Christian Harrison is a professor of Leadership and Enterprise and director of the Centre for Leadership and Empowerment at the University of Greater Manchester, United Kingdom. A native of Abia State and a devoted family man, he was formerly a Reader in Leadership and chair of the Staff Forum for Research at the University of the West of Scotland. Over the years, he has led modules and delivered lectures on leadership at undergraduate, postgraduate, and DBA levels. An old boy of King’s College Lagos, he earned a First-Class degree in Pharmacy from the University of Lagos, followed by a PhD in Leadership from the University of Aberdeen. His early career was in Pharmacy, where he practised professionally and held several roles.
He has supervised doctoral students researching themes such as authentic, ethical, transformational, and servant leadership. He is the founder of The Leadership Mould Initiative International, an NGO that supports students and nurtures future leaders.
In this insightful chat with Temitope Obayendo, Prof. Harrison examines Nigeria’s healthcare delivery system through a leadership lens. He highlights critical gaps in leadership styles and the absence of a coherent and accountable leadership framework at all levels—federal, state, and institutional. He emphasises the need for strategic policy implementation frameworks, inclusive governance, and empathetic leadership as vital to driving sustainable improvements in patient outcomes. He also underlines the importance of investing in the capacity building of the healthcare workforce. Read excerpts from the interview below:
What inspired the shift in your career from Pharmacy to leadership?
Although I loved Pharmacy and the impact it had on individual lives, I always felt a strong conviction to influence systems and empower people on a broader scale. This desire led to a significant career shift. I pursued an MBA at the University of Aberdeen, graduating with Distinction and as valedictorian, and later completed a PhD in Leadership. That marked the beginning of my academic journey in management and leadership studies—a field in which I have found deep purpose and fulfilment.
People often ask why I left Pharmacy, a respected and well-paying profession. I jokingly say I got tired of earning more money, but the truth is, I wanted to expand my impact. Pharmacy allowed me to help individuals; leadership allows me to influence communities, systems, and future generations. Academia offered a platform to teach, mentor, research, and shape future leaders across sectors and nations.
My journey began in Pharmacy but continues in leadership—with the same core goal: to serve, empower, and make a meaningful difference.
I’ve authored several research papers and books, with over 100 published journal articles, conference papers, and book chapters. Some of my books include Leadership Theory and Research: A Critical Approach to New and Existing Paradigms, Leadership and Leadership Development: Critical Perspectives and Contemporary Approaches, Qualitative Research Methods for Business Students: A Global Approach, Leadership During a Crisis: A Focus on Leadership Development, Contextualising African Studies: Challenges and the Way Forward, and The African Context of Business and Society.
My research maintains strong ties with the health sector. For example, I developed the first entrepreneurial leadership skills framework tailored for pharmacists—bridging my two professional worlds. This framework serves as a valuable resource for practitioners and policymakers interested in advancing leadership within pharmacy and beyond.
I’m also actively involved in leadership development practice. I’ve delivered CPD and leadership programmes for various organisations, including the Scottish Government, the NHS, SMEs, and higher education institutions. I serve as chair of the Leadership and Leadership Development Special Interest Group at the British Academy of Management and the Academy for African Studies, where I promote scholarship in leadership and African studies. I also contribute regularly to media outlets such as STV, Scotland Tonight, Arise News, The Herald, and The Conversation, offering expert insights on leadership and current affairs.
From a leadership perspective, what are the most critical gaps in Nigeria’s healthcare delivery system that must be addressed to drive meaningful reform?
One of the most critical gaps is the absence of a coherent and accountable leadership framework across all levels—federal, state, and institutional. Leadership in healthcare goes beyond policy formulation; it involves implementation, coordination, and sustainability. Nigeria’s system suffers from fragmented governance, with limited synergy between the various tiers of government and institutions responsible for healthcare delivery.
Another major gap is the lack of visionary and transformational leadership committed to long-term health system strengthening. Too often, decision-making is politicised rather than evidence-based. This results in underinvestment in primary healthcare, inadequate preventive care, and poor resource allocation.
