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Wednesday, March 11, 2026

COMMUNIQUÉ ISSUED AT THE END OF THE 42ND ANNUAL GENERAL MEETING AND SCIENTIFIC CONFERENCE OF THE ASSOCIATION OF PUBLIC HEALTH PHYSICIANS OF NIGERIA (APHPN) HELD FROM 9TH–13TH FEBRUARY 2026 MUHAMMAD INDIMI

CONFERENCE CENTRE, UNIVERSITY OF MAIDUGURI, BORNO STATE

Conference Theme:

“Healing in the Crossfire: Health Under

Threat – Delivering Health Services in

Conflict and Crisis.

”

PREAMBLE

The Association of Public Health Physicians of Nigeria

(APHPN) convened its 42nd Annual General Meeting

and Scientific Conference in Maiduguri, Borno State,

bringing together over 300 public health physicians,

policymakers, humanitarian actors, development partners,

and academics from across Nigeria.

The conference theme reflects both global and national realities: fragile and conflict-affected  settings account for a disproportionate burden of maternal and child mortality, infectious disease outbreaks, malnutrition, gender-based violence, and mental health disorders. In Nigeria, overlapping insecurity in the North-East, North- West, North-Central and other regions has resulted in displacement, weakened health systems, and widening inequities.

Through plenary lectures, keynote address, policy dialogues, and scientific abstract presentations, participants examined strategies for delivering Reproductive, Maternal, Newborn, Child, Adolescent, Elderly Health plus Nutrition (RMNCAEH+N) services, strengthening health systems, addressing gender-based violence, integrating mental health and psychosocial support, responding to epidemics, and protecting healthcare workers in conflict and crisis settings.

KEY OBSERVATIONS

1. Conflict as a determinant of poor health outcomes:

Conflict and insecurity continue to undermine health

system functionality across several regions of Nigeria.

Destruction of infrastructure, disruption of supply chains,

displacement of health workers, and weakened surveillance

systems have contributed to  increased maternal and

neonatal mortality, low immunization coverage in insecure

areas, rising malnutrition, outbreaks of communicable

diseases, escalating mental health disorders and increasing

incidence of emerging and re-emerging diseases.

2. Women, children, adolescents, the elderly, and internally displaced populations bear a disproportionate burden of poor health outcomes in crisis settings, including heightened exposure to gender-based violence and psychosocial distress.

3. Delivering RMNCAEH+N in conflict settings remains fragile: The North-East remains emblematic of a protracted humanitarian health crisis. States in the North-East continue to report some of the poorest RMNCAEH+N indicators nationally. In several LGAs previously affected by insurgency, over half of health facilities were rendered non-functional at the peak of the crisis.

Although recovery efforts are ongoing, service delivery remains dependent on mobile outreach, task-shifting, community health volunteers, and humanitarian partnerships. Innovative interventions such as the Safer Birth Bundle of Care in Borno State demonstrate the potential of continuous quality improvement even in fragile settings.

4. Mental Health Crisis in Conflict and Fragile Settings: There is a substantial but under-recognised burden of trauma, depression, anxiety, and post-traumatic stress

disorders in conflict-affected populations. Mental health services remain underfunded and poorly integrated into primary health care.

Health  workers themselves experience burnout  and secondary trauma in insecure environments

5. Violence Against Health Workers: Violence against healthcare workers and attacks on health facilities continue  to  undermine  service delivery, threatening service continuity. Insecurity limits workforce retention, discourages rural posting and compromised emergency response capacity.

6. Weak Health Information Systems in Crisis Contexts: Poor data systems at national, subnational, and local government levels limit evidence-based planning, resource allocation and epidemic response in fragile settings.

Conflict-sensitive surveillance systems remain inadequate

7. Climate change as a health risk multiplier: Climate change is compounding insecurity-related vulnerabilities, contributing to malnutrition, vector-borne diseases, Lassa fever outbreaks and other epidemic risks, and displacement.

