A child’s death and a high-profile emergency should never become spectacles, yet they often do. In recent weeks, the death of Nkanu Nnamdi Adichie-Esege and public questions following Anthony Joshua’s road accident have drawn national attention not because they are ordinary, but because they sit at the uneasy intersection of trust, expectation, and healthcare delivery in Nigeria. These moments test more than individual hospitals or responders; they test whether the country’s health system is built to respond transparently, learn responsibly, and protect patients and professionals alike.
The circumstances surrounding these two cases are distinct. The death of Nkanu followed a medical procedure at Euracare Multispecialist Hospital in Lagos, after which his family raised concerns relating to clinical monitoring and response. The hospital has denied any wrongdoing, and Lagos State regulatory authorities have since initiated a formal inquiry. In the second case, Anthony Joshua’s involvement in a fatal road traffic accident did not raise allegations of malpractice but rather questions around emergency evacuation, coordination, and response timelines.
What links these incidents is not culpability, nor similarity of facts, but the broader public response they have triggered. In a healthcare system where expectations are rising and scrutiny is intense, adverse outcomes, particularly in high-profile contexts, inevitably provoke public anxiety. That reaction is understandable. Yet healthcare systems are complex, high-risk environments, and the path to safer care does not lie in assumption or speculation, but in disciplined process, evidence-based review, and institutional accountability.
Moments like these demand restraint as much as they demand scrutiny. Public outrage may amplify attention, but it does not replace investigation. Nor does it strengthen systems. If Nigeria is to improve the quality and reliability of care its citizens receive, especially in facilities offering specialised or advanced services, the conversation must move beyond incident-driven judgement toward accountability grounded in transparency, professional standards, and continuous learning.
Excellence, expectations, and system pressure
Nigeria’s healthcare sector is neither uniform nor static. It comprises a wide range of public and private providers, operating under very different conditions and constraints. Across this spectrum are dedicated professionals delivering care in challenging environments, often with limited resources. At the same time, no healthcare system, anywhere in the world, is immune to failure. When systems falter, the consequences can be profound.
Incidents occurring in premium or highly visible facilities tend to attract heightened attention, in part because such institutions are associated with higher expectations. Branding, pricing, and international benchmarking shape public perception. When outcomes do not align with those expectations, confidence can be shaken, not only in the facility involved but in the wider health system. How institutions and regulators respond in these moments matters enormously.
In the case of Euracare, the allegations raised are serious and warrant careful, impartial examination. That process is already underway. Allowing regulatory institutions to do their work fairly, transparently, and without pre-judgement is essential to maintaining professional integrity and public trust. Similarly, the questions prompted by the Anthony Joshua incident highlight the importance of strong emergency response systems that function reliably under pressure. These are system challenges, not individual ones.
Trust is built by process, not performance claims
At the heart of these discussions lies the issue of trust. Trust in healthcare is not built solely on reputation. It is built on governance, on clear standards, on robust oversight, and on credible mechanisms for accountability when outcomes fall short.
When adverse events occur, responsible institutions must communicate clearly, engage openly with affected families, and cooperate fully with regulatory review. These actions are not admissions of fault; they are obligations of professional healthcare delivery. Equally, regulators must act with independence, technical competence, and timeliness. Where investigations are perceived as opaque, delayed, or inconclusive, public confidence inevitably erodes. Transparency, therefore, should be understood not as a threat to institutions but as a cornerstone of patient safety and system improvement.
Litigation, accountability, and learning
The legal notice issued by Nkanu’s family has also reignited debate about the role of litigation in Nigerian healthcare. Legal action remains a legitimate avenue for accountability and redress. However, when litigation becomes the primary mechanism for resolving medical disputes, it can produce unintended consequences, including defensive medical practice, rising costs, and reduced willingness to manage high-risk cases.
Many health systems address this tension by complementing legal processes with structured medical injury resolution mechanisms. Expert review panels or specialised health adjudication frameworks can provide faster resolution, fair compensation where harm is established, and—crucially—translate findings into system-wide safety improvements. Such approaches balance patient protection with professional fairness and institutional learning.
What system reform should look like
Rebuilding trust in Nigerian healthcare requires moving from reflection to deliberate reform. First, clinical governance must be mandatory, particularly in private facilities delivering complex or high-risk services such as paediatrics, obstetrics, anaesthesia, and emergency care. Formal governance structures, regular clinical audits, morbidity and mortality reviews, escalation protocols, and independent oversight should be baseline requirements, not optional best practices.
Second, serious medical incidents should trigger structured, time-bound reviews focused on learning and prevention. Findings, appropriately anonymised, should inform national standards and regulatory action. Nigeria does not need to invent these mechanisms anew. A bill currently before the National Assembly proposing the establishment of a National Health Facility Regulatory Agency presents an opportunity to strengthen oversight, standardise accreditation, coordinate incident reporting, and ensure consistency across both public and private providers.
A standing, technically competent regulator is far better suited to sustaining quality and accountability than ad hoc task forces convened in moments of crisis. While task forces may provide short-term reassurance, lasting reform depends on institutions with continuity, authority, and enforcement capacity.
Third, minimum emergency response standards must be clearly defined and enforced, particularly in urban centres. These should address ambulance coordination, response times, triage capacity, and handover protocols between emergency services and healthcare facilities.
Fourth, transparency should be institutionalised through the public reporting of core quality and safety indicators. While such data may initially be imperfect, responsible disclosure is a powerful driver of improvement and accountability.
Finally, Nigeria should develop a structured medical injury resolution pathway that balances patient protection, professional fairness, and system learning.
A system worthy of public trust
Nigeria’s healthcare system faces undeniable challenges, but it also possesses significant professional expertise and institutional potential. By embedding transparency, accountability, and continuous learning into healthcare delivery and regulation, the country can strengthen public confidence and improve patient outcomes.
The recent tragedies involving Nkanu Nnamdi Adichie-Esege and Anthony Joshua should not be reduced to moments of outrage or blame. They should serve as catalysts for strengthening the systems that protect patients, professionals, and institutions alike. With strong processes, credible regulation, and collective responsibility, Nigeria can build a healthcare system that is not only aspirational in name but also consistently safe, trustworthy, and worthy of the people it serves.
This article is a partnership between the Healthcare Federation of Nigeria (HFN) and BusinessDay to highlight policies and programmes to promote the rebuilding of Nigeria’s health sector. As a private sector-led coalition, HFN advocates for policies and partnerships to strengthen healthcare delivery. This partnership aims to spark meaningful discussions and drive transformative change in Nigeria’s health sector.
This article was developed with input from members of the HFN Editorial Committee, including Njide Ndili (President of HFN and Country Director of PharmAccess) and Dr Folajimi Adebowale (CEO, Recon Health Media)
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