Additionally, there is limited investment in leadership development for healthcare professionals. Clinical competence does not always equate to managerial or strategic capability, yet many facilities are led by individuals without formal leadership training. Developing the leadership capacity of healthcare workers—especially in entrepreneurial, ethical, and adaptive leadership—would equip them to navigate complex challenges and innovate within the Nigerian context. This area is particularly close to my heart, and I have been engaged in it for many years.
There’s also a leadership gap in patient advocacy and community engagement. Meaningful reform requires closing the divide between providers and the communities they serve. As I often say, leadership is not about “me” but “us.” Engaging patients, civil society, and local leaders in the design and accountability of health systems is essential for building trust and ensuring responsiveness.
Lastly, the persistent brain drain—especially of doctors, nurses, and pharmacists—underscores a failure of leadership to create an enabling environment for professional retention, development, and recognition. This exodus, now dubbed the “japa” syndrome”, will persist unless leadership at all levels prioritises staff welfare, career progression, and a culture of ethics and excellence.
How can Nigerian healthcare leaders better balance short-term service delivery with long-term structural reforms?
Balancing immediate service needs with long-term reform is among the most demanding but essential leadership tasks in Nigeria. Leaders must adopt a dual-focus approach—delivering short-term impact while building systems for sustained change.
First, they must practise strategic prioritisation. Urgent issues like medical supply shortages or understaffing must be addressed, but within a broader vision. For instance, while temporary medical outreaches are helpful, they should be linked to strengthening supply chains, improving data systems, and building workforce resilience.
Second, leaders must adopt systems thinking. Challenges like hospital overcrowding or poor referrals are often symptoms of systemic weaknesses—such as an underdeveloped primary care system. Solutions must address root causes and support integration, data use, and coordinated care.
Inclusive leadership is also key. Engaging a broad coalition—including healthcare workers, policymakers, community leaders, and patients—ensures relevance, shared ownership, and sustainability. Aligning incentives and accountability mechanisms to both immediate outcomes and long-term goals is vital.
Continuity is another crucial factor. Reforms are often derailed by political transitions. Leaders must institutionalise change through legislation, strong governance, and capacity building, empowering state and local health systems with autonomy and resources.
Finally, leaders must adopt a learning mindset. Monitoring and evaluation should serve not only reporting purposes but also enable real-time improvements. Effective leadership in Nigeria’s health sector requires vision, discipline, empathy, and the ability to lead through complexity—delivering today while building for tomorrow.
In your view, what leadership qualities are most lacking—or most urgently needed—among healthcare administrators and policymakers today?
Several critical leadership qualities are lacking in Nigeria’s healthcare system. First is the absence of long-term strategic vision. Leaders are often caught in a cycle of crisis management—responding to strikes, shortages, or outbreaks—without planning for systemic resilience. Despite recurring diseases like Lassa fever, Nigeria still lacks a robust surveillance and early warning system.
Second, there is a deficiency in human-centred leadership. Patients suffer poor communication and substandard care, while healthcare workers face burnout. Leaders who prioritise empathy and actively listen to both groups can bridge this trust gap. We need to transition from bureaucracy-driven to people-driven leadership. We need servant leaders.
Third, integrity is sorely lacking. Mismanagement and corruption have long plagued the sector, with funds often diverted or misused. Transparent, ethical stewardship is vital for rebuilding public trust and ensuring resources reach those in need.
Fourth, siloed thinking persists. Healthcare is affected by sanitation, education, and food systems, yet inter-ministerial collaboration is rare. Successful examples—like the polio eradication campaign—demonstrated the power of cross-sector partnerships.
Lastly, the COVID-19 pandemic revealed how fragile the system is. Leaders must be trained to act decisively under uncertainty, adapt to evolving situations, and motivate teams through crisis. Static policy implementation is no longer enough—what’s needed now is agile leadership and continuous innovation.
