigate the gaps between hospitals, laboratories, pharmacies and specialist services without adequate guidance.

Mr Ajao said information and responsibility for care must follow patients as they move between providers, warning that poor communication and weak referral processes could leave them uncertain about where to seek further treatment.

“A patient does not experience healthcare as a collection of professional mandates, institutional departments or organisational charts. A patient experiences a journey,” he said.

He urged stakeholders to identify the institutional and operational barriers preventing patients from receiving coordinated care across different facilities and levels of the health system.

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The conference, held from 13 to 15 October, was themed ‘Care Coordination as the Core Engine of Health Equity’. It brought together representatives of government, healthcare institutions, professional associations and other sectors to discuss ways to improve access to healthcare.

Making referrals work

To illustrate the coordination gaps, Mr Ajao presented a patient scenario involving a woman named Amina. He asked participants to consider what happens when a patient is referred from one healthcare provider to another.

He asked whether patients knew where to go after receiving a referral, whether the receiving provider had the information needed to deliver appropriate care, and whether anyone followed up to confirm the referral was completed.

He said these questions should inform decisions about healthcare policies, financing, and technology.

The scenario highlighted the importance of treating care as a connected process rather than a series of isolated encounters with different providers.

When referral information isn’t shared effectively, or follow-up responsibilities are unclear, patients may have to coordinate their own treatment, complicating access to appropriate care.

Mr Ajao said the conference aims to examine patient journeys, institutional responsibilities, financing, partnerships, data, and implementation through plenary discussions and policy laboratories.

He urged participants to recognise the constraints facing institutions while identifying practical measures to improve coordination and continuity of care.

He called for collaboration among government agencies, regulators, healthcare professionals, private organisations and civil society to address gaps in service delivery.

According to him, effective referrals, timely information sharing and clear responsibility for patients’ care could help improve the healthcare experience and restore public confidence in the system.

“National pride grows when people can see their country working for them,” he said.

Reforms must improve patients’ access

Also speaking at the conference, Adijah Elijah, Director of Health Planning, Research and Statistics at the Federal Ministry of Health and Social Welfare, said government policies and investments must translate into tangible improvements in access to healthcare.

READ ALSO: Donor cuts, govt inaction negatively impact HIV patients in Rivers, Akwa Ibom (3)

Mrs Elijah said Nigeria’s commitment to achieving universal health coverage by 2030 would require government institutions, healthcare providers, development partners and communities to work towards shared priorities.

“Health equity is both a moral imperative and a practical investment in Nigeria’s human capital, productivity and sustainable development,” she said.

She identified the Nigeria Health Sector Renewal Investment Initiative and the Sector-Wide Approach as frameworks for aligning investments, strengthening coordination and improving accountability across the health sector.

However, she said the effectiveness of the health system should not be measured solely by the number of facilities established, the resources committed or the policies adopted.

Rather, she said, progress should also be assessed by whether people could obtain quality healthcare without suffering financial hardship.

Mrs Elijah urged stakeholders to prioritise implementation and measurable improvements in access, particularly for underserved populations.


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Health

Plateau records 11,000 TB cases in 2026, 2,047 detected in three months

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Plateau State has an estimated 11,000 tuberculosis (TB) cases in 2026, with 2,047 patients identified between July and September, according to a state health official.

The cases were disclosed by Yohanna Bot, the monitoring and evaluation officer of the Plateau State Tuberculosis and Leprosy Control Programme, at a media advocacy meeting on community-led monitoring of health services in Jos.

Mr Bot said the estimated burden was based on a TB prevalence rate of 219 cases per 100,000 people, warning that the disease remained a major public health challenge in the state.

“From our quarterly survey, we discovered that between July and September, 2,047 patients were identified and placed on treatment,” he said.

He added that the identified patients were receiving treatment at health facilities across the state.

Tuberculosis is an infectious disease that primarily affects the lungs and spreads through the air when an infected person coughs, sneezes or speaks.

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Mr Bot identified malnutrition, advanced age, weakened immunity, overcrowding and HIV infection as factors that could increase the risk of contracting the disease or developing severe illness.

He also expressed concern over stigma and misconceptions surrounding TB, saying some residents attributed the disease to spiritual or ritual causes rather than seeking medical attention.

According to him, such beliefs discourage people from undergoing early diagnosis and starting treatment promptly.

Insecurity, displacement worsen TB risks

Mr Bot said insecurity and displacement were complicating efforts to detect and manage tuberculosis, particularly in Mangu, Jos South and Barkin Ladi local government areas.

He said displacement had led to the establishment of camps for internally displaced persons (IDPs), where overcrowded living conditions could facilitate the spread of the disease.

To address the challenge, he said the state programme was prioritising community outreach and active screening in IDP camps and correctional centres to identify people with TB and link them to treatment.

Mr Bot said patients who received effective treatment could become much less infectious after starting therapy, although the timing depended on their clinical condition and response to treatment.

He, however, raised concerns about shortages of anti-TB medicines, attributing the gaps in availability partly to disruptions in the supply chain and the programme’s dependence on international support, particularly funding from the Global Fund.

He called for increased public awareness to address stigma and misconceptions and urged residents with symptoms suggestive of TB to seek medical evaluation at health facilities.

Community monitoring targets healthcare gaps

Peter Ezekiel, the Plateau State programme officer of the Global Fund AIDS, Tuberculosis and Malaria Integrated Community-Led Monitoring Project, said Nigeria continued to face a significant burden of tuberculosis, HIV and malaria.

He said community-led monitoring was designed to involve residents and other stakeholders in identifying gaps in healthcare delivery and supporting interventions to improve access to essential services.

