Nigeria’s fragile healthcare system is facing renewed scrutiny following revelations that no fewer than 3,715 Primary Healthcare Centres across 19 states and the Federal Capital Territory are currently non-operational, raising concerns over access to lifesaving basic healthcare services for millions of citizens.
Findings from an analysis of the PHCs indicator dashboard of the National Primary Health Care Development Agency showed widespread inactivity of facilities meant to serve as the foundation of healthcare delivery, particularly in rural and underserved communities.
The data paints a troubling picture of Nigeria’s primary healthcare system, long regarded by health experts as the backbone of disease prevention, maternal care, immunisation and emergency first-response services.
According to the analysis, Katsina recorded the highest number of non-operational PHCs with 349 facilities lying dormant, while Osun followed closely with 326.
Other states with significant numbers of inactive PHCs include Kano with 279; Enugu with 268; Benue with 265; Delta with 246; Kogi with 230; Ogun with 227; and Adamawa with 225.
The dashboard also showed that Bauchi recorded 212 inactive PHCs, while Rivers had 205. Ondo recorded 198; Cross River had 172; and Yobe recorded 161.
Further analysis revealed that Edo had 146 non-operational facilities, while Borno recorded 120. Nasarawa had 115 inactive PHCs, Bayelsa recorded 100, while the FCT accounted for 62 dormant centres.
Primary Healthcare Centres represent the first point of contact for millions of Nigerians seeking medical attention, especially those in remote communities where access to general hospitals and specialist care is limited.
The centres are expected to provide essential health services including antenatal and postnatal care, immunisation for children, malaria treatment, tuberculosis screening, management of common illnesses, family planning, nutrition support, health education and disease surveillance.
PHCs are also central to Nigeria’s response to infectious disease outbreaks and public health emergencies.
During outbreaks of cholera, measles, meningitis and COVID-19, PHCs served as frontline centres for vaccination, awareness campaigns and case referrals.
Nigeria’s PHC system has struggled for decades with chronic underfunding, a shortage of skilled health workers, weak infrastructure, and a poor maintenance culture.
Several previous reports by health sector stakeholders have identified abandoned projects, lack of medical equipment, irregular electricity supply, inadequate water facilities and poor road access as recurring factors crippling healthcare centres nationwide.
In many communities, PHCs reportedly exist only in name, with buildings either deserted, partially completed or operating without qualified personnel and essential drugs.
Insecurity has also compounded the crisis in some northern states.
In insurgency-affected states such as Borno, Yobe, and parts of Adamawa, attacks on communities and the displacement of health workers have disrupted healthcare services over the years.
Flooding and environmental challenges have equally affected health facilities in riverine states, including Bayelsa and Rivers, where difficult terrain often limits access to healthcare infrastructure.
The Federal Government, through the NPHCDA, has, over the years, introduced several programmes aimed at revitalising primary healthcare delivery.
Among them is the Basic Health Care Provision Fund, designed to improve funding for essential health services at the grassroots level, as well as the policy drive to ensure at least one functional PHC in every political ward in the country.
Authorities have also launched periodic renovation and upgrade programmes targeting selected PHCs nationwide.
Despite these interventions, stakeholders say implementation gaps, delayed funding releases, poor accountability and inadequate monitoring continue to undermine progress.
