Breaking the Cycle of Tragedy: Governor Eno’s Emergency Health Reforms in Akwa Ibom

Breaking the Cycle of Tragedy: Governor Eno’s Emergency Health Reforms in Akwa Ibom

By Ekaette Okon-Joseph

Nigeria remains one of the most dangerous places in the world to give birth. According to the World Health Organization, the country records an estimated 1,047 maternal deaths per 100,000 live births, the second-highest global burden. UNICEF reports that 262,000 newborns die at birth every year in Nigeria, also the second-highest worldwide.

Infant mortality stands at 69 per 1,000 live births, and under-five mortality at 128 per 1,000. A Nigerian woman’s lifetime risk of dying from pregnancy-related causes is 1 in 19, compared with 1 in 4,900 in developed nations. These grim statistics stand in stark contrast to the Sustainable Development Goal 3 target, which seeks to reduce global maternal mortality to fewer than 70 deaths per 100,000 live births by 2030.

The Abuja Declaration of 2001 recommended that African governments allocate 15 percent of their annual budgets to health. In 2025, Nigeria earmarked only 5.18 percent (₦2.48 trillion) of its ₦54.99 trillion federal budget for healthcare. By contrast, Akwa Ibom state committed 7.3 percent, ₦70 billion of its ₦955 billion budget to health, signalling stronger intent.

That commitment has now been deepened. Following Governor Umo Eno’s declaration of a state of emergency in the sector, the state has introduced a ₦695 billion supplementary budget proposal to be sent to the House of Assembly, raising the 2025 fiscal plan from ₦980 billion to ₦1.7 trillion.

The expanded budget makes provision for the hiring of 2,000 additional health workers and new infrastructure, reflecting a deliberate prioritisation of human capital development.

Akwa Ibom’s reality is sobering. The BudgIT 2024 State of States report ranked the state among the lowest in primary healthcare delivery, citing underfunding, infrastructure deficits and workforce gaps. Maternal mortality prevalence has been estimated at 774 deaths per 100,000 live births. Only 38.6 percent of births occur in health facilities, and just over half (51.5 percent) are attended by skilled personnel.

The reliance on traditional birth attendants (TBAs), who often lack formal training and emergency capacity, continues to undermine safe delivery despite their cultural acceptance. These figures explain why Governor Eno’s September declaration of a state of emergency in health is both urgent and necessary.

“This state of emergency is not about politics, but about people’s lives,” Governor Eno, through the Commissioner of Information, Aniekan Umanah, said at the Executive Council meeting. “We are upgrading facilities, reopening recruitment portals, and engaging 2,000 health workers, even waiving voter identification requirements for applicants. No mother should die giving life.”

Leadership and Accountability

The emergency regime is backed by leadership across agencies. State Commissioner for Health, Dr Ekem John, highlighted the danger of preventable deaths: “Pregnancy and childbirth are not death sentences. Too many women die because they patronise unskilled attendants. That is why we are aligning the ARISE Agenda with the Renewed Hope vision to eliminate maternal and neonatal deaths in Akwa Ibom.”

Dr John also disclosed that the rising incidence of renal failure has necessitated new investments in dialysis facilities, with haemodialysis units planned across all 10 federal constituencies. At the same time, his ministry is re-registering all private hospitals, laboratories and pharmacies to curb medical quackery and enforce compliance with global standards.

Strengthening Primary Healthcare
The Akwa Ibom State Primary Healthcare Development Agency, led by Dr Martins Akpan, is rehabilitating and remodelling primary health centres across the 31 local government areas.

“The Model Primary Health Centre, Ikot Nkwo, already completed, meets WHO and NPHCDA standards,” Dr Akpan said. “Our plan is to deliver one functional PHC in every ward, bringing quality healthcare closer to the people.”

This aligns with WHO’s Primary Health Care Performance Initiative, which promotes functional PHCs as the backbone of maternal and child survival. UNICEF, meanwhile, has partnered with states like Akwa Ibom to expand immunisation, deploy midwives and train skilled birth attendants to reduce reliance on TBAs.

