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“Our commitment to the health of our people is a sacred trust. We inherited a troubled system and we are very determined to make a fundamental difference.” — Governor Ahmed Aliyu
Governor Ahmed Aliyu has more than demonstrated his commitment to transforming healthcare in Sokoto State through strategic investments in the training of medical professionals and the modernization of both urban and rural healthcare facilities. His vision is to build a healthcare system in which the principle that “health is wealth” becomes a lived reality for every resident of the state, regardless of their social or economic status. At the heart of its ambition is the belief that healthcare is a right, not a privilege, and that no mother should be forced to give birth in unsafe conditions or any citizen should be denied access to quality medical care.
Guided by his transformative 9-point Smart Agenda, Governor Aliyu seeks to establish a healthcare system that is efficient, inclusive and capable of meeting the needs of people across Sokoto State. He strengthened this direction with the appointment of Dr. Faruk Umar Abubakar, an experienced medical professional and former Registrar/Chief Executive of the Nursing and Midwifery Council of Nigeria, as Commissioner for Health. The appointment also highlighted the administration’s determination to strengthen health care delivery through experienced leadership and institutional reform.
Even though the narrative of the healthcare system in Sokoto State has changed drastically in the last three years, it doesn’t appear that the governor has any plans of slowing down. At the heart of the governor’s reforms is a simple principle: access to health care should be universal; easily accessible to all. This is a remarkable development, unlike the eight-year administration of former governor Aminu Tambuwal, when many health facilities in Sokoto state were poorly equipped, suffering from manpower shortages, unreliable electricity and inadequate maternal care services. As a result, many primary health centers were operating under extremely difficult conditions.
When Dr. Abubakar assumed office, he famously described the healthcare sector as an “intensive care unit (ICU),” a stark metaphor for a system that was facing deep-seated structural challenges. In addition to deteriorating infrastructure, many facilities were severely understaffed, especially in rural areas, where most of the population resides and access to trained staff remains limited.
In the worrying context of a collapsing system inherited by Tambuwal, the crucial question is; What tangible difference has the Aliyu administration made in reversing the decline and restoring confidence in the state healthcare system?
Since its inception, the administration has conducted a comprehensive assessment of health care facilities across the state to determine the extent of infrastructure decay, equipment shortages and staffing shortages. The findings revealed non-functional departments, inadequate diagnostic tools and severe shortages of essential consumables in many facilities, providing the basis for subsequent reforms and targeted interventions.
Governor Aliyu’s first priority was to stabilize the health workforce, recognizing that infrastructure alone cannot save lives without trained professionals capable of providing much-needed care. The administration has restructured the state healthcare pay scale to match and, in some cases, exceed the federal government’s scale. This strategic policy had an immediate chilling effect on the “brain drain”, with many doctors and nurses withdrawing their letters of resignation.
In addition to retention, the administration is investing in a long-term reserve of qualified personnel. More than 270 medical students are currently on the state payroll, along with pharmacy and medical laboratory students. By placing these students on 07-level wages while still in school, the government not only reduced the financial pressure on their families but also ensured their future service through bond agreements that require recipients to serve the state for two years after graduation.
Perhaps the most transformative aspect of Governor Aliyu’s health policy is the “Rural Detachment Policy”. To bridge the gap between urban and rural healthcare, the State Executive Council has approved the mandatory secondment of every medical professional sponsored by the Sokoto State Government to serve in a rural health facility for a minimum of two years. This was also supported by a 10% base salary increase as an incentive. By ensuring that qualified staff are sent to work in places like Bodinga and Gudu, the administration also ensures that the referral system actually works, that the Sokoto Specialist Hospital focuses on treating the most severe cases, and that it is the advanced tertiary hospital it was designed to be. This policy is already making a huge difference in several communities that previously lacked qualified healthcare workers and now boast doctors and nurses.
The Aliyu administration has also focused on restoring basic functionality of health facilities through targeted infrastructure upgrades. An initial batch of 240 hospital beds, mattresses and supports have been distributed to various facilities, while solar power systems have been installed in labor wards, operating theaters and neonatal units to ensure uninterrupted service delivery. In Sokoto state, the lack of electricity is no longer a death sentence for patients. Diagnostic equipment, including ultrasound and X-ray machines, were also distributed across the three senatorial zones to improve access to medical services in rural communities. Boreholes have been installed and sanitation systems have also been rehabilitated to improve hygiene and access to water in health centers. For many residents these changes are not only visible, but taken for granted.
These interventions significantly restored the functionality of structures that had effectively ceased to function under Tambuwal.
Another critical area of intervention was that of governance and accountability in the healthcare sector. The Ministry of Health has introduced strategic planning mechanisms that require various healthcare facilities to justify funding requests through implementation plans and performance evaluations. Control over drug procurement and medical supplies has also been strengthened through the State Agency for Drugs and Medical Supplies, to improve transparency and reduce the circulation of counterfeit medicines.
The government further expanded maternal and child health services by increasing access to free obstetric care, including caesarean sections, under health insurance arrangements. Antenatal services have also been scaled up in several facilities, with some clinics increasing attendance days from once a week to multiple sessions a week, in an effort to improve early detection of pregnancy-related complications and reduce maternal mortality.
Likewise, immunization campaigns have received renewed attention through collaboration with the traditional institution – the Sultanate Council – and religious leaders. According to health officials, intensified awareness campaigns and grassroots engagement have contributed to a significant reduction in vaccine rejection rates in affected communities. Vaccine refusal figures have fallen from more than 4,000 cases to fewer than 1,000 in a single immunization round following stepped-up awareness campaigns and grassroots engagement, according to health officials.
Under Governor Aliyu, disease surveillance and emergency response systems have been strengthened. Rapid response teams and epidemiological monitoring units are known to be activated quickly to address the detection and containment of public health emergencies such as measles and hepatitis epidemics. For example, within hours, epidemiologists were dispatched to villages in the Tambuwal LGA to identify and isolate a measles outbreak, thus preventing what could have been a statewide outbreak.
Dr. Abubakar’s position that the health system needed urgent stabilization before broader reforms could succeed significantly shaped the administration’s policy direction. His extensive professional experience and expertise in the Nigerian healthcare sector appears to have influenced the emphasis on institutional reconstruction, workforce retention and phased implementation of rehabilitation programmes.
While conditions in some facilities remain far from ideal, the reforms undertaken from 2023 represent an attempt to move the sector away from years of institutional decline towards a more functional and accountable healthcare system. The scale of the challenge remains notable, given the size of the state’s health care network and the depth of long-standing structural problems.
While significant challenges remain, Governor Aliyu’s approach of prioritizing gradual rehabilitation and systemic reform rather than biting off more than one can chew represents a clear strategic departure from years of wholesale neglect of the health sector. Investments in infrastructure, workforce retention, maternal health care, rural access and disease surveillance are gradually improving public trust in public health facilities.
While the transformation remains a work in progress, the administration has managed to stabilize the once-dysfunctional collapsed system. In many rural communities where childbirth once occurred in darkness, births now occur with a constant supply of electricity.
The road to full recovery remains long, but the Sokoto State health system is no longer alive. For many communities whose health facilities have long been abandoned by Tambuwal, signs of recovery are finally visible because the reforms championed by Governor Aliyu are addressing both the immediate gaps in service delivery and the deeper structural issues that have long plagued the system.
Ado writes from Sokoto, Sokoto State.
