By Fatima Saka
The Federal Government of Nigeria’s ambition to guarantee “health for every Nigerian, wherever they are” is facing a critical test, as Benue, Kwara, and Imo states continue to lag in onboarding the Nigerian Emergency Medical Services and Ambulance System (NEMSAS), exposing governance gaps that experts warn are costing lives.
Despite the reform drive anchored on the National Health Sector Renewal Investment Initiative (NHSRII) Compact, a binding agreement involving state governments, local authorities, private sector actors, and traditional institutions, these states have yet to demonstrate full commitment to operationalising the emergency response system.
At the ongoing NEMSAS Media Cell Training Workshop in Abuja, stakeholders raised concerns over the uneven implementation of the national emergency framework. All 36 states and the Federal Capital Territory, spanning 774 local government areas across six geopolitical zones, are expected to achieve full operational status.
However, evidence from states such as Rivers, though officially onboard but not yet fully functional shows that onboarding alone does not guarantee effective emergency service delivery.
Nigeria’s emergency response deficit remains severe. With only about 500 ambulances available nationwide against an estimated requirement of 4,000, the system is further weakened by poor fleet management, idle vehicles, and limited private sector participation.
While the NHSRII Compact signals a unified commitment on paper, participants at the workshop questioned whether states are genuinely fulfilling their obligations. Delays in onboarding and operationalizing NEMSAS point to a disconnect between policy and practice, raising concerns about political will and institutional accountability.
Funding Without Visible Impact
Concerns were also raised about the impact of funding within the system. More than ₦1 billion has reportedly been disbursed through NEMSAS, yet many Nigerians have not experienced meaningful improvements in emergency response services.
At the workshop, issues such as alleged double billing in federal teaching hospitals were highlighted and broader inefficiencies in service delivery, calling for deeper investigative scrutiny to uncover possible financial leakages.
Beyond Infrastructure, the National Coordinator of NEMSAS, Dr. Doubra Emuren, stressed that emergency response extends beyond ambulances and physical infrastructure.
“It is about timely, accurate, and strategic communication with the public,” he said, urging media professionals to build trust, counter misinformation, and drive public utilisation of emergency services.
He highlighted that as Nigeria advances its health sector reforms, the uneven rollout of NEMSAS underscores a critical reality: without strong governance, coordination, and accountability, even well-funded initiatives risk underperforming.
“For millions of Nigerians, particularly in underserved states, the delay is more than administrative, it is a matter of life and death. Until all states move from commitment to concrete action, the promise of a responsive, life-saving emergency system will remain unfulfilled”, he stressed.
The Media’s Role in Accountability
Chief Mrs. Moji Makamjuola, Chairperson of Community Awareness and Engagement, NEMSAS, highlighted the urgency of strengthening public communication and trust.
“Every day in Nigeria, lives are lost, not always because help is unavailable, but because help does not arrive on time or systems fail when they are needed most,” she said.
She urged journalists to go beyond routine reporting and embrace investigative journalism to expose systemic gaps, verify claims with state emergency coordinators, and hold institutions accountable.
Also speaking, Dr. Lawal Bakare of the Sector-Wide Approach (SWAp) Coordination Office at the Federal Ministry of Health and Social Welfare acknowledged the deep trust deficit within Nigeria’s health sector.
“We all know that trust is a real issue in this country. When reports suggest everything is working perfectly, citizens become skeptical, as if they are being told what they already know is not the full reality,” he said.
He expressed optimism, however, that ongoing efforts by NEMSAS and the National Emergency Medical Treatment Committee (NEMTC) would strengthen transparency and improve service delivery.
Dr. Bakare further revealed that significant work is underway to address critical gaps in maternal and neonatal health, which he described as a top priority within Nigeria’s health reform agenda.
“If Nigeria’s human capital development indicators are poor, and if the health sector is underperforming, a significant part of that burden is tied to maternal and neonatal outcomes,” he explained.
He added that targeted improvements in maternal and neonatal care would have far-reaching effects across the health system.
“We believe that addressing maternal and neonatal health effectively will significantly reduce the overall health burden on the population, without diminishing the importance of other priorities,” he said.
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