Background: Public health NGOs in Nigeria operate within a complex environment marked by limited fiscal space for health, high household spending, uneven service readiness, workforce instability, fragile data systems, donor dependence, and recurrent humanitarian shocks. Yet most available ERM frameworks are either generic, corporate, public-sector oriented, or insufficiently adapted to the programmatic realities of nonprofit and humanitarian public health delivery in Nigeria.
Objective: This paper develops a Nigeria-specific conceptual framework for integrated governance and enterprise risk management for NGO-led public health programming and proposes an implementation and validation protocol capable of linking risk governance to service continuity and programme health outcomes.
Methods: The manuscript uses critical synthesis of pre-2022 literature and official policy documents, combined with secondary analysis of Nigeria-specific health financing and humanitarian indicators. The proposed empirical validation phase adopts a convergent mixed-methods design involving document review, expert Delphi, structured survey measurement, and qualitative key informant interviews. Integration is proposed through joint display analysis and pillar integration methods.
Results: The synthesis identifies seven core domains for an integrated Nigeria-specific ERM model: governance and risk appetite; contextual and programmatic risk mapping; financing and donor-risk management; service delivery and workforce resilience; data integrity and digital governance; safeguarding and community accountability; and monitoring, assurance, and adaptive learning. Secondary evidence shows that Nigeria’s health financing structure remains highly exposed to private and out-of-pocket burden, while humanitarian pressures intensify continuity, access, and operational risk in affected regions. 
Conclusion: A context-sensitive integrated governance and ERM framework is both theoretically justified and operationally necessary for NGO-led public health programming in Nigeria. The next empirical step should be field validation using expert consensus, psychometric testing, and stakeholder-based implementation assessment across multiple programme areas and geographies.