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Doctors demand public ranking of govs on healthcare performance

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Medical doctors have called for the public ranking of governors and states based on health outcomes, saying such a system would promote accountability and encourage greater investment in healthcare delivery.

The physicians argued that assessing state governments using indicators such as maternal and child mortality, immunisation coverage, primary healthcare performance and disease control would provide a clearer picture of their commitment to improving citizens’ health.

They noted that making the rankings public could foster healthy competition among states and drive evidence-based policymaking.

Speaking exclusively with PUNCH Healthwise, the President of the Nigeria Medical Association, Prof. Afekhide Omoti, said healthcare failure should not primarily be that of the Federal Government alone.

He said the country must strengthen the state and local governments’ responsibility in financing healthcare.

“Healthcare failure is not only a federal problem. Many primary healthcare centres are under the state and local governments, but remain abandoned.

“States should match federal healthcare interventions, local governments should begin publishing PHC spending reports, governors should be assessed publicly on health outcomes, while federal allocations for health should be tied to measurable performance. Nigeria cannot centralise all blame in Abuja while states neglect frontline healthcare,” he said.

He urged relevant government agencies and health institutions to develop transparent performance assessment frameworks and publish regular scorecards on state health outcomes.

Omoti stressed that measuring and publicising progress is essential to improving health systems and accelerating Nigeria’s journey towards universal health coverage.

Omoti, who spoke on the effect of shrinking donor funding and poor release of budgetary allocation to health, said it was time for states and local governments to fully contribute to the healthcare of their residents.

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The NMA president also said that the government should enforce full and timely budget releases to the healthcare sector.

“One major problem is that ministries and hospitals receive partial releases long after budgets are passed. We have observed that the problem is no longer only about budget allocation; it is now fundamentally about budget credibility, release efficiency, and accountability.

“Nigeria can decide to announce ambitious health budgets every year, but if funds are not fully released, poorly utilized, or diverted through bureaucratic bottlenecks, the health sector will continue to deteriorate,” he said.

According to him, the government must move from symbolic budgeting to enforceable health financing reforms.

“Critical healthcare funding should be treated like debt servicing and national security obligations. This means that certain health expenditures, especially primary healthcare, immunization, emergency response, and salaries, should receive automatic statutory releases,” he said.

He said that releases for healthcare funding should not depend on political discretion or quarterly cash-flow politics.

“Healthcare cannot remain the first victim whenever revenue falls short,” he said.

The NMA president said Nigeria’s heavy reliance on oil revenues to fund public services has made healthcare financing unstable.

He called for increased diversification of health financing through increased domestic resource mobilisation and expanded health insurance coverage, among others.

Although the FG finances healthcare through a combination of direct budgetary allocations, mandatory health insurance, the Basic Health Care Provision Fund, and tax-based revenue, donor funding is still used for some health services.

But the funding cuts by the Donald Trump administration in January 2025 are affecting many health services largely funded by donors in Nigeria.

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In the wake of the funding crisis, PUNCH Healthwise reported that experts warned Nigeria’s heavy reliance on donor support could trigger a rise in HIV, tuberculosis, and malaria infections, urging the immediate mobilisation of domestic resources.

In August 2025, the United Nations Children’s Fund stated that it faced a $160 million funding gap for crucial humanitarian aid in Nigeria.

But speaking on what the country can do, the NMA president said Nigeria can expand health financing beyond oil revenue.

He listed public-private partnerships, diaspora health investment bonds, among others, to support revenue from oil in financing healthcare in Nigeria.

“Depending heavily on oil revenues makes health financing unstable. Nigeria should diversify health funding through expanded health insurance contributions, sin taxes on tobacco, alcohol, and sugary drinks dedicated specifically to health, public-private partnerships, diaspora health investment bonds, and special intervention funds for health infrastructure,” he said.

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Catholic bishops’ inconvenient truth

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Politics and religion often conflate into a toxic brew. So, it is with the storm over John Onaiyekan’s comments after the recent meeting between President Bola Tinubu and the Catholic Bishops’ Conference of Nigeria. As the waves billow and swell, the encounter opens a window into the tremors in government rather than the cardinal’s intentions.

Instead of treating the bishops’ observations as sincere moral feedback from a respected institution, some of the administration’s vocal defenders responded with personal attacks, accusing the cardinal of partisanship and abuse of clerical privilege.

That reaction was unfortunate and avoidable.

No elected government claiming democratic credentials should treat independent criticism as hostility.

Yet the ferocious responses from the Minister of the FCT, Nyesom Wike; the President’s Special Adviser on Policy Communication, Daniel Bwala; and the SSA on Media, Temitope Ajayi, suggested Onaiyekan had committed a grave offence by saying the bishops told the President Nigeria was “bleeding,” that poverty was worsening, and many were struggling under economic reforms.

The cardinal’s fault was not fabricating facts but speaking publicly about an uncomfortable conversation.