The health sector’s adaptation strategies remain insufficient

8. Emerging and context-specific public health concerns— including Lassa fever outbreaks reported in Bauchi State, Buruli ulcer outbreaks in Benue State, HIV burden in certain states, like Taraba, and increasing recognition of Vitamin D deficiency as silent epidemic among the upper class with increasing risk of bone disorders, metabolic diseases, immune  dysfunction, depression, and  cardiovascular conditions—require public health advocacy, public enlightenment, strengthening surveillance and coordinated policy response.

9. Health Governance and Workforce Policy Concerns: Recent workforce policy developments like the creation of a Public Health Officer (PHO) cadre in Lagos State without adequate stakeholder consultation risks fragmentation, duplication of roles, and disruption of established public health structures if not guided by broad stakeholder consultation.

RECOMMENDATIONS

The Association makes the following recommendations:

A. Strengthening Health Systems in Conflict Settings

1.   Federal    and    State   Governments     should

institutionalise conflict-sensitive health planning and

integrate humanitarian-development  approaches into

state health strategies.

2. Increase investment in rebuilding and protecting

health infrastructure in conflict-affected regions.

3.  Establish mechanisms  to  safeguard  healthcare

workers  and   enforce  protections   consistent   with

international humanitarian principles.

4. Develop retention incentives and security support

systems for frontline health workers.

B. RMNCAEH+N Continuity in Crisis

5. Scale up adaptive service delivery models, including

mobile outreach, community-based interventions, and

task-shifting frameworks.

6. Expand quality improvement initiatives such as the

Safer Birth Bundle of Care in high-mortality states.

7. Ensure uninterrupted immunisation and nutrition

services in hard-to-reach communities.

C.  Gender-Based  Violence  and  Mental  Health

Integration

8. Integrate comprehensive GBV services — including

clinical management of rape, psychosocial support, and

referral pathways — into primary health care.

9. Mainstream  Mental Health and Psychosocial Support

(MHPSS) into  state health  plans and  humanitarian

response frameworks.

10. Provide  structured  psychosocial support  and

trauma care for health workers in insecure environments.

D. Data, Surveillance, and Epidemic Preparedness

11.  Strengthen  health  information   systems  and

conflict-sensitive surveillance mechanisms at all levels.

12. Establish multi-sectoral Technical Working Groups

(TWGs) for Lassa fever and other emerging epidemics

in high-burden states.

13. Improve  integration  of  genomic, spatial, and

environmental data for diseases such as Buruli ulcer.

E. Climate-Resilient Health Systems

14. Recognise climate change  as  a  public  health

emergency and integrate climate adaptation into health

infrastructure planning.

15. Develop climate–health early warning systems and

promote renewable energy transition in health facilities.

F. Public Health Workforce Governance

16. Withdraw the circular establishing the PHO cadre

in Lagos State and engage stakeholders in developing

coherent public health workforce reforms.

G. Emerging Public Health Priorities

17. APHPN should engage in intensive public health

enlightenment,  screening  and  supplementation  for

high-risk  populations  and  advocacy towards  policy

formulation to address the silent epidemic of vitamin D

deficiency in Nigeria.

18. Strengthen cross-border and migratory surveillance

for neglected tropical diseases and infectious disease

threats

CONCLUSION

Nigeria cannot achieve health equity or Universal Health

Coverage without addressing the realities of conflict,

insecurity, climate vulnerability, and systemic fragility.

Healing in  the  crossfire demands  resilient systems,

protected  health  workers,  integrated  services, and

sustained political commitment.

The Association of Public Health Physicians of Nigeria reaffirms its commitment to advancing evidence-based policies and collaborative action to safeguard the health of all Nigerians, even in times of crisis.

APPRECIATION

The Association expresses profound  gratitude to the

Government and people of Borno State, development

partners, humanitarian agencies, academic institutions,

and all participants who contributed to the success of the

conference.

Dr. Terfa Simon Kene             Dr. Augustine Ajogwu

President                                Secretary General

Date: 9/03/26