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Globally, the intense pressure to transform the public sector has led to various organisational changes through reforms and policies in an effort to sustain organisational effectiveness and to gain competitive advantage. The poor performance of the Nigerian public health sector has been brought into sharp focus with the advent of the COVID-19 pandemic, which has led to a strain being placed on the health care system of the country. Previous reform initiatives in the public health sector have failed dismally. These failures have been blamed on initiatives’ concentration on functional changes rather than on cultural changes and their neglect of organisational culture. There is limited literature that explores the required administrative culture in the public health sector to achieve improved change outcomes and performance in Nigeria. Hence, this study used a qualitative approach by reviewing extant literature to enhance an understanding of organisational culture as a concept, and to investigate the perceived culture of the Nigerian public health sector and the alignment of the management to a change of culture. The study adopted a desktop study approach. Secondary data were collected. These included government reports, documents and current comprehensive scholarly literature sourced from different academic databases such as Scopus, Google Scholar, SABINET and EBSCO. Textual and thematic analysis were used to analyse data. The study reveals that the poor governance and leadership including corruption, organisational lack of effectiveness and inefficiency in the delivery of health services were amplified by the nature of its bureaucratic approach and poor work ethic culture. The deficiency of value in organisational culture undermines efforts to transform the Nigerian public health sector and the attainment of the Sustainable Development Goals for health. The study recommends a diagnostic evaluation of the public health sector and organisational cultural change to improve performance and sustainable transformation of the Nigerian public health sector. The empirical evidence from the evaluation would support the design of focused reforms that would yield the greatest impact.