FG Urges States to Sustain Primary Healthcare Centres as Nigeria Reports Millions of Quarterly Visits

By Simpson Global Media News Desk

Government warns that renovation alone cannot guarantee lasting healthcare

The Federal Government has called on state and local governments across Nigeria to take greater responsibility for maintaining primary healthcare centres (PHCs), ensuring adequate staffing and keeping essential services operational after facilities have been renovated.

The appeal was made by the Executive Director and Chief Executive Officer of the National Primary Health Care Development Agency (NPHCDA), Dr Muyi Aina, during a quarterly media briefing in Abuja. He stressed that federal interventions are designed to strengthen the primary healthcare system, not permanently take over the responsibilities of the authorities expected to operate facilities at the state and community levels. <Cite refs={["turn936116search1","turn936116search4"]}/>

The warning comes amid a nationwide programme to rehabilitate primary healthcare facilities and improve access to basic medical services. The government has reported progress in renovating centres, expanding healthcare attendance and connecting pregnant women with maternal services. However, officials say the sustainability of these investments depends on what happens after construction work is completed and facilities are handed over.

For patients, that distinction is fundamental. A renovated building does not automatically guarantee that a nurse will be available, essential medicines will be in stock, electricity and water will be dependable, or a patient requiring emergency treatment will be referred promptly to a better-equipped hospital.

The government’s message therefore places attention on the practical requirements of running a clinic every day: budgets for routine maintenance, permanent health workers, medical supplies, equipment servicing and effective supervision.

More than 4,400 facilities included in revitalisation drive

According to figures reported by the NPHCDA, the federal government’s wider revitalisation programme has covered 4,434 primary healthcare facilities nationwide.

At the October briefing, Aina said 3,526 facilities had been renovated, commissioned and handed over to state governments or other relevant authorities, while work was continuing at additional centres. Other reports on the briefing described refurbishment or construction activity at 908 facilities. The figures distinguish the overall programme from facilities already completed and handed over; they should not be read as meaning that every centre in the programme is fully operational. <Cite refs={["turn936116search4","turn936116search8","turn936116search15"]}/>

The initiative is intended to improve access to essential healthcare, particularly in communities where public facilities have been in poor condition or where residents face long journeys to reach medical services.

Primary healthcare centres are often the first point of contact for families seeking treatment for common illnesses, immunisation for children, antenatal services, family planning, health education and screening for conditions that can become more serious when diagnosis is delayed.

Aina said the agency’s role includes providing technical direction, setting standards and supporting the development of the primary healthcare system. Day-to-day service delivery and facility maintenance, however, require action by state and local governments.

The appeal is significant because capital investment and recurrent spending serve different purposes. Capital funding can renovate a building, install equipment or provide infrastructure. Recurrent spending is needed to keep the facility operating: salaries, cleaning, electricity, water, essential supplies, repairs and the replacement of worn-out equipment.

Without that continuing expenditure, a centre that initially appears improved may struggle to maintain services over time.

Permanent health workers identified as a priority

Staffing is another major issue raised by the NPHCDA chief executive. Aina urged state authorities to recruit health workers permanently rather than rely heavily on temporary appointments.

The availability of trained personnel influences whether a clinic can provide dependable services throughout the week, including during busy periods and emergencies. Even when equipment and buildings are in place, a shortage of nurses, midwives, community health workers or other essential personnel can limit what patients receive.

Permanent recruitment can also help facilities maintain continuity. Staff who remain in a community over time may become familiar with local health needs, follow up with patients and build relationships that encourage residents to seek care before illnesses become severe.

But recruitment alone is not enough. Health workers also need appropriate supervision, continuing training, safe working conditions, essential medicines and functioning equipment. Rural and underserved locations may face additional difficulties attracting and retaining staff, particularly where accommodation, transport or other basic amenities are limited.

