The 2023 PSHAN Annual Conference themed on building sustainable health systems in Nigeria, could not have happened at a more opportuned time. This is a transition period, with the new administration setting its agenda for the next four years. As we prioritize the competing needs for limited resources, it is critical to recognize that the good health & well-being of Nigerians remain a key driver of economic growth.
The Annual PSHAN conference, held on the 20th & 22nd of June, provided an ideal platform for intellectual discourse on opportunities that can be explored on the journey to achieving Universal Health Coverage in Nigeria by 2030. During this conference, stakeholders and subject-matter experts agreed, that innovation and multi-sectoral collaboration, using the whole-of-society and government approach, is critical to achieving Universal Health Coverage. Salient points during this conference are summarized in this communique:

• Collaboration – Innovative partnerships between stakeholders have proven to be effective in addressing challenges facing the healthcare system. The importance of continued collaboration between all players within the health ecosystem remains critical to the attainment of Universal Health coverage. The role of the private sector cannot be over-emphasized as it is impossible for Government to do it alone.
• Private sector participation through PPPs is critical to the attainment of UHC. Private sector engagement must be done using evidence, proof of concepts and structured collaboration. This is important in ensuring efficiency, and more health for more investment and improvement in the health ecosystem. Population dynamics must be
  considered in building an investment case for private sector engagement so that the needs of the more vulnerable population are adequately addressed.
• Population Demographics – A demographic transition that has a larger workforce, who are healthy and able to drive the economy with less dependency ratio. The relationship between health and economic growth remains significant in determining how quickly we can achieve our SDG goals. Quality reproductive healthcare service is a key factor to attain desired demographic transition that is necessary to achieve UHC.
• Innovation – The role of innovation as a mechanism to attain UHC is critical, and it is important to ensure that UHC attainment is efficient as well as effective. We need to attract more funds to the budget whilst ensuring efficient spending and that the gaps are clearly articulated to non – government actors including the private sector. Innovative healthcare financing will improve access to healthcare through health
  insurance and other pre-payment mechanisms.
• Primary Healthcare as the backbone to achieve UHC – In the midst of resource constraints, primary healthcare remains the most cost-effective, equitable, and inclusive way to achieve UHC. A lot of the systemic issues at the secondary and tertiary levels can be dealt with at the PHC level so critical investment in the primary healthcare system can avert a lot of the expenditure at higher levels of care. It is crucial that we do not wait for pandemics to push us into action but work constantly to ensure that our health systems are strong and resilient.
• Policy and Resources – Nigeria is not bereft of policies but has continued to struggle with the domiciliation and implementation of several policies at national and subnational levels. There is a major challenge with the linkages at the various levels which has created differentiation in the quality of implementation and level of compliance. There is a need for an improved accountability framework to track and
  monitor policy implementation and resource mobilization and utilization. Continuous stakeholder mobilization and engagement will ensure the efficiency and accountability of policy frameworks and resource mobilization.
• Technology for Health remains vital in building a sustainable healthcare system and achieving UHC in Nigeria. However, infrastructure to ensure high-quality and easy-touse technology is still a challenge in healthcare delivery. There is also the need for Government and Private sectors to invest in enablers of digital technology like electricity and internet, especially in rural areas. This will improve access and effective monitoring of healthcare.
• Healthcare worker motivation, retention and capacity building remain critical to the attainment of sustainable health systems in Nigeria. Healthcare worker depletion is a major threat that the country is facing right now so it is important that the needed steps are taken to ensure an improvement in the numbers and quality of healthcare worker capacity.

In conclusion, building sustainable health systems in Nigeria requires all the elements described throughout the discussions. Addressing all the issues in an integrated manner will ensure that the health systems in Nigeria can truly address the health needs of Nigerians, guarantee improvement in the population’s health outcomes, and move the country towards attaining Universal Health Coverage by 2030.