By Fatima Saka
The Gates Foundation has called for urgent action, stronger accountability and improved service delivery to ensure that no Nigerian mother or child dies from preventable causes.
Mr. Ekenem Isichei, Deputy Director, Programme Advocacy & Communications (PAC), Nigeria, Gates Foundation, made the call while delivering a keynote speech at the 2026 Gender and Inclusion Summit in Abuja, stressing the need to translate government policies, commitments and innovations into measurable improvements in the lives of ordinary Nigerians.
Isichei illustrated the consequences of weak healthcare delivery with the experience of a woman who arrived at a primary healthcare centre in need of urgent care, but encountered a system where health workers could be absent, essential commodities unavailable and referral mechanisms ineffective.
He recounted a case involving two women who went to hospital to deliver their babies, noting that while one survived, the other died after she required a Caesarean section that could not be performed at the primary healthcare facility.
According to him, the referral process was too late to save the woman, highlighting the devastating consequences of inadequate capacity and ineffective referral systems within the healthcare system.
“For that woman that goes to primary healthcare centre, the issue is not a lack of innovation. There’s a distance between a good idea and a service that she can actually use,” he said.
Isichei said the experience reflects the reality faced by many Nigerians who encounter a significant gap between government policies and the services available to them.
He commended the organisers of the summit for creating a platform for stakeholders to deliberate on practical solutions, noting that Nigeria was at a critical period requiring a shift from policy announcements and commitments to specific actions with measurable results.
“We have to think about what can we do between now and the end of the year, especially going into an election period,” he said.
The Gates Foundation official identified three major aspirations of the organisation, including ensuring that no child or mother dies from preventable causes, eliminating deadly infectious diseases and helping people escape poverty.
He said mothers and children should be able to walk into healthcare facilities and return alive after receiving the care they need.
On infectious diseases, Isichei called for sustained efforts to eliminate tuberculosis and malaria, saying Nigeria should aspire to a future where malaria would no longer constitute a major disease burden.
He also linked health and development outcomes to poverty, noting that rising costs could push more Nigerians into poverty and make it increasingly difficult for vulnerable populations to access essential services and opportunities.
Isichei said the Gates Foundation views people who are underserved not as a location but as individuals whose needs should determine how policies and systems are designed.
He identified them as pregnant women who recognise danger signs but cannot reach quality care on time, survivors of gender-based violence who report abuse but remain disconnected from protection, justice and support, women entrepreneurs unable to access finance and markets, and persons with disabilities confronted by services that were not designed with their needs in mind.
He questioned whether the systems being built in Nigeria were genuinely designed to serve the people who need them most.
Isichei identified three key shifts required to bridge the gap between policy and impact.
The first, he said, was a shift from policies and innovations to outcomes, stressing that policies and innovations alone do not constitute results.
“Between commitment and impact sits that thing called service delivery,” he said.
He called for the timely release of funds, effective procurement and distribution of medical commodities, adequate support for frontline health workers, functional maternity facilities, reliable data and stronger accountability among leaders.
Isichei urged stakeholders, particularly government officials and citizens, to ask critical questions about public resources, including whether allocated funds had been released, where they were being utilised and whether they were reaching the people for whom they were intended.
“Everyone here, again for the government, please ask more questions: Is the money being released? If it is, where is it being utilised? Is it going out to the last mile?” he asked.
The second shift, he said, should be from access to meaningful agency, particularly in the area of digital services.
He noted that having a mobile phone, National Identification Number or bank account did not automatically guarantee access to useful digital services.
According to him, stakeholders must determine whether such services are affordable, accessible and designed to meet the needs of young people, persons with disabilities and underserved communities.
The third shift, Isichei said, was from pilots to sustainable systems, stressing that Nigeria was not short of ideas or innovations but needed to develop the capacity to scale successful interventions.
“We focus a lot on pilots, but pilots are also scalable,” he said, urging stakeholders to build sustainable systems capable of strengthening trust in communities and improving efficiency in service delivery.
He challenged participants to identify specific barriers preventing people from accessing essential services and take responsibility for removing them.
Isichei asked stakeholders to consider four critical questions: “What specific barrier are we committed to remove or change? Who is responsible for that next action? By when will it be done? What evidence will show people’s lives or services have actually improved?”
He said accountability must ultimately be measured by whether policies and investments produce tangible improvements for Nigerians.
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“The last mile is not where ambition disappears. It should be where and how accountability becomes visible and where innovation proves its value,” Isichei said.
He added that everything being done by government, development partners and other stakeholders must ultimately be accountable to the people who need the services most.
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