He said the President disagreed, insisting the economy was improving and reforms were laying the foundation for recovery.

The bishops, he said, neither expected agreement nor sought to embarrass the President; they were discharging a moral duty to tell him what many Nigerians could not.

That should have ended the matter. Instead, critics turned a healthy exchange into a public quarrel. Bwala questioned the cardinal’s neutrality, alleging the church supported Peter Obi in 2023.

Ajayi dismissed the bishops as offering only one perspective. Wike argued that having taken sides in a past election disqualified the cardinal from impartiality and faulted the bishops for questioning INEC’s neutrality ahead of 2027 without stronger proof.

These points merit consideration. Religious leaders, like journalists and civil society actors, should aim for fairness as credibility rests on intellectual honesty. Achievements by government should be acknowledged. But fairness works both ways.

The administration’s defenders owe Nigerians an honest engagement with the bishops’ substance rather than attempts to discredit the messengers.

Who the cardinal voted for is irrelevant to whether millions of Nigerians are suffering. Hunger and inflation do not check party membership before striking families.

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One of the weakest responses to public criticism is to attack motives while avoiding the issues raised. That strategy failed to convince many Nigerians. Therefore, it is no surprise that support for Onaiyekan flowed from across civic space.

The Northern Youth Council said he reflected lived realities; the Middle Belt Forum called the attacks unfair; the Catholic Laity Council defended the church’s pastoral duty to speak for the vulnerable.

Former governor and minister Rotimi Amaechi, himself a Catholic, reminded the Presidency that bishops have every right to criticise governments and urged responses based on evidence, not indignation.

Even Orji Kalu, APC senator and former Abia State governor, threatened to resign from the party if the bishops were insulted, noting their similar interventions across Africa.

The public backlash appears to have prompted moderation. Secretary to the Government of the Federation, George Akume, reaffirmed the administration’s respect for the Catholic Church and promised deeper consultations.

That is the mature response expected of a confident government, and it should have been the first instinct.

The episode exposes a deeper problem.

With the 2027 elections on the horizon, there is a growing tendency in official circles to interpret every criticism through a partisan lens.

Independent institutions that refuse to sing from the government’s hymn book risk being branded hostile. Such defensiveness serves neither democracy nor good governance.

Onaiyekan’s sharper point was that too many people around the President paint an overly rosy picture of the country. Whether entirely fair, the observation highlights a real danger that administrations insulated by courtiers and loyalists risk mistaking praise for patriotism.

Presidents need more than briefings, official statistics and flattering presentations. They need uncomfortable truths from independent voices including economists, labour unions, journalists, business leaders, traditional rulers and religious organisations.

Governments that refuse to listen lose touch with the people they govern. That is why criticism is not the enemy of reform; silence is.

The Tinubu administration can rightly argue it inherited an economy in deep distress and that difficult choices were necessary. Removing the petrol subsidy and liberalising the foreign exchange market were politically costly but, many economists agree, economically inevitable.

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The government has expanded fiscal space for states, created NELFUND, launched youth initiatives, and helped end the destructive cycle of prolonged ASUU strikes. These are notable achievements and deserve acknowledgement.

But governments are judged by citizens’ lived realities, not only by economic theory or improving macro indicators.

Foreign reserves have strengthened to $52 billion from about $3 billion, fiscal revenues rose to all-time highs, and the naira exchange rate has stabilised compared with the immediate post-reform shock.

Yet these gains have not delivered meaningful relief for the average Nigerian. Inflation remains punishing at over 15 per cent and above 37 per cent in at least 10 states; food and transport costs are soaring; healthcare and medication are costly; electricity tariffs and rent have escalated; small businesses struggle with high energy costs and expensive credit.

For too many families, over 70 per cent of income is spent on feeding alone. Multidimensional poverty affects 63 per cent of Nigerians, per the World Bank.

The bishops sought to communicate that reality. It cannot be dismissed by citing encouraging macro trends.

The reforms are also incomplete. A parallel foreign-exchange market persists, reflecting distortions and weak confidence.

Oil production remains below projections. Domestic refiners complain of inadequate crude supply even as the government extends Project Gazelle with a new $4.5 billion refinancing, raising concerns about future crude commitments while local refining capacity is planned to double.

External debt keeps rising, increasing exchange-rate exposure and debt-service obligations, which already consume half of revenues.

Terrorism, banditry and kidnapping continue to terrorise large swathes of the country, driving farmers from fertile lands and worsening food inflation.

Official and independent reports indicate that more than 628,000 people have been killed and over 2.2 million abducted since 2023, according to a BusinessDay report in June.

These are measurable national realities, not opposition talking points. Governments need independent voices to speak honestly about them.  No pushback can erase the fact that Nigeria is bleeding.

The Catholic Church has a long history of such moral witness. During military rule, bishops such as Olubunmi Okogie, an Emeritus Cardinal, condemned authoritarianism, corruption and human-rights abuses.

