Advocates Call for Local Govt Autonomy to Curb Child Deaths

Following the landmark granting of financial autonomy to Nigeria’s local governments, a coalition of health advocates is issuing an urgent “call to action.” Their message is clear: the newly accessible funds at the third tier of government must be treated as a lifeline to save the thousands of mothers and children currently dying from preventable causes at the “last mile.”

During a high-level meeting of the Integrated Child Survival Advocacy (ICSA) project in Abuja, experts warned that the shift in funding power creates a unique opportunity and a massive responsibility for local administrators to fix the broken primary healthcare system.

The “Five-State” Crisis

Medical expert and lead advocate Dr. Fatima Adamu pointed a spotlight on five specific northern states Sokoto, Kebbi, Kano, Kaduna, and Katsina. These regions currently hold the most distressing child survival indices in the country.

Dr. Adamu argued that the survival of a child in these vulnerable communities should no longer depend on state or federal bureaucracy. “We need to link our health economy to the additional funding coming to the local government,” she stated. “We must engage with local authorities to ensure they don’t spend all the resources elsewhere while mother-and-child interventions remain underfunded.”

Empty Shelves and Ghost Clinics

A recurring theme among the advocates was the “out-of-stock” crisis. Many Primary Healthcare Centres (PHCs) serve as little more than empty buildings because they lack basic commodities, life-saving vaccines, and malaria prevention kits.

Dr. Nihinlola Mabogunje of the ICSA Project emphasized that while policies exist on paper, the reality on the ground is often one of neglected malnutrition services and erratic immunization. “The community must take charge,” she urged. “They need to monitor these facilities, identify the gaps, and walk directly to the Local Government Chairman to demand that essential stocks are replenished.”

From Policy to “Cash Backing”

The advocates are shifting their strategy from national lobbying to grassroots accountability. The goal is no longer just to get a health budget approved, but to ensure there is “cash backing” real money being released and used judiciously for vaccines and emergency care.

Dr. Mahmoud Mustafa Zubeiru, Head of Missions at the Centre for Wellbeing and Integrated Nutrition Solutions, noted that vaccines and medicines are useless if there is no commitment to deliver them.

READ ALSO: Remi Tinubu Calls for Compassionate, People-Centred Cancer Care

“If I am a health worker and I know the survival of this child is vital, I will make every effort to carry that vaccine from the store to the center,” Dr. Zubeiru said. He added that the mission is now to “arm” local influencers and community health agents with evidence so they can demand accountability for every single Naira allocated for child health.

The Power of the “Last Mile”

The ICSA project aims to foster a sense of “community ownership.” By empowering local leaders to monitor the flow of funds, the advocates believe Nigeria can finally tackle the structural inequities that prevent a mother in a remote village from accessing the same life-saving care available in the city.

As local government chairmen begin to manage their own budgets, the eyes of the health sector are on them. The verdict is unanimous: the success of local autonomy will not be measured by new roads or offices, but by the number of children who live to see their fifth birthdays.