Nigeria, June 16 -- Part I of this essay examined developments at the frontline of healthcare delivery, particularly in primary healthcare and maternal health. Those areas matter because they are where citizens most directly experience the strengths and weaknesses of the health system. They are also where the consequences of failure are often most severe. A functioning primary healthcare centre, a skilled birth attendant, a timely referral, and access to emergency care can mean the difference between life and death.

Yet the primary healthcare centre and the maternity ward do not exist in isolation. The quality of care available within them is shaped by factors that are often less visible to the public: the availability of trained health ...