Aina said approval had been secured to use the human-resources-for-health component of the Basic Health Care Provision Fund (BHCPF) as an incentive to encourage states to recruit health workers permanently. The arrangement is intended to support staffing, but its effectiveness will depend on how states implement recruitment plans and sustain the associated costs. <Cite refs={["turn936116search1","turn936116search4"]}/>

The appeal also highlights the need for clear accountability. Residents need to know which authority is responsible when a facility lacks staff, remains closed or has equipment that cannot be used. Federal programmes, state health ministries, local government authorities and facility managers must coordinate their responsibilities rather than leave gaps between construction, handover and operation.

Quarterly healthcare visits rise to between 43 million and 45 million

The NPHCDA has also reported an increase in the use of primary healthcare services. Aina said quarterly service contacts had grown from approximately 33 million to 34 million when the agency began tracking the current reform effort to between 43 million and 45 million in more recent reporting periods. Service contacts reportedly peaked at about 46 million in 2025. <Cite refs={["turn936116search0","turn936116search2","turn936116search15"]}/>

The figures cover contacts across different services and should not automatically be interpreted as the number of unique individuals treated. One person may visit a facility more than once, while a single contact may involve immunisation, antenatal care or another service.

Even with that qualification, the reported increase suggests that primary healthcare facilities are handling a substantial volume of activity. It also increases the importance of ensuring that buildings, staff, supplies and referral arrangements can meet demand.

A rise in attendance can be encouraging when it reflects improved access and greater public confidence. It can also place pressure on clinics if investment in personnel and supplies does not keep pace with patient numbers.

Facilities need sufficient capacity to serve children requiring routine vaccinations, pregnant women attending antenatal appointments, patients seeking treatment for common infections and adults needing checks for conditions such as hypertension or diabetes.

The central challenge is to ensure that more visits translate into timely, effective care rather than longer queues or repeated journeys caused by unavailable medicines, absent staff or non-functioning equipment.

The reported attendance figures are government-reported programme indicators. They do not, by themselves, establish that every community has adequate access or that health outcomes have improved equally across all states.

Maternal and newborn care remains a key focus

A related development is the government’s effort to connect pregnant women with primary healthcare facilities and provide support throughout pregnancy, childbirth and the immediate postnatal period.

Aina said more than 773,000 pregnant women had been linked to care under the Maternal and Newborn Mortality Reduction Initiative, known as MAMI, across programme areas. Reports on the briefing said the initiative was being implemented in 172 local government areas across 33 states. <Cite refs={["turn936116search0","turn936116search19"]}/>

The programme is designed to provide more continuous support rather than treat antenatal appointments, delivery and postnatal checks as unrelated events. It can involve connecting women with caseworkers, ensuring that necessary investigations are conducted and directing high-risk pregnancies to facilities equipped to manage complications.

The approach is important because pregnancy-related emergencies can develop quickly. Severe bleeding, high blood pressure, infection and obstructed labour may require urgent medical intervention. Identifying risks early and establishing a clear referral pathway can help families reach appropriate care without avoidable delays.

The initiative also illustrates why primary healthcare centres need reliable links with hospitals that can provide more advanced treatment. A community clinic may deliver essential routine services, but it must be able to recognise when a patient needs emergency obstetric care, specialist assessment or a higher level of monitoring.

The number of women linked to care is an important measure of programme reach. It is not, on its own, proof that every woman received every recommended service or that a particular number of deaths was prevented. Assessing the programme’s overall impact requires additional evidence about the quality and continuity of care, referrals, birth outcomes and maternal and newborn survival.

For the programme to achieve its intended purpose, women must be able to attend appointments, obtain necessary tests, access skilled birth attendants and reach suitable facilities when complications arise.

Federal support and state responsibility must work together

Nigeria’s primary healthcare system relies on several levels of government and a range of partners. Federal authorities can establish standards, coordinate national programmes and support infrastructure, while state and local authorities have essential roles in managing facilities, deploying staff and ensuring services continue.

Aina’s appeal reflects the challenge of turning this shared structure into a consistent service for patients. If one authority renovates a facility but another does not provide adequate operating funds, the public may see a completed building without the full range of services it was intended to deliver.

