Health
Chinedu Moghalu
IN a country as vast, diverse and complex as Nigeria, achieving widespread success in public health campaigns requires more than just medical interventions—it demands trust, community engagement, and culturally attuned strategies. Over the last two decades, traditional and religious leaders in Northern Nigeria have been at the forefront of this effort, driving the successful implementation of vaccination campaigns, information, communication, and health education initiatives, and disease prevention measures. Their involvement, alongside key partners like the National Primary Health Care Development Agency (NPHCDA), global health organizations, and development partners, has transformed how health interventions reach the most vulnerable populations in the region. As Nigeria continues to implement the Health Sector Renewal Investment Initiative (NHSRII) through the Sector-Wide Approach (SWAp), the role of these leaders remains indispensable in improving quality health outcomes for all Nigerians.
Why Traditional and Religious Leaders Matter in Public Health
At the heart of effective health campaigns is trust, and in many parts of Nigeria, traditional and religious leaders are the custodians of that trust. They hold a sacred and influential position, particularly in rural and underserved communities where government outreach may not always be sufficient. Over the past 15 years, leaders like His Eminence Muhammadu Sa’ad Abubakar CFR, the Sultan of Sokoto, have led the charge in bridging the gap between formal health systems and communities. Their ability to communicate in culturally relevant lingo has been pivotal in fostering vaccine acceptance and debunking myths, especially in times of rampant misinformation and disinformation.
Bill Gates, who has been a long-standing partner through the Bill & Melinda Gates Foundation, noted, “Without the trust and leadership of traditional and religious leaders, we would have struggled to reach many areas with life-saving interventions. Their role is not just supportive but central to the success of these health campaigns.”
A Model of Success: Polio and HPV Vaccinations
One of the most remarkable examples of the effectiveness of engaging traditional and religious leaders is Nigeria’s successful eradication of the wild poliovirus. A decade ago, polio was raging through Nigeria, particularly in the northern states where vaccine resistance was high due to misinformation. During his tenure as the Executive Director of NPHCDA, Muhammad Ali Pate, now the Honorable Coordinating Minister of Health and Social Welfare, initiated the collaboration with these leaders to address the patent challenges. Engagement with them soon enabled vaccine acceptance in communities where formal health messages alone had little impact.
Reflecting on this success, His Eminence Muhammadu Sa’ad Abubakar CFR, who has remained the linchpin in the collaboration, remarked, “Polio was a threat we faced with unity and persistence. Through consistent engagement with our people, we were able to eliminate this disease, showing the world what is possible when communities work hand in hand with their leaders.”
More recently, the successful introduction of the HPV vaccine to protect young girls from cervical cancer equally demonstrated the continued relevance of this model. Working with the NPHCDA and partners such as Gavi, traditional / religious leaders played a crucial role in ensuring the campaign’s success, achieving 86% coverage among girls aged 9 to 14. This was not only a health victory but a demonstration of how trust-driven leadership can drive the success of even the most challenging public health interventions.
A Catalyst for Achieving the Health Sector Compact
As Nigeria advances its health system reforms through the NHSRII, leveraging the Sector-Wide Approach (SWAp) and the “whole-of-government” and “whole-of-society” as outlined in the Compact signed with all the State Governors and the FCT, the critical role of traditional and religious leaders comes to the fore anew. The endorsement of these leaders from across Nigeria signaled the recognition that health is not just a government responsibility but a societal affair that requires smart collaboration at all levels.
The NHSRII’s aim to address systemic challenges in healthcare delivery, from expanding access to primary care to strengthening the health infrastructure at state and federal levels is resolute. However, without the continued engagement of local leaders, orchestrated through the SWAp, the initiative risks being disconnected from the people they are meant to serve. The inclusion of traditional and religious leaders in the implementation of these reforms ensures that the strategies are not only inclusive but also resonant with the realities on the ground.
Hon. Pate emphasized this need during the NTLC meeting: “The Compact we signed last year was a recognition that our leaders—whether they be in government or communities—are critical partners in ensuring the success of our health sector renewal. We need their continued support to ensure that health policies translate into real, meaningful change for all Nigerians.”
