Kwara is best place to give birth, raise a child in Nigeria—Amina El-Iman, commissioner for health

•Governor AbdulRahman AbdulRazaq is not the loud type but in health sector, he has converted 7 years to a lifetime

She is bold, beautiful, brilliant, effortlessly eloquent and above all, fiercely passionate about her work.
Dr. Aminat Ahmed El-Imam, Kwara State’s Commissioner for Health, doesn’t just occupy the office; she lives it. Her passion fuels a level of professionalism that is impossible to miss. Armed with data and a sharp command of her subject, she speaks with clarity and conviction about the transformation of healthcare under Governor AbdulRahman AbdulRazaq.

And she doesn’t mince words.”He has converted seven years into a lifetime in the health sector in Kwara,” she says with unmistakable pride. “He has transformed Kwara in many ways.”
Then she leans into the evidence.
“Before he came on board, UN agencies like UNICEF had exited Kwara over issues such as counterpart funding. Today, those same agencies are back. Kwara is now counted among the best-performing states in healthcare.”

It’s not just a statement, it’s a story of reversal, of rebuilding trust, and of a system brought back to life.
Speaking with candour and confidence, Dr. Aminat sat down with Saturday Editor Onochie Anibeze and Kwara State Correspondent, Demola Akinyemi, offering deep insights into the governor’s strides in the health sector. Piece by piece, she laid out a narrative of progress, one driven by leadership, backed by data, and delivered with conviction. Excerpts.

What was the state of healthcare in Kwara before this administration came into office, and what is it now?
First, let me say that health is constantly evolving. It’s not something you can say has been fully achieved, this is because universal health coverage is still a global challenge.

However, while acknowledging that we are on a journey of universal health coverage and global systems, it’s important to recognize that we have made significant progress more than we are often given credit for.

My boss is not the loud type,he is a gentleman to the core. He believes results should speak for themselves and in the health sector, results take time because they are often intangible.
Let me give you some measurable indicators.
Before this administration came on board, one of the largest; United Nations agencies, UNICEF, had exited Kwara State. That meant losing support in child health, nutrition, and immunization. When His Excellency assumed office in 2019, he worked to bring them back and cleared outstanding counterpart funding obligations. He also sustained funding for key programs like the World Bank-supported ANRiN (Accelerating Nutrition Results in Nigeria).

Beyond that, we attracted new partners like UNFPA, which had never operated in Kwara state before. Today, in partnership with UNICEF and UNFPA, we are implementing programs such as EU-SARAH (European Union Support to Adolescent Reproductive and Sexual Health). They relieved us in terms of maternal mortality and access to contraceptives.

So,these are a few examples where we moved from a situation where partners were leaving to one where partners are returning and new ones are coming in.

So Kwara has moved considerably and empirically progressed since his Excellency came into government. Today, we have 14 deaths per a thousand births in Nigeria. That’s the lowest in Nigeria. Children who live to see their 5th birthday. So, Kwara is the best state in which a child can be born and raised in Nigeria today. It wasn’t an accident. It’s a deliberate effort. We partnered with UNICEF, we’re solving immunization, nutrition issues. Immunization issue is a child disease killer, so if we’re serious about children not dying we just have to be serious about immunization and since health is the business of everyone, not just the government,we must be serious about collaborations. We are victims of our own hard work as it is.

14 deaths per a 1000 births? That’s impressive. Can you be specific about source of data?
Yes. Today, Kwara has an under-five mortality rate of about 14 deaths per 1,000 live births, which is the lowest in Nigeria. The national average is around 43-45 per 1,000. This is based on the NDHS 2023/2024 data.
This didn’t happen by accident-it was deliberate. Through partnerships, we improved immunization, nutrition, WASH (Water, Sanitation, and Hygiene), and service delivery.
We also invested heavily in infrastructure. When this administration came in, many primary health centres were in terrible condition, some even had collapsing roofs. Today, we have renovated, equipped, and staffed 193 primary healthcare centres under the Basic Healthcare Provision Fund. They were not only equipped but also solarized and we are working on additional facilities.
We’ve also upgraded secondary facilities and converted the General Hospital Ilorin into the Kwara State University Teaching Hospital, now accredited by the Medical and Dental Council of Nigeria.

