Health Sector Stability Hinges on Policy Implementation, Experts Urge Government Action
The Nigerian health sector has been plagued by recurrent industrial actions for years, a trend that continued into 2025 and threatens to persist without decisive government intervention. Medical professionals across the nation are united in their call for the Federal Government, led by President Bola Tinubu, to prioritize the full implementation of existing health policies and agreements as the most critical step to prevent further strikes in 2026.
The core of the issue, as articulated by physicians, lies in the government’s persistent failure to enact frameworks and fulfill commitments that have already been approved. This neglect, they warn, directly fuels the cycle of agitation and strikes that cripple healthcare services, leaving patients vulnerable and undermining the system’s capacity.
A Year of Disruptions: 2025 in Review
The year 2025 saw significant disruptions within the health sector. In a notable instance, the National Association of Resident Doctors (NARD) commenced a strike on November 1, 2025. Their grievances centered on a range of unresolved issues, including inadequate remuneration, severe staff shortages, unpaid allowances, and unsafe working conditions.
Resident doctors, who form the bedrock of clinical services in the nation’s teaching hospitals, specialist hospitals, and federal medical centres, are instrumental to the functioning of these facilities. Their industrial action, involving approximately 11,000 doctors across 91 healthcare institutions nationwide, led to a widespread paralysis of essential services.
Compounding the challenges, the health sector faced further strain on November 15, 2025, when the Joint Health Sector Unions (JOHESU) initiated their own indefinite strike. This dual action resulted in immense suffering for patients and their families, who were denied access to medical care, even in life-threatening situations.
While the Federal Government allocated N50 billion in November 2025 to address outstanding arrears for health workers, doctors argue that this intervention was insufficient and did not adequately cover their members’ dues. The fund was reportedly intended for all health sector workers, not exclusively for doctors. NARD estimates that the Federal Government owes doctors and other health professionals a staggering N38 billion in accumulated allowances.
A Unified Call for Action in 2026
In light of these persistent challenges, doctors, under the auspices of the Nigeria Medical Association (NMA) and NARD, have clearly stated their singular expectation for 2026: the full implementation of existing policies and agreements by the Tinubu administration.
Professor Bala Audu, President of the NMA, emphasized that the complete execution of current health policies is the paramount step the Federal Government must take. He highlighted several key policies that remain largely unimplemented years after their adoption, including:
- Health Workforce Retention Policy: Measures designed to keep skilled professionals within the country’s healthcare system.
- National Health Act: A foundational piece of legislation that requires robust implementation to achieve its objectives.
- Presidential Initiative on Health Sector Value Chain Development: A program aimed at enhancing the entire health sector ecosystem.
Professor Audu stressed that stability within the health sector and the delivery of quality healthcare services are contingent upon the government’s commitment to execution. He warned that a failure to prioritize implementation would inevitably lead to continued industrial unrest.
“For doctors, and indeed for all healthcare providers, there is only one major expectation: the full implementation of existing policies,” Professor Audu stated. “The quality of any policy is meaningless if it is not executed. All the reforms we need already exist within current policies. What is lacking is implementation.”
He further elaborated that the demands being made by healthcare professionals are not new or unreasonable. Instead, they represent a consistent pursuit of agreements that have been reached in the past but have not been honored.
Root Causes of Industrial Unrest
The NMA president underscored that strikes within the Nigerian health sector are rarely spontaneous. They are typically rooted in:
- Unresolved Agreements: Past commitments made by the government that have not been fulfilled.
- Prolonged Policy Failures: The consistent neglect of established policies and frameworks.
“What happens in Nigeria is no different from what happens in any other country. When you put in quality input, you get quality results. Strikes by doctors and other healthcare workers are hinged on a single issue: non-implementation of already approved policies,” he explained.
The Cost of Neglect and the Promise of Implementation
Professor Audu cautioned that continued inaction would perpetuate instability in the health sector. Conversely, he asserted that implementing existing agreements would restore confidence and significantly improve service delivery.
“If the government fails to implement these agreements, agitation will naturally continue. But if the government implements what has already been approved, the health sector will be stable, and Nigerians will be able to access quality healthcare across the country,” he concluded.
Reflecting on the state of the healthcare system in 2025, Professor Audu described the situation as mixed, particularly from the perspective of frontline health workers. Despite persistent challenges, healthcare professionals have strived to maintain services for Nigerians under arduous conditions, navigating structural weaknesses and policy deficiencies.
However, he expressed grave concern over the continuous exodus of skilled professionals, which he identified as a significant impediment to the system’s capacity. “The continued loss of skilled professionals has created serious drawbacks, limiting the capacity of those who remain to provide the level of care they are trained to offer. In effect, the system is increasingly handicapped by workforce shortages,” he warned.
NARD’s Specific Demands for 2026
Dr. Mohammad Suleiman, President of NARD, echoed the call for the Federal Government to prioritize the welfare of doctors. He highlighted the numerous outstanding remunerations, including salaries and promotion arrears, that continue to burden doctors.
- Unpaid Arrears: Promotion arrears dating back to 2020, 2018, and 2017 remain unpaid. Salary arrears, ranging from four months to over 20 months, are also outstanding for individuals who have already rendered services. Specialist allowances are also yet to be paid.
- Professional Allowance Table: NARD demands the immediate implementation of the corrected professional allowance table, which was approved but has not yet been reflected in payments. The new allowance structure, which became law, supersedes the old, illegal one, yet payments continue based on the outdated scale. This corrected table was expected to be implemented in 2019.
- Entry-Level Placement: The government’s reduction of entry-level placement for doctors from CONMESS 3 to CONMESS 2 has resulted in financial losses. Despite a clarification from the Head of Service mandating continuation on CONMESS 3, new entrants are still being enrolled on CONMESS 2, leading to a monthly financial deficit of approximately ₦120,000 to ₦250,000 per doctor.
Dr. Suleiman emphasized the interconnectedness of a healthy workforce and a healthy nation. He urged the Federal Government to deliberately shift its focus and implement policies that genuinely prioritize the well-being of all health sector workers. “A healthy workforce means a healthy Nigeria. The Federal Government must deliberately shift its attention and bring in policies that truly prioritise the welfare of the health workforce, doctors, resident doctors, and everyone working in the health sector, because we all live in the same Nigeria. We go to the same markets, face the same economic realities, even though we may have different qualifications,” he stated.
The consensus among medical professionals is clear: the path to a stable and functional health sector in Nigeria in 2026 lies not in the creation of new policies, but in the diligent and comprehensive implementation of those already in existence.
