A recent visit by BusinessDay to Primary Healthcare Centres (PHCs) across Nigeria's Federal Capital Territory (FCT), Plateau, and Kano states revealed that many facilities are struggling to provide basic maternal care due to staff shortages, lack of equipment, and inadequate infrastructure. Hannatu Yakubu, a resident, recounted her experience of having to travel by motorcycle at night to deliver her baby because the PHC serving her community had stopped functioning. Her situation is not isolated, as many women face similar challenges in accessing reliable maternal care.
BusinessDay's visits to PHCs in the FCT, Kano, and Plateau states found that many facilities exist but lack the necessary staff, electricity, equipment, and emergency referral systems to provide effective care. At Alayita PHC in Abuja, patients waited for hours for basic care due to a shortage of health workers, with only seven workers on the facility's payroll and about 80 percent of workers being volunteers. This shortage has resulted in long wait times and difficulties in obtaining care, particularly at night or during emergencies.
Jama Medan, chairman of the National Association of Nigerian Nurses and Midwives (NANNM) FCT chapter, attributed the shortage of health workers to the last recruitment into PHCs by the FCT Area Councils, which took place in 2008. He emphasized that investing in buildings and equipment would have limited effect without enough skilled workers to operate the facilities. Medan also highlighted poor roads, insecurity, and the absence of basic amenities like water, electricity, and suitable accommodation as factors discouraging health workers from accepting postings in remote communities.
The lack of ambulances at PHCs also hampers emergency referrals, with one worker at Alayita PHC stating that an ambulance based at the AMAC headquarters could be requested through a WhatsApp group when needed. However, this centralized arrangement can delay emergency responses, particularly from communities far from where an ambulance is stationed. Medan noted that such delays can be life-threatening, with responses taking up to four hours.
Despite government commitments to address these challenges, the situation at many PHCs remains dire. In 2025, Muyi Aina, Executive Director and Chief Executive Officer of the National Primary Health Care Development Agency (NPHCDA), announced plans to prioritize workforce development, with a target of deploying at least four skilled birth attendants to every functional PHC. The previous year, the government disbursed about N45 billion directly to PHCs across the country through the Basic Health Care Provision Fund (BHCPF).
However, BusinessDay's visits to PHCs revealed that power failures persist, leaving facilities relying on lanterns or torchlights. At Piwoyi PHC in AMAC, pregnant women received antenatal care in a facility without electricity, water, or adequate security. A staff member noted that the facility could conduct basic tests but referred cases beyond its capacity to Kuje General Hospital. Residents also described damaged floors, poorly maintained infrastructure, and equipment that workers said was no longer functioning.
The decay of PHCs has persisted across different periods of government, with residents recounting their experiences of seeking care in dilapidated facilities. Fatima Usman registered at her local PHC but also registered at Wuse General Hospital due to fears of complications. Johnson Emmanuel, another resident, noted that pregnant women in his community now travel to a neighboring community for antenatal care and delivery due to the deterioration of their local PHC.
Key points
- Many Nigerian PHCs lack staff, equipment, and electricity, straining maternal care.
- The shortage of health workers in PHCs has resulted in long wait times and difficulties in obtaining care.
- Despite government commitments, the situation at many PHCs remains dire, with power failures and infrastructure decay persisting.
