In a transformative move for Kaduna State’s healthcare sector, Governor Uba Sani has approved the implementation of the Consolidated Health Salary Structure (CONHESS) and hazard allowance for health workers across the state. This decision, announced in September 2025, addresses longstanding demands from health professionals and their unions, marking a significant step toward improving the welfare of healthcare workers, enhancing service delivery, and strengthening the state’s healthcare system. The approval comes as a response to persistent advocacy from groups such as the National Association of Nigerian Nurses and Midwives (NANNM), the Association of Hospital and Administrative Pharmacists of Nigeria (AHAPN), and the Association of Medical Laboratory Scientists of Nigeria (AMLSN), who have championed better remuneration and working conditions for years.
This milestone is particularly timely, as Kaduna State navigates the challenges of a strained healthcare system, compounded by economic pressures and the lingering effects of recent industrial actions by health workers. The approval of CONHESS and hazard allowances is expected to boost morale, reduce brain drain, and ensure that Kaduna’s health sector remains a cornerstone of its development agenda. This article explores the details of the governor’s decision, its implications for health workers and the state, and the broader context of healthcare challenges in Nigeria.
Background: The Struggle for Fair Remuneration
Kaduna State, located in Nigeria’s North-West region, is a hub of economic and political activity, with a population of over eight million people. Its healthcare system serves a diverse populace, from urban centers like Kaduna and Zaria to rural communities with limited access to medical facilities. However, like many parts of Nigeria, the state has faced significant challenges in its health sector, including inadequate infrastructure, staff shortages, and poor remuneration for health workers. These issues have fueled discontent among professionals, leading to strikes, protests, and, in some cases, the migration of skilled personnel to other countries—a phenomenon known as the “japa syndrome.”
The Consolidated Health Salary Structure (CONHESS), introduced by the Federal Government of Nigeria in 2009, is a specialized salary framework designed for non-physician health professionals, including nurses, pharmacists, laboratory scientists, radiographers, and others. It aims to provide equitable pay, reflecting the critical role these workers play in the healthcare system. CONHESS is complemented by allowances such as hazard pay, which compensates health workers for the risks associated with their jobs, including exposure to infectious diseases and occupational hazards.
In Kaduna, health workers under the State Ministry of Health and the State Primary Health Care Board have long demanded the full implementation of CONHESS, particularly the 30% balance of the 2009 agreement, as well as the 2021 hazard allowance. These demands were at the heart of an indefinite strike launched on October 2, 2024, by NANNM, AHAPN, and AMLSN, which disrupted healthcare services across government-owned hospitals. The strike, described as a “last resort” by union leaders, highlighted the government’s failure to address longstanding grievances, including unpaid arrears, delayed promotions, and inadequate working conditions.
Governor Uba Sani’s approval of CONHESS and hazard allowances is a direct response to these demands, signaling a commitment to resolving the industrial crisis and prioritizing the welfare of health workers. The decision aligns with similar efforts in other states, such as Kwara, where local government health workers began receiving 100% CONHESS and hazard allowances in January 2024.
Details of the Approval
The approval, announced in September 2025, encompasses several key components:
Full Implementation of CONHESS: Governor Sani has approved the full implementation of the Consolidated Health Salary Structure for health workers in the State Ministry of Health and the State Primary Health Care Board. This includes the 30% balance of the 2009 CONHESS agreement, which had been a major point of contention. The implementation ensures that health workers receive salaries commensurate with their qualifications, experience, and responsibilities.
Hazard Allowance: The 2021 hazard allowance, designed to compensate health workers for the risks inherent in their profession, has also been approved. While specific figures were not disclosed in the announcement, previous federal circulars indicate that hazard allowances for CONHESS-grade workers range from N15,000 to N34,000 monthly, depending on grade level and clinical status. This allowance acknowledges the dangers faced by health workers, particularly those handling infectious diseases like Lassa fever, COVID-19, and cholera.
Arrears and Promotions: The approval includes provisions for addressing outstanding salary arrears, particularly for health workers recruited in 2023, and the release of pending promotions. These measures aim to clear backlogs that have demoralized workers and strained labor relations.
Barau Dikko Teaching Hospital: The announcement also covers the implementation of the 2019 CONHESS for health workers at Barau Dikko Teaching Hospital, ensuring that professionals in this critical institution benefit from the salary structure.
The implementation is expected to take effect immediately, with health workers likely to see improved pay reflected in their September or October 2025 salaries. The decision applies to professionals across various cadres, including nurses, pharmacists, laboratory scientists, and administrative health staff, ensuring broad coverage.
The Significance of the Decision
Governor Sani’s approval is a landmark achievement with far-reaching implications for Kaduna’s healthcare system and its workforce. Below are some key areas of impact:
1. Boosting Morale and Retention
The approval addresses a critical pain point for health workers: inadequate pay. Low salaries and poor working conditions have driven many skilled professionals to seek opportunities abroad, with Nigeria losing thousands of nurses and doctors annually to countries like the United Kingdom, Canada, and Saudi Arabia. By implementing CONHESS and hazard allowances, Kaduna State is taking a proactive step to retain its healthcare workforce, boost morale, and reduce the brain drain. A motivated workforce is essential for delivering quality healthcare, particularly in a state with high disease burdens such as malaria, tuberculosis, and maternal mortality.
2. Ending Industrial Actions
The recent strike by health workers, which began on October 2, 2024, severely disrupted healthcare services, leaving patients stranded and forcing many to seek costly treatment at private facilities. The approval of CONHESS and hazard allowances is expected to resolve these disputes, restoring industrial harmony and ensuring that government hospitals resume full operations. This is particularly critical for vulnerable populations who rely on public healthcare facilities for affordable care.
