At the turn of the century, medical
services, as is the case with some other services, in Gambia, Sierra Leone,
Ghana (then Gold Coast) and Nigeria were merged and controlled by the Colonial
Office in London.
This was the first centralization of control of health
services in West Africa.[2] The Colonial Office determined the
services that were available and provided the manpower. As health care
management became more complex, the central administration of health care
services became regionalized, while maintaining some common West African
facilities such as the West African Council for Medical Research, which came
into being in February 1954. In Nigeria specifically, medical services
developed and expanded with industrialization. Most medical doctors were civil
servants, except those working for missionary hospitals, who combined
evangelical work with healing. Among the civil service doctors, one was
appointed the Chief Medical Officer, who became the principal executor of
health care policies in Nigeria. Along with his several other junior colleagues
(Senior Medical Officers and Medical Officers), they formed the nucleus of the
Ministry of Health in Lagos. The details of centralized administration of
health services up to this point are complex and they reflect the complex
political transformation of the whole region. Between 1952 and 1954, the
control of medical services was transferred to the Regional governments, as was
the control of other services.[3]
Consequently, each of the three regions (eastern, western and northern) set up
their own Ministries of Health, in addition to the Federal Ministry of Health.
Although the federal government was responsible for most of the health budget
of the States, the state governments were free to allocate the health care
budget as they deemed fit. 
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