What about healthcare workers?
When we came in, health workers were poorly paid, and many were leaving the state.
This administration has increased salaries twice in two years and aligned with federal salary structures to retain talent in IGR and allocation because we have a governor who stretched every dollar for the people.
His Excellency also created Ready To Use Utilized Foods to tackle the problem of malnutrition.
We have also recruited extensively and invested in continuous training and payment of salaries to ensure we don’t lose our doctors to the federal healthcare systems. Today, our health workers are more confident and capable and we can now train student doctors and consultants. I recall a case where a doctor in KWASUTH said that due to recent training, they were able to successfully handle a complex maternal emergency that previously might have resulted in death. That happened because we have had experts come to train our health workers. His Excellency has changed the narrative and now EU is proud they chose Kwara.
Let me show you the numbers. The theme for this year’s world health day is Together for health stand with science. Let me show you the NDHS data. Death per one thousand: 14 in #1000.
I could go on and on.

How effective is primary healthcare in the state, are they meeting the expected demands?
Primary healthcare is the foundation of the system. Kwara is one of the states that has best implemented the Minimum Service Package for health.
We ranked:
o 1st in North Central Nigeria (2023)
o 1st again (2024)
o 2nd (2025)
In primary health care leadership.
Nationally, it shows that we are among the top performers in facility readiness-2nd out of 37 states. I think that unequivocally shows improvement.
However, our challenge is utilization. Despite improved facilities, some people still don’t use them due to old perceptions. It’s not easy to change that mindset and changing that mindset is our next focus. But overall service has improved.

How is the state handling disease control and public health emergencies?
That’s one of our strengths. Kwara is lucky with His Excellency Governor AbdulRahman AbdulRazaq.
During the cholera outbreak last year, neighboring states were affected, but Kwara remained largely unaffected due to proactive measures,public awareness, environmental interventions, assessments and preparedness for commodities.
During COVID-19, Kwara had one of the strongest responses in Nigeria. It’s a trend in Kwara.
We’ve also effectively managed outbreaks like measles and Lassa fever by acting quickly,deploying vaccines,doctors,nurses isolating cases, and preventing further spread. After the first and second deaths, we controlled it.
We are really good at responding. Same with Lassa fever. After the first death ,we took necessary steps and there wasn’t a second one. This is because we did all the necessary things because we have the support of his Excellency.
We now operate an Integrated Emergency Operations Centre (IEOC) to handle both health and humanitarian crises.

How about partnerships with federal and international agencies,how did you leverage them?
We have strong relationships with federal bodies like the Federal Ministry of Health, NCDC, and NPHCDA. They recognize our modest efforts and are willing to collaborate with them anytime.
Partners work beautifully with us courtesy of his Excellency. International partners also find Kwara attractive due to transparency, accountability, and efficiency. We have not lost any partner in recent years,in fact, more are coming in.

What are the major challenges? Is security problem not affecting health sector?
Security is a key challenge. When security is affected, healthcare delivery is impacted.
We’ve had some incidents affecting health workers, but we’ve taken steps as a sector under the federal ministry of health to mitigate these effects,deploying staff, working with partners, and ensuring continuity of care.
We have anticipated the possible challenges and we’re prepared for them and we’re hoping the security challenges do not escalate .While challenges exist, we are actively minimizing their impact.

Finally, what would you say is the governor’s legacy in the health sector?
It’s difficult to pick just one, because the achievements are extensive. We are now a state to reckon with. We went from nothing to having a Cancer Centre. And the 40% salary increase. We have our challenges because we don’t have enough staff. We’re not where we want to be but it’s not as a result of the failure of his administration but the present realities.
He has converted 7 years to a lifetime in Kwara.
But if I must highlight:

1. Establishment of strong tertiary healthcare – including the teaching hospital.
2. Massive strengthening of primary healthcare across the state.
3. Emergency preparedness and response systems.
4. Expansion of health insurance – from zero coverage in 2019 to over 100,000 people today, with plans to reach 150,000. People are getting care for free.
   He has transformed Kwara into a state that is now nationally recognized in healthcare.
   We are not perfect, but we are far better than we were seven years ago-and that is backed by data, not sentiment.

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