Data assurance mechanisms based on a non-blame culture and regular audit cycles improving the quality and timeliness of information, combined with rapid feedback and local use of all collected data, will show value. Local and state governments should maintain ownership of local digital infrastructure, using federal funds. The federal government, through the Ministry of Health and National Bureau of Statistics, should set national standards for the digitisation of health records, building on existing systems such as District Health Information System version 2, the Surveillance Outbreak Response Management and Analysis System, and the National Health Logistics Information System to improve preventive and curative care, support decision making, and guide system management at all levels. Improvements in infectious disease surveillance led by the Nigeria Centre for Disease Control (NCDC) have resulted in timely national data reporting on outbreaks of COVID-19 The initiation of the Basic Health Care Provision Fund scheme and the introduction of state health insurance have provided an important starting point for future reform towards universal health coverage. And despite the country's reputation for intractable governance, developments over the past two decades have shown that positive reforms are possible. There is a distinct opportunity to redefine the national social contract using health benefits to the most vulnerable households as a key element of the relationship of citizens to the state. A detailed critical evaluation of the historical and current challenges facing the health of the country is presented to contextualise recommendations for the future. The Lancet Nigeria Commission aims to reposition future health policy in Nigeria to achieve universal health coverage and better health for all. And importantly, such efforts must be integrated with climate action for healthy resilient futures.
Government action needs to move away from treating disease to creating health. Taking bold multisectoral preventive action on the determinants of health can in turn prevent and even reverse the rise of non-communicable diseases. Reducing the burden of HIV, tuberculosis, malaria, and other communicable diseases will change the epidemiological landscape, allowing greater scope to simultaneously tackle rising non-communicable diseases. Reducing maternal and child mortality and unmet need for family planning are basic first steps to improve families' well-being, with implications for security, resource utilisation, economic growth, and shared prosperity. There are immense opportunities to alter Nigeria's population health and economic development trajectory, if only they can be seized. Presenting an opportunity to better frame health as a determinant of national achievement in the next plan. The Lancet Regional Health – Western Pacific.The Lancet Regional Health – Southeast Asia.The Lancet Gastroenterology & Hepatology.
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