By Niniola Williams
Sir: Following the tragic deaths of a 21-month old boy in a private Lagos hospital and a mother of five in Kano amid allegations of medical negligence, Nigeria is once again debating the safety of patients across the country. The grief, anger, flood of “this happened to my family too” stories, and collective outcry demonstrate many Nigerians believe preventable harm is common in our hospitals.
A critical review found 47 per cent of patients rated Nigeria’s health system “poor/very poor”, and Demographic and Health Survey data shows care-seeking for under-5 children with fever and acute respiratory infection falling from 75 per cent in 2018 to 60 per cent in 2023/2024.
These figures suggest a worrying erosion of confidence in care. Each new allegation triggers a familiar cycle. Some institutions default to denial: protect the facility, minimise the incident, move on. Others swing to scapegoating: punish one person or one hospital and assume the problem is solved. Neither response builds the learning and accountability systems that prevent harm from repeating. The better path is clinical governance with clear standards, routine measurement, independent oversight, and rapid learning when things go wrong.
Fortunately, efforts to develop such an approach are already well underway. In 2024, the Federal Ministry of Health and Social Welfare released the first-ever National Patient Safety and Care Quality Policy and Implementation Strategy, calling for stronger safety standards across health institutions.
In January 2026, the Ministry established the National Task Force on Clinical Governance and Patient Safety to ensure quality and patient safety become routine elements of health service delivery. My organisation, Dr Ameyo Stella Adadevoh (DRASA) Health Trust – founded in memory of my aunt whose heroic actions helped stop Ebola in Nigeria – helped develop the National Patient Safety Policy. The policy covers common sources of avoidable harm, including medical, diagnostic, and medical on-related errors. Having the policy is progress, but implementation is the test. If safety is not measured, funded, and regulated, preventable harm will persist and trust will keep falling. As such, I propose three practical outputs for the Task Force in its first 12 months.
First, publish a National Clinical Governance and Patient Safety Framework with minimum standards for each level of care and a clear pathway for states and facilities to implement. Whether delivered through agencies like Lagos State’s Health Facility Monitoring and Accreditation Agency (HEFAMAA), or through health ministries and hospital boards, the outcome must be that basic safety expectations are clear, monitored, and tied to their licensing.
Second, establish a national patient safety incident reporting-and-learning system that is simple to use, protects reporters, provides feedback, and turns reports into actionable items rather than witch hunts.
Third, build a ‘just culture’ across the system by strengthening clinical audit and peer review, standardising root-cause analysis for serious incidents, and requiring transparent, blame-free communication with patients and families when harm occurs. A just culture, as used in the aviation industry, distinguishes between human error, risky behaviour, and deliberate violations, so clinicians are not scapegoated for systemic failures while reckless conduct is not excused.
Certainly, not every death, complication, or poor outcome is due to negligence as adverse outcomes will occur even with excellent care. When cases are pending, we must not treat allegations as final verdicts. Health workers deserve due process and protection from scapegoating while patients deserve clear standards, transparent review, and health systems that learn from incidents. With the policy and the Task Force, Nigeria has signalled that higher-quality care is a national priority. Now we must move from frameworks to accountable action that is implemented at scale, measured publicly, and financed sustainably.
Safety must be built into the daily practice of healthcare delivery so thoroughly that it does not depend on who you are, who you know, or how loudly your story travels across headlines and social media. Access to safe, quality healthcare is not a privilege but a fundamental human right and this is Nigeria’s opportunity to get it right.
Niniola Williams is the Managing Director of DRASA (Dr. Ameyo Stella Adadevoh) Health Trust, a public health nonprofit combining grassroots participation with government partnerships to drive comprehensive, lasting change in the health sector.
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