Expanding the Model Nationwide
While this approach has been highly effective in Northern Nigeria, it is a model that should be devolved to other regions and states nationwide. In many regions, particularly rural and underserved areas, traditional and religious leaders have stronger ties to the community than government officials. Their ability to effectively communicate in a culturally relevant manner, and their sacred positions within the community, make them key assets for public health campaigns.
Alhaji Aliko Dangote, a strong advocate for health efforts, emphasized the importance of replication: “The model we’ve seen in the North, where traditional leaders drive vaccine uptake and health campaigns, is one that works. We need to replicate it across the entire country to ensure no region is left behind.”
By extending this model to regions outside Northern Nigeria, the government could tackle a range of pressing health challenges, from reducing child mortality rates and poor nutrition to addressing non-communicable diseases (NCDs). This inclusive approach could lead to more sustainable health outcomes across the country.
The Imperative of Cross-Border Health Campaigns
With Nigeria’s porous borders and the cross-border transmission of diseases such as polio and measles, the role of traditional and religious leaders is equally vital in regional health security. As part of a cross-border vaccination campaign scheduled for October and November 2024, traditional leaders in border regions will spearhead efforts to ensure synchronized immunization drives between Nigeria, Niger, Chad, and Cameroon. By working collaboratively, these leaders will prevent the import or export of diseases, reinforcing the importance of cross-border partnerships.
Alhaji Dangote, addressing the need for these coordinated efforts, stated, “We have seen how viruses can spread across borders. Coordinating cross-border vaccination campaigns, led by our traditional leaders, is essential to prevent the import or export of diseases.”
This coordinated effort mirrors the earlier success in tackling polio, where cross-border collaboration was key to halting the spread of the virus. The mutual respect that exists between traditional leaders across borders provides a unique framework for joint health initiatives, contributing not only to Nigeria’s health security but also to the region’s overall resilience against diseases.
The Value of Collaboration with Development Partners
The success of these health campaigns would not have been possible without the collaboration of development partners. Organizations such as the Gates Foundation, WHO, Gavi, UNICEF, and Rotary International have provided critical financial resources, expertise, and global best practices, helping Nigeria implement large-scale public health campaigns. However, the real power of these partnerships lies in the way they are adapted to local contexts through traditional and religious leadership.
As Hon. Pate remarked, “Development partners bring vital resources and knowledge, but it is our traditional and religious leaders who ensure these interventions are delivered in a way that resonates with communities. Their involvement is what turns a good plan into a successful one.”
The NPHCDA, as the government’s coordinating agency, has been instrumental in aligning these partnerships and ensuring that health interventions reach even the most remote areas. By working closely with traditional leaders and international partners, the NPHCDA has been able to bridge the gap between policy and practice, making Nigeria a model for how public health interventions can be successfully localized.
Expanding the Model beyond Immunization
While the engagement of traditional and religious leaders has been most visible in vaccination campaigns, their influence should extend to other areas of public health. From maternal and child health to nutrition and non-communicable diseases (NCDs), the trust these leaders command can be harnessed to address a broader spectrum of health challenges. Alhaji Dangote’s Crown Community Engagement Program is one such initiative that uses local leadership to tackle health issues beyond immunization, ensuring that no child or family is left behind.
Hon. Pate echoed this sentiment: “We must expand our focus beyond immunization. The trust that traditional and religious leaders have built within their communities must be harnessed to address a range of health issues. This is how we build a truly resilient health system.”
Conclusion: A Unified Path toward a Healthier Future
The engagement of traditional and religious leaders has proven to be one of Nigeria’s most effective tools in advancing public health. Whether it’s eradicating polio, expanding HPV vaccination, or leading cross-border campaigns, these leaders have shown that their involvement is not just beneficial—it’s essential. As Nigeria implements the Health Sector Renewal Investment Initiative through the Sector-Wide Approach, their role will be even more critical in ensuring that the reform is felt by the people who need them most.
His Eminence Muhammadu Sa’ad Abubakar CFR captured this vision perfectly: “We have walked this journey for 15 years, and we have seen what can be achieved when leaders work together with their communities. The journey is far from over, but with continued collaboration, we can secure a healthier future for Nigeria.”
By combining the strengths of local leadership with global partnerships and government support, Nigeria can achieve its health goals and set a global example for delivering public health interventions that are both effective and culturally resonant.
Chinedu Moghalu is a lawyer, expert in sustainable development, and a ministerial advisor.
A.I
Sept. 5, 2024
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