3. Strengthening Healthcare Delivery
Improved remuneration is likely to enhance the quality of healthcare delivery in Kaduna. Studies have shown that well-compensated health workers experience lower levels of stress and burnout, leading to better patient outcomes. By addressing financial grievances, the state government is creating an environment where health workers can focus on their duties, from routine care to emergency interventions.
4. Economic Ripple Effects
The increased salaries and allowances will inject additional income into Kaduna’s economy, as health workers spend on goods, services, and investments. This multiplier effect can stimulate local businesses, particularly in urban centers like Kaduna and Zaria, where many health workers are based. Additionally, the resolution of labor disputes reduces the economic losses associated with strikes, such as reduced healthcare access and increased costs for patients.
5. Setting a Precedent
Kaduna’s decision sets a precedent for other Nigerian states grappling with similar demands from health workers. States like Ondo, where nurses and midwives have threatened strikes over unpaid allowances, may look to Kaduna as a model for addressing labor concerns. The move also aligns with federal efforts to improve health workers’ welfare, as evidenced by President Bola Tinubu’s approval of a CONHESS review and accoutrement allowance in 2023.
Challenges and Considerations
While the approval is a significant victory, its implementation faces several challenges that must be addressed to ensure its success:
Funding Sustainability: Implementing CONHESS and hazard allowances requires significant financial resources, particularly for a state like Kaduna with competing developmental priorities. The government must ensure sustained funding to avoid delays or partial implementation, which could reignite labor disputes. Collaboration with federal agencies, such as the National Salaries, Incomes and Wages Commission (NSIWC), may be necessary to secure additional support.
Arrears and Backlogs: Clearing outstanding salary arrears and promotion backlogs is a critical component of the approval. Delays in disbursing these payments could undermine trust in the government’s commitment. The experience of Kwara State, where arrears were addressed alongside CONHESS implementation, offers a blueprint for Kaduna.
Infrastructure Deficits: Improved salaries must be complemented by investments in healthcare infrastructure, such as modern equipment, adequate staffing, and reliable power supply. Without these, health workers may struggle to deliver quality care, diminishing the impact of the salary increase.
Monitoring and Accountability: The government must establish mechanisms to monitor the implementation of CONHESS and hazard allowances, ensuring that funds are disbursed transparently and reach the intended beneficiaries. Past criticisms of salary structures, such as the discriminatory categorization of “clinical” and “non-clinical” staff, highlight the need for fairness and inclusivity.
Public Awareness: Effective communication is essential to ensure that health workers and the public understand the scope and timeline of the implementation. The government should engage with unions and media to provide regular updates, preventing misinformation and managing expectations.
Voices from the Ground
The approval has been met with cautious optimism by health workers and their unions. Comrade Ishaku Yakubu, Chairman of NANNM in Kaduna, described the decision as “a step in the right direction” but emphasized the need for prompt implementation. “We have heard promises before, but what matters is seeing the money in our accounts,” he said. “We hope this will mark the end of our struggles and allow us to focus on saving lives.”
Patients and community members have also expressed relief at the resolution of the labor crisis. Fatima Ibrahim, a mother who was turned away from Dantsoho Hospital during the October 2024 strike, welcomed the news, stating, “I hope this means our hospitals will be open again. We need our nurses and doctors to be happy so they can take care of us.”
The Broader Context: Nigeria’s Healthcare Crisis
Kaduna’s initiative must be viewed within the broader context of Nigeria’s healthcare challenges. The country’s health sector is plagued by underfunding, with only 4.7% of the 2025 national budget allocated to health, far below the 15% recommended by the African Union’s Abuja Declaration. This has led to dilapidated facilities, shortages of essential drugs, and a critical deficit of health workers, with Nigeria having only 3.9 doctors per 10,000 people compared to the World Health Organization’s recommended 25 per 10,000.
The federal government has made efforts to address these issues, including a 2023 review of CONHESS and hazard allowances for federal health workers. However, implementation has been inconsistent, with the Nigeria Labour Congress (NLC) noting in 2022 that approved hazard allowances were yet to be paid. Kaduna’s proactive stance could pressure other states and the federal government to expedite similar reforms.
Governor Uba Sani’s Vision
Since assuming office, Governor Uba Sani has prioritized human capital development and social equity, with healthcare as a cornerstone of his administration’s agenda. The approval of CONHESS and hazard allowances aligns with his broader vision of transforming Kaduna into a hub of opportunity and progress. In a statement, the governor emphasized that “health workers are the backbone of our healthcare system. Investing in their welfare is investing in the health and future of our people.”
Sani’s administration has also invested in infrastructure projects, such as road construction and rural electrification, to complement healthcare reforms. By addressing both human and physical capital, the governor aims to create a holistic development framework that uplifts all sectors of Kaduna’s economy.
Looking Ahead: A Call to Action
The approval of CONHESS and hazard allowances is a pivotal moment for Kaduna’s healthcare sector, but its success depends on effective implementation and sustained commitment. The government must work closely with unions, health institutions, and communities to ensure that the benefits reach every eligible worker. Investments in training, equipment, and facilities are equally critical to maximizing the impact of this initiative.
For health workers, this is an opportunity to rededicate themselves to their profession, knowing that their contributions are valued. For the people of Kaduna, it is a chance to access improved healthcare services from a motivated and well-compensated workforce. And for Nigeria, Kaduna’s example offers hope that strategic interventions can address the systemic challenges facing the health sector.
As Kaduna moves forward, the eyes of the nation are on Governor Sani and his administration. The successful implementation of this policy could serve as a model for other states, proving that with political will and stakeholder collaboration, Nigeria can build a healthcare system that meets the needs of its people. For now, the approval of CONHESS and hazard allowances stands as a beacon of hope, signaling a brighter future for Kaduna’s health workers and the communities they serve.