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Under democratic governments, the church continued to criticise administrations across the political spectrum over insecurity, governance failures and human suffering. Its loyalty has been to moral principles, not to any party.

Tinubu should not regard himself as uniquely persecuted, nor should his supporters mistake clerical witness for partisan politics.

Religious leaders are, firstly, citizens. They bury terrorism victims, counsel unemployed graduates, comfort widows and feed hungry families. If such leaders cannot speak about poverty, insecurity and governance, democracy becomes a farce.

Political parties are also inconsistent. Many who now defend petrol subsidy removal opposed it when it was proposed under President Goodluck Jonathan. Those who benefited from the freedom to criticise must not deny others the same liberty when roles reverse.

One of the most perilous governance tendencies is believing that criticism weakens government. On the contrary, governments make worse mistakes when they become prisoners of official optimism.

They need independent feedback to test whether policies yield intended outcomes. Economic models and official reports are necessary but insufficient; they must be complemented by honest input from labour, business, academia, the media, civil society and faith leaders. Without it, governments risk governing statistical abstractions rather than human realities.

It is encouraging that the administration now appears to be recalibrating. Akume’s pledge of deeper engagement deserves commendation.

Consultation, not confrontation, marks mature democratic leadership. The Presidency gains nothing by quarrelling with institutions focused on the country’s welfare.

Tinubu has often said he welcomes constructive criticism. He insisted that he sought the job and should not be pitied. This episode is a chance to prove it.

Labelling respected clerics as partisan for voicing uncomfortable truths suggests the administration may lack confidence in the transformative power of its own reforms. That is diminishing.

Nigeria’s problems are too serious for official defensiveness. Reform is a journey requiring constant feedback. The bishops fulfilled their civic and moral duty. The Presidency must perform its constitutional role by listening, not by silencing dissent.

Source: punchng.com

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LACK OF TRUST IN MARRIAGE

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A marriage can survive difficult times, financial struggles, and disagreements—but when trust disappears, the relationship begins to lose its foundation.

When a husband no longer trusts his wife, or a wife no longer trusts her husband, even innocent actions can become suspicious. A simple phone call becomes a question. Coming home late becomes an accusation. A private conversation becomes a source of fear and jealousy.

Lack of trust creates emotional distance.

It produces constant suspicion, arguments, insecurity, resentment, and sometimes secretive behaviour. Instead of feeling safe with each other, couples begin to feel like enemies living under the same roof.

Trust is not built by controlling your spouse, checking their phone every minute, or constantly demanding explanations. Trust is built through honesty, faithfulness, transparency, consistency, and keeping your word.

If trust has been broken, don’t pretend everything is fine. Talk about it. Admit mistakes. Forgive where possible. Set healthy boundaries. And be willing to rebuild what has been damaged.

Remember: love may bring two people together, but trust helps keep them together.

💔 Don’t allow suspicion to destroy what communication and honesty can repair.

BUILD TRUST. BE FAITHFUL. BE HONEST. PROTECT YOUR MARRIAGE.

“Wherefore putting away lying, speak every man truth with his neighbour.”
— Ephesians 4:25 (KJV)

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LACK OF OPENNESS IN MARRIAGE

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A marriage can look beautiful on the outside and still be struggling on the inside when there is no openness between husband and wife.

When couples stop communicating honestly, keep secrets, hide their feelings, or are afraid to discuss important issues, emotional distance begins to grow. What starts as “I don’t want to cause a problem” can eventually become mistrust, resentment, loneliness, and constant misunderstanding.

Openness does not mean telling your spouse everything in a hurtful or careless way. It means creating a safe relationship where both partners can honestly talk about their feelings, concerns, mistakes, finances, expectations, struggles, and dreams without fear of unnecessary humiliation or condemnation.

A strong marriage requires:

• Honest communication — Talk about problems instead of allowing them to grow in silence.
• Trust and transparency — Avoid unnecessary secrecy that can damage confidence in the relationship.
• Active listening — Listen to understand, not simply to respond or attack.
• Emotional vulnerability — Let your spouse know when you are hurting, worried, disappointed, or afraid.
• Respect — Honesty should never become an excuse for insults, threats, or emotional abuse.
• Forgiveness — When mistakes are acknowledged, work together toward healing and restoration.

The Bible says:

“Where no counsel is, the people fall: but in the multitude of counsellors there is safety.” — Proverbs 11:14 (KJV)

And:

“Let every man be swift to hear, slow to speak, slow to wrath.” — James 1:19 (KJV)

Marriage should be a place where two people can feel safe enough to communicate, honest enough to admit their weaknesses, and humble enough to work through their differences.

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Don’t allow silence, secrets, and suspicion to build walls between you and your spouse. Talk. Listen. Understand. Forgive. Grow together.

❤️ Openness builds trust. Trust strengthens intimacy. And healthy communication helps build a stronger marriage.

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