UNICEF: Leadership, Governance Gaps Undermining Maternal, Child Healthcare in Kwara, Sokoto, Adamawa 

Funmi Ogundare 

The United Nations Children’s Fund (UNICEF) has identified critical leadership, governance and management gaps hindering effective delivery of maternal and child healthcare services in Kwara, Sokoto and Adamawa States.

The gaps, uncovered through baseline assessments conducted by Development Governance International (DGI) Consult on behalf of UNICEF, cut across all dimensions of healthcare leadership and management in the three pilot states. 

The findings were presented to key health stakeholders in Ilorin, Sokoto and Yola for validation.

According to the report, major challenges include limited technical understanding of planning and implementation processes, absence of clearly defined Terms of Reference for Technical Working Groups, and failure to domesticate the Reproductive, Maternal, Newborn, Child, Adolescent Health and Nutrition (RMNCAH+N) strategic plan.

Other issues identified are fragmented supportive supervision, low use of data for decision-making, particularly at the facility level and persistent workforce shortages and inequitable distribution of health personnel.

The assessments form part of a broader UNICEF-backed initiative aimed at strengthening leadership, management and governance capacity for RMNCAH+N and Gender-Based Violence (GBV) services across the three states.

At the validation workshop in Ilorin, Kwara State Commissioner for Health, Dr. Amina Ahmed El-Imam, represented by the Permanent Secretary, Dr. Taoheed Abdullahi, described the findings as a wake-up call despite ongoing improvements in RMNCAH+N services. 

He acknowledged the impact of the EU-SARAH initiative but stressed the need to strengthen leadership and governance systems across the health sector.

In Sokoto, a representative of UNICEF’s field office, Dr. Danjuma Nehmiah, expressed optimism that the identified gaps and subsequent interventions would significantly improve healthcare delivery. 

He stated: “Effective leadership is crucial to achieving progress in service delivery,  strategic plans would be developed in collaboration with DGI to transform governance in the health sector.”

Similarly, in Yola, the Permanent Secretary and Acting Commissioner for Health in Adamawa State, Zirra Mathias Bubabi, welcomed the intervention, expressing appreciation for efforts to address systemic gaps. 

He said the state looked forward to implementing actionable steps arising from the assessment.

Also speaking, the World Health Organization (WHO) representative, Kirfi Mansur Habibu, described the initiative as timely, noting that it provides an opportunity to align ongoing efforts, identify service delivery gaps and prioritise evidence-based interventions to accelerate progress in key health areas.

Chief Executive Officer of DGI, Dr. Gafar Alawode, said the baseline assessment was designed to guide targeted interventions. 

He disclosed plans to establish a community of practice to foster collaboration among the three states, as well as an RMNCAH+N fellowship to showcase implementation outcomes.

Alawode added that the project would prioritise strengthening coordination, improving annual operational planning, digitising resource tracking, and institutionalising data-driven decision-making. 

Other focus areas, he noted, include enhancing human resource management through functional technical working groups and establishing effective family health departments within state ministries of health.

He said the initiative underscores the importance of evidence-based decision-making in improving health outcomes, adding that stakeholders’ strong commitment would be critical to achieving sustainable progress in maternal and child healthcare delivery.