According to him, the approach helps communities identify barriers such as discrimination, stigma and gender-related challenges while advocating better infrastructure and increased domestic funding for healthcare.

Mr Ezekiel said the initiative had supported infrastructure rehabilitation, service improvements and stronger community participation in Plateau State.

He listed the rehabilitation and re-piping of toilet facilities at the Primary Health Centre in Rantya, Jos South, among the interventions carried out since June.

He said community stakeholders had also donated a scanning machine and 10 iron-framed chairs to the Primary Health Centre in Gangare, Jos North, as well as a blood pressure monitoring device to the facility in Dogon Agogo.

Other interventions included the provision of hospital bed mattresses to the Primary Health Centre in Pushit, Mangu, and tuberculosis sputum collection cups to the COCIN Rehabilitation Centre in Mangu.

Mr Ezekiel said community members had also provided 500 copies of patient enrolment forms to support healthcare delivery.

In Lamingo, he said residents mobilised resources to engage security personnel to protect night-shift workers and property at the local primary healthcare centre, with an agreed monthly payment of N15,000.

He said the interventions had improved infection prevention, patients’ experiences and healthcare delivery.

Mr Ezekiel called for stronger collaboration among communities, government agencies and health partners, alongside adequate funding for primary healthcare and greater accountability in the management of health resources.

READ ALSO: PT Health Watch: What you should know about Tuberculosis, why it persists

He also urged the expansion of national and state health insurance programmes to cover vulnerable people, particularly low-income earners.

Official highlights role of community monitoring

Yakubu Izang, the director of disease control and immunisation at the Plateau State Primary Health Care Board, said community-led monitoring was important for identifying healthcare delivery problems that might otherwise go unnoticed by government agencies.

He said the approach enabled communities and public officials to work together to identify challenges and develop solutions to improve access to healthcare services.


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Health

Katsina health workers suspend strike

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Health workers in Katsina State have suspended their seven-day warning strike following talks with Governor Dikko Radda over outstanding salary adjustments and welfare demands.

The suspension took effect on Sunday, 18 October, according to a circular reportedly issued by the Assembly of Healthcare Professionals (AHCP).

The development was announced in a newsflash attributed to the governor’s Chief Press Secretary, Ibrahim Mohammed, and also reported by Katsina Times.

The circular, dated 17 October and attributed to the assembly’s chairman, Ibrahim Balange, directed members to resume clinical and administrative duties across public health facilities following a meeting with the governor on 16 October.

The assembly comprises the Medical and Health Workers Union of Nigeria (MHWUN), the National Association of Nigerian Nurses and Midwives (NANNM), and the National Union of Allied Health Professionals (NUAHP).

According to the statement, the governor committed to reopening negotiations over the workers’ outstanding demands, including salary adjustments, allowances and career progression.

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However, the announcement did not establish whether the government had agreed to the workers’ proposed salary adjustments or when outstanding payments would be made.

Government’s commitments

The statement attributed to Mr Kaula said the government agreed to reopen negotiations through a technical roundtable.

The commitments include a review and implementation of the Consolidated Health Salary Structure (CONHESS) in accordance with applicable government circulars, alongside a comprehensive review of hazard, call duty and shift duty allowances.

The government also reportedly agreed to address the skipping of CONHESS grade level 10 for eligible officers, in line with the applicable scheme of service.

A joint technical committee is expected to be established with defined terms of reference and a timeline for addressing the outstanding issues.

However, neither the statement nor the reported circular specified when the committee would begin work or when the proposed adjustments would be implemented.

The assembly reportedly commended Mr Radda for intervening in the dispute and thanked its members for their cooperation during the industrial action.

How the dispute began

The suspension follows months of disagreement between health workers and the Katsina State Government over salary disparities and allowances.

As PREMIUM TIMES reported on 15 October, the assembly declared the warning strike after a seven-day notice issued on 7 October expired without a satisfactory resolution.

Mr Balange said the dispute dated back to 2024, when the government indicated plans to review health workers’ remuneration in line with what their counterparts receive in federal health institutions.

A committee established to examine the complaints subsequently submitted recommendations in March 2025, but the union said the government failed to implement them.

According to the union, the state’s Office of Public Service Reform initially offered workers 10 per cent of the salary difference between state and federal health professionals.

The government later increased the offer to 15 per cent, but the workers rejected it as inadequate.

Mr Balange said the assembly had sought full implementation of the applicable federal salary structure and allowances but was willing to accept 75 per cent as a compromise.

The disagreement eventually led to the warning strike, which began on 14 October.

Patients affected by strike

The industrial action disrupted services at public hospitals, leaving patients and caregivers uncertain about access to treatment.

A PREMIUM TIMES report published on Sunday documented disruptions at Turai Yar’Adua Maternal and Child Hospital in Katsina.

During a visit to the hospital on Saturday, only a few patients were seen around the surgical ward.

Caregivers expressed concern over the disruption, including difficulties accessing treatment for patients requiring medical attention.

The state Head of Service, Masa’ud Banye, had confirmed that government officials were engaging the unions to resolve the disagreement.

Although the assembly has now directed its members to return to work, the extent to which normal services have resumed across affected hospitals has not been independently established.

What remains unresolved

The suspension ends the immediate industrial action but leaves questions about the implementation of the government’s commitments.

The reported agreement does not clarify whether the government has withdrawn its earlier 15 per cent offer, accepted the union’s proposed 75 per cent compromise or agreed to another salary adjustment.

It also provides no specific date for settling outstanding allowances or completing negotiations.

The workers are seeking improved remuneration and allowances comparable to those available to their counterparts in federal health institutions.

For now, the reported agreement provides a basis for renewed negotiations, while the resolution of the underlying dispute depends on whether the government and unions reach an implementable settlement.


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