Why Nigeria’s Healthcare System is Falling Apart – Don Discloses at RSU Inaugural Lecture
A university don, Professor Kalada McFubara has revealed why Nigeria’s healthcare system remains fragile and unsustainable, proposing that the country needs to returns to its original tripartite structure.
McFubara, who is a Professor of Health Policy and Medical Ethics at the Rivers State University (RSU), who made this revelation on Wednesday, May 14, 2026 while delivering the university’s 131st Inaugural Lecture at its main campus in Port Harcourt, Rivers State.
He said that Nigeria’s tripartite healthcare system accords public health its rightful place alongside primary and hospital care, warning that the continued treatment of a three-component system as either bipartite or, at best, incomplete, has weakened healthcare delivery and undermined outcomes across the country.
Speaking on the topic, “Medicalization of Public Health: Imperatives for the Health System Reform in Nigeria,” the don described public health as the backbone of the entire system, lamenting its persistent neglect and “invisible medicalization,” which he said has imposed a curative, rather than preventive, philosophy on the sector.
According to him, the dominance of curative medicine has shifted responsibility for healthcare away from citizens and communities to medical professionals and institutions, turning Nigerians into “habitual consumers” of medical services rather than active participants in preventive health practices.
He argued that the sidelining of public health has placed an avoidable burden on an already weak system, stressing that leadership and governance, core pillars of public health, have not received the attention required to drive efficiency and equity.
Prof. McFubara called for a fundamental restructuring of the health sector through the formal adoption of a tripartite model comprising public health, primary healthcare and hospital services, with public health positioned as the first point of contact.
He said such a shift would strengthen disease prevention, promote hygiene and sanitation, and improve referral systems, in line with provisions of the National Health Act 2014.
The Professor urged strict enforcement of the “first contact” principle, recommending that citizens be properly educated on sanitation and registered with primary health centres to ensure access to basic care.
To deepen institutional capacity, he proposed the establishment of a National Public Health Development Agency and State Public Health Management Boards, alongside sustained investment in infrastructure and manpower.
He also advocated clearer delineation of roles within the system, insisting that Hospitals Management Boards, not Ministries of Health, should oversee referral services as stipulated by law.
Professor McFubara further stressed the need to institutionalise research and development to support data-driven policy decisions tailored to Nigeria’s peculiar health challenges, while calling for wider dissemination of the Patient’s Bill of Rights to empower citizens and promote accountability.
He recommended statutory recognition for public health professionals and proposed the creation of a Health Ombudsman to enforce compliance with health laws in collaboration with the judiciary and legislature.
On professional conduct, the don called for a unified ethics curriculum across health professions to foster collaboration and strengthen leadership.
He concluded by advocating a preventive approach anchored on deterrence, targeting diseases, infections and environmental hazards before they escalate, while maintaining adequate capacity for curative care.
Professor McFubara also raised concerns over political and ethical challenges in the sector, noting that effective leadership and governance remain critical to repositioning the system.
Drawing lessons from countries in Europe and Africa, he said sustained investment in public health has proven pivotal in building resilient and efficient health systems.
In his remarks, the Vice Chancellor of the university, Professor Isaac Zeb-Obipi, commended the lecturer for addressing a critical gap in Nigeria’s healthcare architecture.
Represented by the Deputy Vice Chancellor (Administration), Professor Blessing Jaja, the Vice-Chancellor described the lecture as enriching and timely, noting that its recommendations, if implemented, could significantly strengthen the nation’s health system.
