Dear Colleagues, Esteemed Leaders of NANNM, NMA, CHPRBN, SCHTSN, and All Health Stakeholders in Kwara State and Beyond,
I am a concerned citizens and health practitioner in Kwara state, a proud son of the soil.
I am writing to open our eyes to the truth: community health practitioners are not just essential team members; they are fully qualified and empowered to lead any health administrative office, from local department heads to higher roles.
To those misled by rumors, let us start with a global example: the Director-General of the World Health Organization (WHO), Dr. Tedros Adhanom Ghebreyesus, holds a PhD in community health, not a medical doctor, nursing, or pharmacy degree. If a community health professional can lead the world’s foremost health body, why should we in Nigeria doubt their ability to head our health departments?
This should awaken those spreading misinformation: community health professionals can lead anywhere, from Oke Ero to international platforms.
I am profoundly dismayed by the baseless propaganda tarnishing the reputation of diligent community health practitioners like Mrs. Ayinde Risikat, a Community Health Extension Worker (CHEW) with a BSc in Public Health, and Mrs. Helen Bosede Olawuyi, the hardworking Head of Department of Health in their region.
Both are exemplary health workers and administrators, trusted by their communities for their dedication and effective health guidelines. To see individuals who have served selflessly for years—building strong relationships with patients who value their care above others—vilified as distasteful is unacceptable. This divisive rhetoric is turning our beloved Kwara—and indeed Nigeria—upside down, fostering rivalries among professionals who should be allies. How can we serve our people when we waste energy on superiority complexes? It is high time we reject these falsehoods and embrace the multidisciplinary reality that strengthens us all.
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To be clear, nurses and doctors are invaluable, but they are not the only professions destined to lead Nigeria’s health departments. Community health practitioners (CHPs), including Junior Community Health Extension Workers (JCHEWs), Community Health Extension Workers (CHEWs) like Mrs. Ayinde Risikat, Community Health Officers (CHOs), and those with National Diploma (ND), Higher National Diploma (HND), BSc, or even Master’s degrees in Community Health, are trained leaders in primary health care (PHC). Regulated by the Community Health Practitioners Registration Board of Nigeria (CHPRBN), with ND and HND qualifications regulated by the Society of Community Health and Technology Stakeholders of Nigeria (SCHTSN), they excel in administrative roles, managing facilities, coordinating teams, and bridging gaps in underserved areas like our 193 wards in Kwara.
Their functions include: delivering health education to prevent diseases; providing basic curative services, such as treating minor ailments and administering vaccinations; supporting maternal and child health services like family planning and growth monitoring; collecting community health data for surveillance; assisting in environmental health inspections; and mobilizing communities for health campaigns, such as malaria or polio programs. JCHEWs work under supervision but are vital in grassroots delivery.
CHOs frequently head PHC centers or local government departments, as exemplified by leaders like Mrs. Helen Bosede Olawuyi, whose administrative excellence ensures effective service delivery.
Degree Holders in Community Health (BSc, Master’s, and Beyond): Professionals like Mrs. Ayinde Risikat, with a BSc in Public Health, or others with Master’s degrees, are equipped for strategic roles. Their functions include: formulating and implementing health policies; leading multidisciplinary teams in outbreak investigations; conducting epidemiological studies and health impact assessments; managing health financing and partnerships; evaluating program outcomes to reduce mortality or improve coverage; supervising multiple facilities; and contributing to national health development through research on issues like malnutrition or infectious diseases.
Holding certificate in in Community Health, CHEWs like Mrs. Ayinde Risikat, who also holds a BSc in Public Health, is expected and super qualified to take on expanded roles, including: conducting advanced health education and community mobilization; providing curative services like managing common ailments, administering therapeutic injections, and supporting deliveries; supervising and volunteers; monitoring environmental health, including water and sanitation; collecting and analyzing health data for local planning; and leading PHC centers or wards, often in rural settings like Oke Ero. Mrs. Ayinde’s dedication and strong patient relationships make her a trusted leader in her community.
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These professionals are primed for high-level administrative positions, including state or federal roles.
These roles, enshrined in CHPRBN regulations, SCHTSN regulations standards, and NPHCDA guidelines, position CHPs as comprising 60–70% of the PHC workforce, making them indispensable leaders. Consider the situation in Oke Ero LGA, where Nurse Rufus Favour Mojisola works under a CHEW, Mrs. Ayinde Risikat, who serves as Head of Department at the Ekan Primary Health Care Center.
This CHEW, a level 15 or 16 officer in the civil service with a BSc in Public Health, is a diligent administrator trusted by her community. Why the controversy? Allegations that CHPs are “jealous and envious” of nurses like Rufus, who may enter as a level 7 or 8 nursing officer, are laughable and baseless. What is there to envy when a CHEW or CHO holds a senior administrative role earned through qualifications and experience? This is not about jealousy but about collaboration, and it is disheartening to hear claims of Rufus’s rudeness to superiors being twisted into professional rivalry.
Mrs. Helen Bosede Olawuyi, as Head of Department, exemplifies the leadership CHPs bring, yet these unfounded narratives seek to tarnish such dedicated professionals. Those instigating this nuisance in Oke Ero must back off and allow our health system to thrive.