Ultimately, healthcare leaders must embody strategic foresight, empathy, integrity, collaboration, and resilience. With these qualities embedded at all levels—from local councils to federal ministries—true and lasting reform is not just possible but inevitable.
What role should public-private partnerships play in reshaping healthcare delivery, and how can leaders ensure these partnerships are both ethical and effective?
Public-private partnerships (PPPs) have immense potential to reshape healthcare delivery in Nigeria, and their role should be seen as complementary rather than supplementary to government efforts. Given the persistent resource constraints and infrastructure gaps in the public health sector, PPPs offer a pathway to leverage private sector innovation, capital, and efficiency to improve access and quality of care.
In a country like Nigeria, where public hospitals are often overstretched and under-resourced, well-structured PPPs can help modernise hospital infrastructure, introduce better management systems, expand telemedicine services, and deliver essential drugs and diagnostics more reliably. However, for these partnerships to succeed, they must be driven by more than just commercial interest—they must be shaped by a shared vision for equitable, inclusive, and sustainable healthcare.
To ensure that PPPs are both ethical and effective, leadership is key. First, transparency must be the foundation. Leaders must set clear guidelines for how partners are selected, how contracts are awarded, and how services are evaluated. This reduces the risk of corruption and builds public trust. Without transparency, PPPs quickly become vehicles for rent-seeking rather than reform.
Second, healthcare leaders must ensure that the public interest is never compromised in the pursuit of private efficiency. This means designing agreements where profit does not trump patient outcomes. Effective regulation, built-in accountability mechanisms, and regular monitoring are essential. Leaders must also negotiate terms that include performance indicators aligned with national health priorities—such as maternal mortality, or the spread of non-communicable diseases.
Third, equity must remain a non-negotiable principle. Leaders must guard against creating a two-tier health system where only the wealthy can access high-quality care through private providers while the majority are left behind. PPPs should aim to reduce the healthcare divide, not widen it. Incentive structures can be designed so that private providers are rewarded for reaching underserved areas or delivering care to vulnerable populations.
Moreover, capacity building should be embedded in every partnership. PPPs should not just be about service delivery—they should also contribute to strengthening the skills of local health workers, upgrading systems, and transferring knowledge and technology to public institutions. In this way, they build long-term resilience rather than short-term dependency.
Finally, successful PPPs require collaborative, visionary leadership that can bring together stakeholders across government, business, and civil society. Leaders must build coalitions, manage competing interests, and foster a culture of mutual accountability. Importantly, these partnerships must be grounded in a long-term national health strategy, not driven by ad hoc needs or donor interests.
There is this perennial battle for healthcare leadership in the Nigerian healthcare system, where the medics lay claim to headship of the team, leading to inter-professional rivalry. With your experience outside the shores of the country, what do you see as a lasting solution to this prolonged war?
The persistent inter-professional rivalry in Nigeria’s healthcare system, particularly the long-standing contention over leadership between medical doctors and other healthcare professionals, is a critical impediment to the sector’s growth, efficiency, and cohesion. From an international leadership perspective, this kind of rivalry is counterproductive, and resolving it requires a fundamental shift from profession-centric leadership to system-centric, collaborative leadership.
In countries with more integrated and efficient healthcare systems, leadership is often based not solely on professional background but on competence, emotional intelligence, administrative capacity, and the ability to inspire inter-professional collaboration. The focus is on patient outcomes and health system performance—not on professional hierarchies. In such systems, pharmacists, nurses, public health experts, and allied health professionals often take on key leadership roles based on merit and expertise, without destabilising the broader team dynamic.
A lasting solution in Nigeria lies in rethinking the leadership model from a hierarchical structure to a team-based, collaborative framework. Leadership in healthcare should be multi-disciplinary and inclusive, recognising that every professional brings unique and valuable perspectives to the table. Doctors, pharmacists, nurses, and allied health professionals must be seen not as rivals but as interdependent actors within a system whose success depends on mutual respect and cooperation.