The NPHCDA has also said that more than 500 primary healthcare centres were directly re-equipped by the agency, distinguishing that work from the broader revitalisation programme involving federal and state governments, development partners and private-sector participants. <Cite refs={["turn936116search1","turn936116search7"]}/>

The distinction matters when progress is assessed. A facility may have been included in a renovation programme, but its current performance must be judged by whether patients can actually receive care there.

A useful assessment would examine whether a centre is open during its expected hours, whether essential staff are present, whether basic medicines and supplies are available, and whether equipment is functional. It would also consider the facility’s ability to provide immunisation, antenatal care, common illness treatment and referral services appropriate to its level.

Public reporting that separates facilities under construction, completed, handed over, staffed and fully operational would help residents understand what has been achieved and where further action is needed.

What communities should expect from a functioning PHC

Primary healthcare centres are meant to provide accessible, essential services close to where people live. Their responsibilities vary according to their level and available resources, but effective services generally depend on a reliable combination of staff, supplies, preventive care and referral arrangements.

For families, a functioning centre can make it easier to obtain childhood immunisation, seek early advice for illness, receive antenatal care and get information on preventing disease. For older adults, primary care can offer opportunities to check blood pressure, identify health risks and obtain guidance on managing long-term conditions.

Preventive services are particularly important because many serious health problems become more difficult and expensive to treat when diagnosis is delayed. A centre that is accessible and trusted can help people seek care earlier, when treatment may be more straightforward.

However, the public cannot judge service quality from a building’s appearance alone. A recently renovated clinic may still face shortages, while an older facility may deliver useful services if it is properly staffed and supported.

Community feedback can help identify gaps, but complaints and individual experiences should be considered alongside routine inspections and service data. Authorities need systems for receiving reports about facility closures, medicine shortages, broken equipment and staff availability—and for documenting how those problems are resolved.

The government’s latest appeal creates an opportunity for states and local authorities to demonstrate how they intend to maintain the facilities handed over to them. That could include publishing maintenance plans, setting staffing targets, monitoring essential medicine availability and reporting the operational status of centres.

Funding must be measured by the services it sustains

The Basic Health Care Provision Fund is one of the mechanisms through which Nigeria supports primary healthcare. Its human-resources component is especially relevant to the current appeal because staffing is a recurring requirement, not a one-off construction expense.

For state governments, a sustainable plan needs to account for salaries and other operating costs alongside infrastructure. A centre requires regular upkeep even when no major renovation is planned. Roofs, plumbing, power systems, water supplies, cold-chain equipment and medical devices all need attention over time.

The challenge is also one of fairness. Communities with limited access to hospitals may depend more heavily on local clinics, yet those communities can struggle when staff and supplies are concentrated in larger urban centres.

A practical funding approach should therefore consider local population needs, travel distances, disease burden and the capacity of nearby referral facilities. Transparent allocation and reporting can help residents and oversight bodies determine whether resources are reaching the communities most in need.

The federal government’s request for greater subnational investment does not remove the need for coordination at national level. Instead, it underlines that long-term progress depends on different authorities carrying out their roles and sharing information about what is working.

The test will be reliable care, not only completed projects

The reported revitalisation of thousands of primary healthcare facilities and the rise in quarterly service contacts represent important indicators of activity. But the long-term value of the investment will depend on whether the facilities remain open, adequately staffed and capable of meeting patients’ needs.

The NPHCDA’s appeal places responsibility on state and local governments to sustain the gains made through renovation and other interventions. Permanent recruitment, maintenance budgets, dependable supplies and effective oversight will be essential to turning those gains into routine healthcare.

The reported connection of more than 773,000 pregnant women to care also highlights the importance of continuity—from antenatal services to delivery and postnatal support. That continuity requires functioning primary healthcare centres and referral systems capable of responding when a pregnancy becomes high-risk.

For Nigerians, the most meaningful measure of progress is whether a person arriving at a local clinic can receive appropriate attention without avoidable delays, whether a child can obtain recommended immunisations, and whether a pregnant woman can access skilled care and emergency referral when necessary.

The federal government has urged states to take greater responsibility for keeping primary healthcare facilities operational. The next stage is to show, through transparent reporting and consistent service delivery, that renovated centres are not simply completed projects but dependable public health services for the communities they serve.