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Since assuming office in 2023, Governor Ahmad Aliyu of Sokoto State has embarked on an ambitious mission to transform the state’s health sector, which was described as being in “intensive care unit” due to years of neglect under the administration that preceded his. His administration’s health reform agenda, anchored on his Nine-Point SMART Agenda, prioritises healthcare as a cornerstone of development. It aimed to create a resilient, accessible, and people-centered healthcare system. His Health Commissioner, Dr. Faruk Umar Abubakar, a veteran health administrator with over 35 years of experience, stated in a recent interview that healthcare in Sokoto was itself in intensive care unit as at May 29, 2023. He noted, however, that Governor Ahmad Aliyu, rather than lament the decay, moved on to address the situation. After all, that was one of the challenges he promised to fix during his election campaign.
According to Dr Abubakar, the systemic neglect suffered by the state’s health sector ranged from dilapidated infrastructure, outdated equipment, and a severe shortage of healthcare personnel. He noted that hospitals in the state lacked basic amenities but had an ample supply of broken beds, torn mattresses, and non-functional diagnostic tools while hospitals in rural areas faced acute shortages of medical professionals, which forced residents to travel long distances to the state capital for basic healthcare services. The Commissioner disclosed, in the interview, that the primary healthcare system, which serves as the backbone of healthcare delivery, was particularly weak, with many of the Sokoto’s 824 health facilities, including primary health centers, health posts, and clinics, in disrepair. The sorry situation was compounded by high maternal and infant mortality rates, malnutrition crisis, and inadequate mental health services.
Governor Aliyu’s recognition of these hurdles to effective healthcare meant that he was ready to tackle them headlong because they had become barriers to human development. For this reason, Aliyu laid emphasis on a health sector reform programme that emphasised strategic planning, infrastructural renewal, human capital development, and partnerships to address both curative and preventive healthcare needs. For instance, the governor focused, first, on upgrading healthcare infrastructure and equipping facilities with modern tools. To this end, he ensured that 10 general hospitals across Sokoto’s 23 local government areas have received attention with ongoing phased rehabilitation. This includes wards upgrade, provision of functional toilet facilities, and addressing issues like open defecation, which was prevalent in some facilities due to poor sanitation infrastructure. The governor also prioritised the completion of two previously abandoned general hospitals in Dange Shuni and Wamakko council areas. These will expand access to secondary healthcare.
He has also decentralised diagnostic services by ensuring the procurement of diagnostic equipment, including ultrasound machines, which have been distributed to general hospitals across the three senatorial zones, with each zone receiving three of the equipment. Also, the governor ensured that X-ray machines have been provided for each geographical zone. This has impacted positively on the people by reducing the need for patients to travel to Sokoto metropolis for basic diagnostic tests. It also enhanced efficiency and reduced the burden the facilities. Added to this, the Aliyu administration has procured 240 beds, 240 mattresses, and 240 stands to replace broken and worn-out equipment in hospitals. It also ensured the procurement of new incubators for premature babies have been acquired, while solar-powered systems have been installed in critical areas like maternity wards to ensure 24-hour electricity to address previous issue of power outages in labour rooms and postnatal wards.
Aliyu’s primary healthcare revitalization programme has ensured the resuscitation of the sector with the renovation of seven primary health centers with further plans to construct 199 additional ones to improve access in underserved rural areas. These efforts aim to bring essential services closer to communities and reduce the strain on secondary and tertiary facilities while boreholes and overhead tanks have been installed to provide regular water supply to enhance hygiene and support medical procedures. According to stakeholders in the state, these infrastructural investments, including the planned establishment of a world-class referral hospital, are part of a strategic framework developed from the needs assessment conducted by the administration, which prioritises addressing gaps at primary, secondary, and tertiary healthcare levels and build the Sokoto healthcare system to international standard.
Human capital development in the health sector is also a major challenge. There is an obvious dearth of qualified medical personnel, particularly in rural areas. But Governor Aliyu is undaunted. His administration has implemented innovative policies to address this challenge. These include the recruitment of 845 nurses and midwives to address staffing shortages in primary healthcare centers. This significant step ensures that communities have access to trained professionals for essential services like immunizations, maternal care, and health education. This is also coming with scholarships and bonding programmes, which aim to build a sustainable supply of medical professionals. The administration is also sponsoring students to pursue medical studies, both locally and abroad, with a commitment to automatic employment upon graduation. According to Dr Abubakar, these professionals are bonded to serve the state for a minimum of two years, particularly in rural areas, in a mandatory rural service scheme.
The mandatory service scheme is one of Aliyu’s bold moves to ensure equitable distribution of healthcare workers across rural communities. Aliyu’s administration introduced the mandatory two-year rural service scheme for state-sponsored medical professionals to address the acute shortage of personnel in rural areas. To incentivize compliance, the government offers a 10% salary increment for those posted to rural areas. Additionally, Governor Aliyu has placed over 270 medical students, including doctors, pharmacists, and medical laboratory scientists on the state payroll, receiving a monthly stipend of about ₦82,000 each alongside bearing the cost of local registration for foreign-trained doctors, and addressing financial barriers to their integration into the workforce.
Also, to maintain high standards of care, the Aliyu administration has implemented regular technical supervision and in-service training programmes for healthcare workers. These programmes ensure that staff are updated on modern medical practices and equipped to deliver quality services. These human capital interventions not only address immediate staffing shortages but also lay the foundation for sustainable healthcare workforce by way of developing local talent and ensuring their retention through bonding and incentives.
Governor Aliyu’s efforts to transform Sokoto State’s health sector represent a bold and comprehensive approach to addressing long-standing challenges. Through strategic investments in infrastructure, human capital, maternal and child health, mental health, and partnerships, the administration has made significant strides in revitalizing a sector that was previously in crisis. The procurement of diagnostic equipment, rehabilitation of facilities, recruitment of healthcare workers, and innovative policies like the mandatory rural service scheme have improved access, quality, and equity in healthcare delivery. And, the governor is just getting started.