The government, regulatory bodies, and academic institutions must play a key role in leading this change. Firstly, there should be a national health leadership framework that defines competencies for leadership roles across the sector—focusing on vision, strategic thinking, management expertise, and the ability to lead across boundaries, rather than defaulting leadership to any one profession. These roles should be earned through transparent, merit-based processes.
Secondly, leadership development programmes in Nigeria must be designed to build the collective capacity of the healthcare workforce. These programmes should focus on relational leadership, systems thinking, conflict resolution, and inclusive decision-making. There should also be platforms for continuous dialogue between professional groups, where issues of leadership and collaboration can be addressed constructively, not combatively.
Importantly, policy reform is also essential. The Federal Ministry of Health and other governing bodies need to review outdated regulations and policies that entrench the dominance of one profession in leadership. Leadership should be based on strategic capability and institutional knowledge—not professional identity. Other countries have done this successfully, and Nigeria can too, with the right political will and visionary leadership.
Finally, culture change must be led by example. Leaders across the health sector must model inclusive leadership, reward team achievements rather than individual dominance, and celebrate inter-professional collaboration. Only by doing so can we begin to heal the divides and focus on what truly matters: improving the health and lives of the Nigerian people. The solution is not to elevate one profession above another but to build a leadership culture that values competence, collaboration, and shared accountability. That’s what drives high-performing healthcare systems globally, and it’s what Nigeria urgently needs to embrace.
How can leadership at the local government level be empowered to improve access to primary healthcare, especially in rural and underserved communities?
Empowering leadership at the local government level is absolutely vital to improving access to primary healthcare in Nigeria, particularly in rural and underserved communities. Local governments are the closest administrative bodies to the people and are best positioned to understand the unique health challenges of their communities. However, their potential is often constrained by structural, financial, and capacity-related limitations.
To begin with, we need to rethink the leadership and governance structure at the local level to give leaders the authority, resources, and capacity to make impactful decisions. This includes devolving more health-related powers from federal and state governments to local governments, particularly in the planning and implementation of primary healthcare services. Autonomy, when coupled with accountability, can be a game-changer.
Leadership capacity-building is another critical factor. Many local government officials are appointed or elected without the necessary training in public health, healthcare management, or systems leadership. A comprehensive leadership development programme tailored to local government health officials should be institutionalised—one that focuses on strategic planning, stakeholder engagement and data-driven decision-making. When local leaders are equipped with these competencies, they are better positioned to lead community-driven healthcare initiatives.
Financing is also central. Local governments must be provided with predictable and adequate funding to run primary healthcare centres effectively. However, they should also be empowered to generate and manage some of their own revenue through transparent local taxes or public-private partnerships. Financial autonomy, combined with strong monitoring systems, encourages innovation and responsiveness to local health needs.
Community engagement is a key lever. Effective local leadership is not just about top-down planning—it’s about engaging local stakeholders, including traditional rulers, community-based organisations, religious institutions, and women’s groups. These actors can be instrumental in mobilising support for immunisation campaigns, maternal health services, and health education. A good leader at the local level must be visible, accessible, and accountable to their communities.
Inter-governmental collaboration must also be enhanced. Leadership at the local level can only thrive if there is synergy between the tiers of government. States should support local councils with technical expertise, supply chain management, and specialist outreach. The federal government, in turn, must provide the policy frameworks and financial incentives that reward innovation and performance at the local level.
Finally, leadership models that focus on shared accountability and collective impact must be adopted. We need to move away from personality-driven leadership to institutionalised, sustainable models of local governance that can survive political transitions. That’s where mentorship, succession planning, and the development of leadership pipelines come in—ensuring continuity and resilience in the local health system.
Local government leadership can be the linchpin in Nigeria’s quest to improve access to primary healthcare. By strengthening autonomy, investing in leadership development, ensuring adequate financing, and encouraging community participation, we can transform local health systems into engines of equity and progress—especially for those most often left behind.
(Continues next edition)
This idea is perfect 👍