This study was an empirical analysis of health sector reform on policy developed and implemented between 2001 to 2010. Multiple data collection was used to generate the findings. Not more than 21 States in Nigeria had either started or are implementing various types of health reforms. National, State and Local Government Areas (LGAs) levels elite had dominated policy through the control of resources. The national policy network on health sector reform had being narrowly based in a small number of institutions. We concluded that without continue and sustained institutional or structural policy reform in health; it is unlikely that existing organizational structures and management systems in health sector will be able to deal adequately with the weak and fragile National health care delivery system. It is recommended that health sector reform should therefore be concerned with defining priorities, refining policies and reforming the institutions through which those policies are implemented.
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