Expanding Insurance and Reducing Out-of-Pocket Spending

The Akwa Ibom State Health Insurance Agency (AKSHIA), launched in September 2023, has grown rapidly. By mid-2025, it had enrolled 138,000 beneficiaries and won the Fastest Growing Agency in Health Care Coverage award from the Institute of Health Insurance and Managed Care.

“This achievement would not have been possible without the governor’s vision,” said Executive Secretary Dr Arthur Igbemi. “By keeping rural communities healthy, we are enabling them to stay close to home, farm, and generate income.”

Board Chairman Dr Edikan Ekwere added: “The advent of health insurance in Akwa Ibom is a great relief. Through this programme, we are reducing out-of-pocket expenses and promoting productivity. This is one intervention that transcends all the fabric of Akwa Ibom state.”

Emergency Response and Critical Care

The Akwa Ibom State Emergency Medical Service and Ambulance System (AKISEMSAS), coordinated by Dr Jacob Etiemana, is enhancing rapid response through capacity building, strengthened referral systems and community sensitization. “With stronger integration at PHC level, we can save more lives when seconds matter,” he said.

In June 2025, Governor Eno, alongside Coordinating Minister of Health and Social Welfare Prof Muhammad Ali Pate, commissioned the Akwa Ibom State Medical Oxygen Production Plant at Ituk Mbang, and the AKISEMSAS base in Uyo.
Prof Pate commended the initiative, saying: “Healthcare is critical because, when you are not healthy, no sector can thrive, and the governor has taken health as a core vision of the ARISE Agenda.”

Infrastructure for Tomorrow

The government’s investments are reshaping the state’s health landscape. The Ibom Specialist Hospital is being repositioned for advanced tertiary care, while plans are underway for a 350-bed Ibom International Hospital, a flagship project within the Ibom Medical City corridor, designed to attract medical tourism.

At the same time, the federal government recently commissioned a 100-bed Renewed Hope Mother and Child Specialist Hospital in Oko-Ita, Ibiono Ibom Local Government Area, marking a significant partnership in the health sector to provide targeted maternal and child health services.

New haemodialysis units are being rolled out across the federal constituencies, while rehabilitation of primary health centres is ongoing in all 31 local government areas to boost healthcare across the state.

To complement these, two oxygen plants have been launched in Ukpum Abak and Eket, alongside the state’s first medical oxygen production plant in Ituk Mbang.

The Stakes

The WHO defines maternal death as a woman’s death during pregnancy or within 42 days of its termination from pregnancy-related causes. Each figure represents a mother, a daughter, a sister or a colleague. As health advocate Vivianne Ihekweazu of Nigeria Health Watch observed: “The figures are not just numbers, they are lives cut short.”

Governor Eno’s reforms are directly tackling the “three delays” that drive maternal and neonatal mortality: the delay in seeking care, the delay in reaching care and the delay in receiving care. By strengthening PHCs, expanding insurance, regulating TBAs, training health workers, increasing human resources in the health sector, and mobilising ambulances, Akwa Ibom is closing deadly gaps.

A Collective Responsibility

These efforts cannot succeed through government alone. Traditional leaders, faith institutions, unions, civil society and development partners such as WHO, UNICEF and the Global Financing Facility must play their part. The vision is clear: an Akwa Ibom where no woman dies giving life, where children see their fifth birthday, and where health is not a privilege but a right.

Governor Eno has raised the stakes with his declaration. With maternal and neonatal mortality still unacceptably high, and Nigeria off-track to meet the SDG target of fewer than 70 maternal deaths per 100,000 live births by 2030, Akwa Ibom’s reforms show a path forward. The time to act is now. The lives of mothers and children depend on it.

Ekaette Okon-Joseph, a former bureau chief of BusinessWorld newspaper and publisher of Niger Delta Post, is the Special Assistant to the Akwa Ibom State Governor on Media. She writes from Uyo, the state capital, and can be reached on +234 816 330 2039
#ekaetteokonjoseph #ariseagenda