Reported by Weng Patrick Atokor | Journalist at Weng Global
Nigeria’s quest to achieve universal healthcare coverage continues to face significant obstacles as more than 6,500 Primary Healthcare Centres (PHCs) across the country remain non-functional despite billions of naira invested in the sector over the years.
The development has raised fresh concerns among healthcare professionals, civil society organisations, and policy analysts who argue that the country’s healthcare challenges are no longer solely about funding but also about governance, accountability, maintenance, and effective implementation of health policies.
Primary Healthcare Centres are regarded as the foundation of every effective healthcare system. They provide essential services including maternal and child healthcare, immunisation, treatment of common illnesses, disease prevention, health education, and referrals to higher medical facilities. However, in many Nigerian communities, especially rural areas, these facilities have either been abandoned, remain poorly equipped, or are operating without adequate personnel.
Millions Left Without Basic Healthcare
Nigeria has over 30,000 Primary Healthcare Centres spread across its 774 local government areas. However, available assessments indicate that thousands of these facilities are either completely shut down or operate at levels far below acceptable standards.
The consequence is that millions of Nigerians, particularly those in rural communities, are forced to travel long distances before accessing healthcare or rely on unregulated traditional medicine and patent medicine vendors for treatment.
Health experts warn that this situation contributes significantly to preventable maternal deaths, infant mortality, disease outbreaks, and delayed treatment of common illnesses.
Women seeking antenatal care, children requiring immunisation, and elderly citizens managing chronic diseases often experience the greatest hardship due to the limited availability of functioning primary healthcare facilities.
Billions Invested Through Health Programmes
Successive Nigerian governments have introduced several programmes aimed at revitalising primary healthcare.
Over the years, federal and state governments, alongside international development partners including the World Health Organization (WHO), UNICEF, the World Bank, Gavi, and other donor agencies, have invested billions of naira in upgrading health infrastructure, supplying medical equipment, training healthcare workers, and strengthening service delivery.
The Basic Healthcare Provision Fund (BHCPF), introduced under the National Health Act, was designed to channel dedicated funding towards strengthening primary healthcare facilities nationwide.
Similarly, the National Primary Health Care Development Agency (NPHCDA) has coordinated multiple interventions focused on expanding immunisation coverage, maternal healthcare, and improving access to essential medicines.
Despite these initiatives, implementation gaps continue to undermine expected outcomes.
Infrastructure Challenges Persist
Across many states, numerous PHCs suffer from dilapidated buildings, broken equipment, lack of electricity, poor water supply, inadequate sanitation, and shortages of essential medicines.
Some facilities reportedly operate only a few days each week because healthcare workers are unavailable or posted elsewhere.
Others lack qualified nurses, midwives, laboratory personnel, or community health extension workers, forcing patients to seek treatment in overcrowded secondary or tertiary hospitals.
Healthcare advocates note that many renovated facilities eventually deteriorate again because maintenance budgets are either insufficient or poorly managed.
Rural Communities Bear the Greatest Burden
The impact of dysfunctional PHCs is most severe in rural communities where secondary and tertiary hospitals may be located several kilometres away.
Pregnant women experiencing labour complications frequently face dangerous delays before reaching referral hospitals, while children suffering from malaria, diarrhoea, pneumonia, and other preventable diseases often miss timely treatment.
Health professionals argue that strengthening primary healthcare remains one of the most cost-effective ways to reduce maternal and child mortality while easing pressure on higher-level hospitals.
Calls for Greater Accountability
Public health experts have urged government authorities to move beyond announcing new projects and instead focus on ensuring that existing facilities remain functional.
They advocate stronger monitoring systems, transparent procurement processes, regular maintenance, adequate staffing, and improved supervision of healthcare infrastructure.
Analysts also recommend greater collaboration between federal, state, and local governments to prevent duplication of projects and ensure that resources reach intended beneficiaries.
Civil society organisations have repeatedly called for independent audits of healthcare spending to determine whether allocated funds are producing measurable improvements in service delivery.
Government Continues Reform Efforts
Federal health authorities have maintained that reforms are ongoing to strengthen Nigeria’s healthcare system.
The government has continued investments under the Nigeria Health Sector Renewal Investment Initiative, aimed at improving access to quality healthcare, expanding the health workforce, upgrading facilities, and enhancing service delivery nationwide.
Officials have also emphasised partnerships with development organisations to increase immunisation coverage, improve maternal health services, and strengthen disease surveillance through functional primary healthcare centres.
While these efforts have recorded progress in some states, stakeholders argue that implementation must become more consistent across all regions to achieve lasting improvements.
Experts Stress Importance of Functional PHCs
Public health specialists describe primary healthcare as the first point of contact between citizens and the health system.
A fully functional PHC network can significantly reduce hospital overcrowding, lower healthcare costs, improve disease prevention, and enhance emergency response at the community level.
Experts insist that Nigeria’s growing population makes investment in primary healthcare more urgent than ever, warning that continued neglect could further widen inequalities in healthcare access.
Looking Ahead
As Nigeria works towards achieving Universal Health Coverage and the Sustainable Development Goals, restoring non-functional Primary Healthcare Centres has become an urgent national priority.
Stakeholders believe that beyond increased funding, stronger accountability, transparent management, effective monitoring, and community participation will determine whether future investments deliver meaningful improvements.
For millions of Nigerians who depend on public healthcare services, particularly those living in underserved communities, the restoration of functional PHCs could mean the difference between accessible life-saving treatment and avoidable health crises.
Sources: Federal Ministry of Health and Social Welfare; National Primary Health Care Development Agency (NPHCDA); World Health Organization (WHO); UNICEF Nigeria; Nigeria Health Watch.
