The Role of Women’s Leadership in Strengthening Subnational Health Systems in Nigeria

A White Paper

Executive summary

Broad Outlook

This paper explores the pivotal role of women’s leadership in strengthening sub-national health systems in Nigeria, effectively making a case and linkage between gender-balanced leadership and effective health outcomes. Women leaders contribute unique perspectives and skills, prioritizing equity, inclusivity, and community well-being above all else. The information we gathered shows that women’s leadership can lead to significant improvements, including increased immunization rates, better reproductive health services, and enhanced maternal and neonatal care.

Methodology

A mixed methodology approach that leveraged extensive desk research, one-on-one interviews, and focus group discussions was used. Through the desk research, existing data from sources including reports, academic papers, and other previously published sources were gathered and synthesized to support the white paper’s objectives. After this, one-on-one interviews were conducted with seven female health commissioners with guided questions to acquire their perspective on the state of women’s leadership in the subnational health system, the existing barriers to women’s advancement, and practical recommendations for bridging this gap.

Insight and perspectives gathered from the two stages formed the base of the first iteration of the white paper. This first iteration was then validated by 26 mid and senior-level professionals of the Medical Women’s Association of Nigeria (MWAN) and Women in Healthcare Network (WIHCN) and 12 stakeholders engaged from various sectors including private sector organizations, academia, local health-focused non- governmental organizations, and health-focused industry. Cumulatively, this added up to 38 validators across two focus group discussion (FGD) sessions.

Upon conclusion of the FGDs, five of the seven female health commissioners were re-engaged for a validation process, after which the final iteration of the white paper was updated.

Barriers to Women’s Leadership

Despite being the majority in the health workforce, women face substantial barriers to leadership. This includes, but is not limited to:

All of these barriers work hand-in-hand to limit their impact on health systems.

Impact of Women’s Leadership on Subnational Health Systems

In developing this white paper, the seven female Health Commissioners in Nigeria who represent 19% of the Nigeria National Council on Health (NCH) were engaged.

Together, these female Commissioners representing FCT, Kaduna, Kwara, Ogun, Oyo, Rivers and Sokoto States are collectively responsible for 40,642,631 million people and have driven critical health initiatives.

Some of these initiatives include:

The NCH is the largest coordinating body of health policy and programs in Nigeria chaired by the Honourable Minister of Health and includes all the Health Commissioners from the 36 States and the Federal Capital Territory (FCT).

Recommendations to Enhance Women’s Leadership

To promote women’s leadership in the health sector, this paper recommends implementing policies at the local, state, and national levels to remove systemic barriers.

Some of the key recommendations include:

Providing training and development opportunities

Establishing mentorship programs and networking opportunities

Enacting supportive legislation

Encouraging family and spousal support

Embarking on social and behavioural change programmes to facilitate the evolution of predominant social norms

Implementing targeted leadership building initiatives.

Conclusion

By addressing these issues and implementing the suggested strategies for increased women’s leadership inclusion in subnational health systems, stakeholders can foster a more equitable, effective, and resilient health system that significantly improves health outcomes and benefits all members of the Nigerian society.

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