Nigeria: Why primary healthcare centres not functioning

•Weak diagnostics, poor staffing turn preventable deaths into daily tragedies —Ifeanyi

Twenty eight-year-old Aisha Sani went into labour in a small community on the outskirts of Benue, only to find the nearest primary healthcare centre locked, no nurse, no midwife, and no drugs. Her tragedy reflects the very real challenges the 2026 World Health Day tagged: "Together for Health: Stand with Science", seeks to address, Good Health Weekly reports.

It is no longer news that millions of Nigerians remain without access to basic, life-saving care. But the cost of human life remains an important daily question that remained unanswered.

For Aisha, her case will always remind thousands of Nigerians of the popular slang, "Nigeria has happened to you". 

 By the time her family reached a private clinic, miles away, it was too late. Aisha and her baby did not survive. Her death was not caused as the result of something far more common in Nigeria's fragile health system, lack of access to science-backed care.

Similarly, in rural Sokoto, 37-year-old farmer Garuba Musa lost his 8-year-old son, to what doctors later confirmed was a treatable bacterial infection. Musa had first taken Ahmed to the local PHC, only to find the building empty. 

"I carried him on my back for hours to reach the nearest hospital. By the time we got there, he was already gone," Garuba recounted. 

Aisha and Musa's stories revealed thousands of similar tragedies across the country, underscoring how geography and poverty can determine whether a child lives or dies.

These human stories illustrate the stark reality that, while medical science exists in Nigeria, access to timely, effective care remains limited for the most vulnerable, precisely the gap World Health Day seeks to spotlight.  

Across Nigeria, a country with no shortage of trained professionals, medical knowledge, or global health partnerships, millions remain cut off from essential healthcare. Science is advancing, but access is collapsing. 

Despite progress in disease control championed by institutions such as the Nigeria Centre for Disease Control and the Nigeria Institute of Medical Research, NIMR, the reality at the grassroots tells a different story, one of neglect, inequality, underfunding, and a widening gap between science and the people who need it most.

In communities across the 774 local government areas, Nigerians remain cut off from even the most basic healthcare.

Science without access

According to a public health expert, Dr. Casmier Ifeanyi, preventable conditions such as malaria, typhoid, Lassa fever, hypertension-related complications, and maternal and neonatal infections remain leading causes of death largely because diagnosis is weak or absent.

"Febrile illnesses are often assumed to be malaria, leading to misdiagnosis of typhoid or bacterial infections, delayed treatment, and avoidable deaths," he said, citing poor disease surveillance and limited diagnostic infrastructure.

He added that the crisis is both financial and systemic. "Chronic underfunding limits infrastructure, equipment, and workforce expansion. Yet poor management compounds the problem, misallocation of funds, lack of maintenance, weak supply chains, and underutilised laboratory services mean that even limited resources are not optimised. When healthcare becomes guesswork, lives are lost."

Primary healthcare centres, PHCs, designed to serve as the first point of contact, are in many cases non-functional. Facilities lack electricity, running water, essential drugs, and qualified personnel.

Nigeria's health financing remains critically low. In the 2025 federal budget, only about 5.2 per cent of the N47.9 trillion budget was allocated to health, far below the 15 per cent Abuja Declaration target. Of the N218 billion allocated for operational and capital projects, only N36 million was released.

Nigeria also bears one of the heaviest maternal health burdens globally. WHO estimates the country accounts for close to one-fifth (about 20 per cent) of global maternal deaths. Between 50,000 and 75,000 women die annually from pregnancy-related causes, most preventable with timely access to quality healthcare. That translates to roughly one death every seven minutes.

Despite recent improvements in facility-based maternal deaths, experts warn the gains remain fragile.

"We know what works medically. The tragedy is that many Nigerians cannot access it. Nigeria does not lack knowledge. What we lack is the system to deliver it," Dr Casmier Ifeanyi.

Primary healthcare in name, not function

While the world talks about Universal Health Coverage, experts say PHCs, the backbone of Nigeria's health system, are failing across the country. Many lack staff, equipment, and essential drugs. Even where facilities exist, they are often locked, understaffed, or unable to respond to emergencies.

Ifeanyi said one of the most critical gaps is diagnostic capacity. "The majority of PHCs lack basic laboratory testing components. Without reliable power, water, reagents, and trained personnel, diagnosis cannot happen," he said.

"When laboratories are non-existent or run out of reagents, diagnosis stops. And when diagnosis stops, treatment becomes blind. These are not minor lapses; they are life-threatening failures. Too many patients are treated based on assumptions rather than evidence. That is not care. That is risk."

He added that infrastructure gaps remain a major barrier. "No laboratory can function in darkness or without water. Power and water are not amenities, they are fundamental to healthcare delivery."

Inequality: A death sentence for the poor

For wealthy Nigerians, quality healthcare is often just a flight away. For the poor, even basic treatment is out of reach. Access to care is deeply unequal, often determined by income and location. Women in poorer households are far less likely to access antenatal care or skilled birth services. In parts of northern Nigeria, a woman is up to 10 times more likely to die during childbirth than her southern counterpart.

"Where you live and how much you earn often determine whether you live or die. That should never happen in a system that claims to stand with science," said Lagos patient Mrs. Grace Obong. Ifeanyi added that inequality is a major driver of preventable deaths. 

"People in rural areas rely on under-resourced clinics or self-medication. Low-income patients cannot afford tests, while others access faster care. This gap is costing lives."

Brain drain, empty clinics

Nigeria's healthcare workforce continues to shrink as professionals migrate abroad, leaving rural clinics abandoned and urban hospitals overwhelmed. A senior nurse at a Lagos PHC, who spoke anonymously, said: "We are exhausted. Too many patients, too few hands, and in some places, no one at all. Many doctors and nurses have left the service."

Confirming this, the Registrar of the Medical and Dental Council of Nigeria, Dr. Fatimah Kyari, revealed that thousands of newly registered doctors are already seeking opportunities abroad, mostly in the United Kingdom and Canada.

Ifeanyi warned that this exodus is crippling diagnostic services. "Many trained professionals are leaving, creating dangerous gaps. This leads to delays, compromised quality, and missed disease surveillance opportunities. Retaining skilled workers is not a luxury, it is a necessity."

System at risk

Beyond workforce and funding challenges, Ifeanyi raised concerns about weakening professional standards. "Any policy that undermines regulation in medical laboratory science is dangerous. When standards fall, patient safety collapses."

He called for urgent reforms: fixing supply chains, strengthening infrastructure, expanding access, and equipping medical laboratories with essential tools, reagents, power, and trained staff.

"A laboratory test should never be a privilege. It is the foundation of proper care. If we get this right, primary healthcare can move from guesswork to precision, from delays to timely care, and from preventable deaths to saved lives. Anything less means we will continue to pay with lives."

As Nigeria continues to battle preventable diseases, maternal deaths, and rising health inequalities, one question remains: if science can save lives, why is it not reaching the people? 

Until that gap is closed, the promise of "Together for Health" may remain nothing more than a slogan, far removed from the daily realities of millions of Nigerians.

Culled from Vanguard