If you’ve ever worked in, or studied, Nigeria’s health sector, you already know the frustration of navigating towering stacks of fragmented records, manual entry errors, and siloed projects, a reality that keeps us caught in an exhausting paper trap. For those passionate about health systems strengthening, it is clear that data is much more than spreadsheets and routine reporting; it is the vital evidence that literally saves lives, especially in maternal and newborn health. Yet, as discussed in a recent ACE Podcast episode featuring Afeez Olajire and Dr. Victory Ekpin, Nigeria continues to struggle with optimizing this critical resource. We pour funds into interventions, but without real-time tracking and an overarching data culture, we are effectively flying blind.
Why is paper such a trap? As Dr. Victory Ekpin highlighted, the problem isn’t just archaic tools; it’s the dangerous ripple effect of “double-work.” Frontline health workers are routinely forced to collect critical patient data on physical paper, only to manually transfer it to digital platforms later. This tedious, two-step process invites massive margins for human error and severely exacerbates the already heavy workload of our healthcare providers.
This fragmented reality is exactly why data is frequently treated as an afterthought during a project’s design phase, rather than a digital-first priority. As Afeez Olajire perfectly captured:
“I think when programs are being planned, data is being treated as an add-on and not as a core part of the program.”
Because data measurement is treated like a “dessert” rather than the main course, the sector ends up with decentralized, partner-hoarded data and a continued reliance on physical paper tools, an unacceptable reality for 2026.
Escaping this trap to genuinely strengthen our health systems requires both the government and stakeholders to radically shift their approach. The government must take the lead by streamlining the heavy bureaucracy surrounding central platforms like DHIS2, ensuring that health indicators can be updated dynamically to reflect ground realities. More importantly, this requires strict, top-down mandates on data integration. Afeez laid down a powerful challenge to public officials and policymakers:
“No investment should fly, whether national or state government, except you have clearly demonstrated your data collection, analysis, archival, and dissemination system, and how all of those fit into the existing government structure.”
Donors similarly hold the keys to systemic change and must leverage their funding power to demand integration. By ensuring that implementing partners integrate their data with existing national systems, donors can prevent the creation of isolated dashboards built simply to claim a quick win. Furthermore, for data to act as the “sole source of truth” in our resource-constrained environment, Afeez noted that it must meet four uncompromising pillars of quality: completeness, correctness, congruency, and consistency.
Beyond these technical metrics, the most profound shift required to modernize our systems is a cultural evolution regarding data ownership. As health data enthusiasts, we must continuously remind ourselves why we build these models and track these indicators. As Afeez powerfully stated:
“The data does not belong to the government, the donor, or the implementing partner. The data belongs to the people.”
Until our data systems are fundamentally designed to carry along and protect the vulnerable communities we serve, our efforts to escape the paper trap and strengthen Nigeria’s health sector will remain entirely incomplete. Because, as podcast host Biobele West reminded us at the close of the episode, the work we do goes far beyond numbers, statistics, and targets:
“It’s real-life people that we’re impacting.”
Watch the full podcast episode here.
To hear more insights on health systems strengthening, resource allocation, and maternal health, watch previous episodes of the ACE Podcast: