The Lancet Commission (2015) revealed that 5 billion people and 1.7 billion children below the age of 15 years worldwide do not have access to safe, affordable surgical obstetric, trauma, and anesthesia services when needed, a major public challenge. Most of these people and children live in Low and Middle-Income Countries (LMICs) as such there was the lunch of the National Surgical Obstetric Anesthesia Plan aimed at promoting and supporting quality, safe and timely surgical healthcare strengthening in LIMCs. However, all the countries that have the plan either at the planning or implementation stage do not have nursing integrated into the nomenclature except for Nigeria. Methods: The Nigerian National Surgical Obstetric Anesthesia and Nursing (NSOANP) plan (2019 - 2023) included nursing from the inception at all levels of the policy in the spirit of leaving no one behind. Results: Nigerias surgical plan included nursing and children’s surgery: the two key elements that have been neglected in the LMICs national surgical plan, making Nigeria the first and the only country that integrated nursing into their surgical plan driven by the power of consistent and well-structured advocacy. The pilot implementation started in 2020, supported by a Non-Governmental Organization driving the essence of galvanizing synergy for public health interest. Now, Nurses have been trained in safe operative care, and research and are also involved in the electronic registry for orofacial cleft. Conclusions: Advocacy is the actual process of supporting a cause. It is the nub of healthcare system transformation. which seems to be neglected in the clinical space but serves as a critical and effective tool to create change. To achieve the goal of prioritization of nursing and children’s surgical care, Advocacy is a core driver and key element to bring to bear a change in the surgical ecosystem.