The Role of Health Policy in Enhancing Health Security: A Case Study of Nigeria’s National Action Plan for Health Security (NAPHS)

Health security remains a critical concern in global public health, particularly in low- and middle-income countries facing recurrent infectious disease outbreaks. National health security plans provide the policy architecture for translating international commitments into domestic preparedness capacities, yet their operational effectiveness depends on stakeholder awareness, financing, coordination and subnational implementation. This study examines the role of health policy in enhancing health security in Nigeria, using the National Action Plan for Health Security (NAPHS) as a case study. Specifically, it assesses stakeholders’ awareness of NAPHS, perceived relevance of the policy framework, implementation effectiveness, perceived improvements in health security domains, barriers to implementation and recommendations for strengthening Nigeria’s preparedness system. A quantitative cross-sectional survey design supported by documentary policy analysis was adopted. Data were collected from 380 purposively selected stakeholders using a structured questionnaire covering institutional profile, familiarity with NAPHS, perceived relevance, implementation effectiveness, preparedness improvements, funding adequacy, inter-agency coordination, One Health awareness, training exposure, barriers and recommendations. Descriptive statistics, cross-tabulations, chi-square tests of independence and Cramér’s V were used for analysis. NAPHS was widely recognised as relevant (90.3%) and strategically aligned with national and international frameworks (81.1% and 80.8%, respectively). However, only 9.2% rated implementation as very effective, while 60.3% rated it moderately effective. Familiarity was strongly concentrated at the federal level (92.4%) compared with state (44.2%) and community/facility levels (15.8%). The strongest improvements were observed in disease surveillance (69.2%) and laboratory capacity (67.1%), whereas funding mobilisation (15.0%), workforce training (26.0%) and inter-agency coordination (26.8%) were the weakest domains. Inadequate funding (84.7%) and weak coordination (76.1%) were the most frequently reported barriers. While NAPHS provides a strong policy foundation for health security in Nigeria, its operational impact depends on sustainable domestic financing, decentralised implementation, strengthened coordination, workforce development and improved subnational awareness. The study contributes evidence-based recommendations for strengthening national preparedness planning in resource-constrained settings.