Ugwu Urges Individuals, Groups To Adopt Public Health Facilities

ENUGU — Prof. George Ugwu, Enugu State Commissioner for Health, has advocated a Community Health Stewardship model under which individuals, professional groups, organisations and community leaders would adopt public health facilities to strengthen supervision, oversight and service delivery.

Ugwu, a Professor of Obstetrics and Gynaecology at the University of Nigeria, Nsukka (UNN), made the proposal while delivering the 251st Inaugural Lecture of the university at its Enugu Campus.

The lecture, titled “The Mother, the Child and the State: My Triumphant Journey from Evidence to Action,” examined the relationship between clinical evidence, public health policy and the practical delivery of healthcare.

Ugwu said government efforts would be strengthened if influential individuals, professional associations, private organisations, faith-based institutions and community leaders took sustained responsibility for supporting public health facilities in their communities.

He said such community contributions should supplement, rather than replace, government responsibility for healthcare delivery.

“I propose a model of Community Health Stewardship, in which respected individuals, professional associations, private organisations, faith-based institutions and community leaders voluntarily adopt public health facilities and provide sustained support through long-term stewardship agreements.

“States should use equity mechanisms to prevent wealthy communities from accumulating well-supported facilities while poorer communities fall further behind,” he said.

Ugwu, a former Executive Secretary of the Enugu State Primary Health Care Development Agency (EN-PHCDA), said the model could improve supervision and accountability while ensuring that facilities remained functional and responsive to local needs.

He said women, young people, persons with disabilities, poor households and residents of marginalised settlements needed meaningful representation and strong advocates to ensure that quality healthcare reached them.

According to him, stronger community involvement could also encourage greater uptake of health insurance and improve access to healthcare.

Ugwu said primary healthcare centres remained central to improving health outcomes because they provided the first point of contact for many pregnant women, children and other vulnerable groups.

He said the centres needed to be resilient, adequately equipped, accessible and capable of delivering measurable and quality healthcare services.

“This will ensure that healthcare issues are dealt with early with less resources at the grassroots and reduce health burden at secondary and tertiary levels as well as on the government,” he said.

The commissioner also called for increased funding for primary healthcare, particularly through the Basic Health Care Provision Fund (BHCPF).

He advocated an increase in the federal allocation to the fund from the current one per cent to five per cent, saying the move had become necessary as some donor countries and international organisations reduced or withdrew their funding support.

“The existing funding from the one per cent from the Federal Government’s Consolidated Revenue Fund and donor support had gone a long way in assisting states put their primary healthcare centres in optimal condition.

“However, there is concern that as donor countries, agencies and organisations are pulling out their funding support, there is a need to shore up existing funding.

“The anticipated increased funding would take adequate care of the perceived and anticipated gaps to be created by pulling out of donors,” he said.

Ugwu said the proposal was particularly relevant to Enugu, where the state government was working toward functional primary healthcare centres across its 260 political wards.

He said wealthy individuals and influential members of communities could complement government efforts by adopting facilities within their wards or communities and supporting monitoring, supervision and, where necessary, intervention.

He also advocated wider health insurance coverage, saying relatively small premium payments could provide healthcare protection for individuals and families and could be extended to people in rural communities and indigent households.

Ugwu said health advocacy and education were equally important in improving health outcomes, urging greater public understanding of disease prevention and healthy lifestyles.

“Prevention is better than cure,” he said.

Protect health workers, make data actionable

The professor also called for stronger protection of the health workforce, saying government must address the conditions driving attrition and physician emigration.

“The government must address the conditions that drive attrition and physician emigration, including poor working conditions, inadequate equipment, insecurity, limited professional opportunities, and weak institutional credibility.

“Workforce policy should combine fair remuneration with safe workplaces, essential tools, continuing development and credible career pathways,” he said.

He also urged authorities to move beyond collecting health statistics to using data to guide concrete decisions and interventions.

“Digital systems should be built around decisions rather than dashboards.

“Every priority indicator should have a named owner, an action threshold, a feedback cycle and an auditable response,” he said.

Maternal, newborn deaths

Ugwu, who has more than two decades of experience as a clinician and researcher, said the major clinical causes of maternal and newborn deaths were already well established.

“Haemorrhage and hypertensive disorders account for large shares of direct maternal deaths, while infection, complications of abortion, thromboembolism and indirect medical conditions add to the burden.

“Prematurity, intrapartum-related events, congenital conditions and infection account for much of newborn mortality,” he said.

He said high-quality antenatal care, skilled attendance at birth, timely emergency obstetric and newborn care, blood transfusion, safe surgery, newborn resuscitation, family planning and appropriate postnatal care could substantially reduce maternal deaths and maternal near-miss cases.

The don, however, said the continued burden of maternal and newborn mortality and maternal near-miss could not be explained simply by a lack of medical knowledge.

According to him, an intervention that works clinically could have little effect if a woman could not access it, a facility could not provide it, health workers lacked the necessary equipment, families could not afford treatment, or institutions failed to learn from previous shortcomings.

“A clinically effective intervention has no effect when the woman cannot access it, the facility does not provide it, the health worker lacks the required tools, the family cannot afford it, or the institution does not learn from previous failures,” he said.

Ugwu said translating evidence into action therefore required stronger health systems, reliable financing, accountable institutions, adequately equipped facilities and policies that reflected the realities of communities.

From research to policy

The inaugural lecturer highlighted his career-long engagement with clinical medicine, research and public health administration, explaining how evidence generated from hospital wards and rural health centres could inform policies and community interventions.

He has more than 70 academic publications and scientific outputs to his credit and has worked as a clinician, researcher and public health administrator.

Ugwu holds an MBBS and a Master of Public Health (MPH), as well as fellowships including the West African College of Surgeons (FWACS), Faculty of the National Postgraduate Medical College of Nigeria (FMCOG) and the International College of Surgeons (FICS).

The 251st inaugural lecture was presented on Sept. 3, 2026, at the University of Nigeria Enugu Campus.