To dispel these myths, let us turn to real examples that illuminate the path forward. In Nigeria, non-doctors and non-nurses have led with distinction. Eyitayo Lambo, an economist with a PhD in health systems, served as Federal Minister of Health from 2003 to 2007. Under his stewardship, the National Health Insurance Scheme was fortified, polio vaccination campaigns were scaled up—contributing to Nigeria’s near-eradication of the disease—and health financing was optimized to save countless lives. At the state level, governors have appointed based on merit: in Abia State under Governor Otti, over 771 health workers, including community health practitioners, were recruited with leadership roles assigned to competent administrators, not solely clinicians. Similarly, in Anambra under Governor Soludo, CHEWs routinely head PHC centers, overseeing thousands of staff and delivering results through inclusive management.
Globally, this truth shines even brighter. Tedros Adhanom Ghebreyesus, WHO Director-General since 2017, holds degrees in biology and community health—not medicine, nursing, or pharmacy. He revolutionized Ethiopia’s health system by deploying 40,000 health extension workers, reducing child mortality by two-thirds and AIDS-related deaths by 90%, and spearheaded the COVAX initiative, which distributed billions of COVID-19 vaccines worldwide. Catherine M. Russell, Executive Director of UNICEF since 2022, is a lawyer by training; her diplomatic expertise has safeguarded millions of children through nutrition and immunization programs in crises from Yemen to Ukraine. And Winnie Byanyima, an aeronautical engineer leading UNAIDS since 2019, has driven a 54% reduction in global HIV infections, securing treatment for 30 million people. These leaders remind us: administrative prowess, not a white coat, builds resilient health systems.
It is crucial to distinguish between roles to avoid further confusion. Administrative positions, such as Heads of Department like Mrs. Helen Bosede Olawuyi, focus on oversight—budgeting, policy implementation, staff supervision, and program coordination. These do not require prescribing medications or diagnosing patients, which remain the domain of licensed clinicians under the Medical and Dental Council of Nigeria (MDCN) or Nursing and Midwifery Council of Nigeria (NMCN). A CHEW HOD in Oke Ero, like Mrs. Ayinde Risikat, manages the facility’s operations while referring complex cases to specialists. This division ensures efficiency and patient safety, not hierarchy.
Our Nigerian framework unequivocally supports this inclusive approach. The 1999 Constitution (as amended), in Sections 192 and 14(4), empowers state governors to appoint commissioners (including for health) based on merit and federal character, requiring only that appointees are qualified for election to the state House of Assembly (Section 177: Nigerian citizens, at least 30 years old, and of good character). Health falls under the Concurrent Legislative List (Second Schedule, Part II), allowing states like Kwara to appoint qualified CHPs to lead PHC without professional restrictions. The National Health Act 2014, particularly Sections 25–28, establishes local government health authorities without mandating clinical qualifications for heads, emphasizing multidisciplinary teams to achieve universal health coverage.
For years, I have pored over data from primary health care centers across our local government areas, including Oke Ero, to ensure our communities receive equitable and effective care. It is from this vantage point that I write this open letter—not as a distant observer, but as one deeply embedded in the trenches of our health system.
Professional guidelines echo this call for unity. The National Primary Health Care Development Agency (NPHCDA) Minimum Standards for Primary Health Care (updated 2012) designate CHEWs and CHOs as key facility heads, comprising 60–70% of the PHC workforce and responsible for ward-level leadership. The Nigerian Medical Association (NMA) promotes inter-professional collaboration to mitigate conflicts and enhance patient outcomes, stressing that teams must work together without rivalry. The Nursing and Midwifery Council of Nigeria (NMCN) integrates multidisciplinary teamwork into its curriculum, affirming that all professions contribute equally to quality care. The Community Health Practitioners Registration Board of Nigeria (CHPRBN) regulates all CHPs, affirming their authority to head departments, while the Society of Community Health and Technology Stakeholders of Nigeria (SCHTSN) authenticates ND and HND qualifications, ensuring their alignment with national standards for PHC leadership.
To the leadership of NANNM, NMA, CHPRBN, SCHTSN, and all involved associations: I urge utmost caution in handling this matter. Those instigating unnecessary nuisance in Oke Ero must back off, as their actions risk eroding the integrity of professionals like Mrs. Ayinde Risikat and Mrs. Helen Bosede Olawuyi, disrupting services, tarnishing Kwara’s reputation, and undermining Nigeria’s health objectives. NANNM, NMA, CHPRBN, and SCHTSN should meet urgently to investigate genuine concerns, such as workplace dynamics involving Nurse Rufus, and correct our wards where needed through joint training and dialogue. Mediation through the Federal Ministry of Health may be necessary to restore harmony. Division weakens us; unity fortifies our resolve.
Fellow Kwarans and Nigerians in health: Let this letter serve as an open eye to our potential. Community health practitioners like Mrs. Ayinde Risikat and Mrs. Helen Bosede Olawuyi can—and should—head any health administrative office, as our laws, guidelines, and their exemplary service prove. I am weary of seeing my state and country diminished by empty rhetoric. Let us rise above it, united in purpose, for our patients deserve nothing less.
With resolve and hope for a collaborative future.
Remember that our Determination remains Unshakeable
September 17, 2025
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