Reported by: Ijeoma G | Edited by: Oravbiere Osayomore Promise.
Communities across Akwa‑Ibom State are confronting a deepening public health crisis as many primary healthcare centres (PHCs) — the frontline of Nigeria’s rural health system — continue to deteriorate, leaving residents with limited or no access to essential medical care. The unfolding situation has exposed structural weaknesses in the state’s health infrastructure, threatening the wellbeing of vulnerable populations, particularly women, children and the elderly.
In Odorikot, a rural community in Ikot Inyang Okop, Mkpat Enin Local Government Area, the local PHC serves as the only accessible health facility for several surrounding settlements. Yet health workers there struggle daily with the facility’s poor condition. The centre lacks basic equipment such as a refrigerator necessary for storing vaccines. To administer routine immunisations, health workers must undertake arduous journeys to nearby communities just to obtain ice blocks for preserving vaccines. The road to the facility itself is nearly impassable, further complicating efforts to deliver basic services to those in need.
Despite some visible upgrades and modern beds, many PHCs in the state fall far short of standards set by the National Primary Health Care Development Agency, which stipulates requirements for functional buildings, equipment, sanitation, reliable power and trained staff. Due to chronic neglect, many centres lack consistent electricity, clean water and even essential medical supplies. In some communities, the PHC buildings remain structurally unsound, discouraging patients from seeking care and undermining confidence in the public health system.
Across rural Akwa‑Ibom, the decay of PHCs has wide‑ranging consequences. Mothers in labour, infants needing immunisation, and patients with common illnesses are often forced to travel long distances to reach secondary or tertiary facilities in urban centres such as Uyo or Eket. These trips can be costly, time‑consuming and dangerous for those in urgent need of care. For families without reliable transportation or sufficient financial resources, delays in care can mean the difference between life and death.
The primary healthcare crisis in Akwa‑Ibom mirrors broader challenges in Nigeria’s health sector. Pregnant women and newborns in rural southern states often face heightened mortality risk because local PHCs lack electricity, essential drugs, skilled personnel and operational referral systems. Faulty funding mechanisms, weak governance, and inadequate oversight of health resources further exacerbate these failures, leaving the most vulnerable at the mercy of an overstretched system.
Healthcare workers within these dilapidated centres also operate under tremendous strain. Many are compelled to use their own meagre salaries to keep services running, purchasing basic supplies just to serve their communities. The chronic underfunding of the sector means that even when federal initiatives aim to improve rural health services, implementation gaps limit their impact, particularly in far‑flung communities.
Community leaders have repeatedly appealed to state and federal authorities to prioritise the rehabilitation and equipping of PHCs. They argue that revitalising primary healthcare is not only morally imperative but also crucial for reducing pressure on higher‑level hospitals, improving health outcomes, and supporting economic productivity through healthier populations. Without functioning PHCs, disease prevention and control — from routine immunisations to early detection of infections — becomes significantly harder, eroding progress on public health goals.
Public health experts emphasise that the primary healthcare system is the foundation of any resilient health structure. When PHCs fail, so do efforts to achieve universal access to care and tackle endemic health challenges such as maternal and infant mortality, malaria, tuberculosis and outbreaks of infectious diseases. In many parts of Akwa‑Ibom, ineffective PHCs have forced residents to rely on under‑resourced general hospitals or traditional healers. This shift often delays treatment and contributes to avoidable deaths and long‑term disabilities.
There have been intermittent efforts to address these problems. Some state health initiatives, occasionally supported by external partners, have sought to renovate selected PHCs. However, these actions have been piecemeal and uneven, with many facilities still in a state of disrepair. Advocates say a comprehensive, well‑financed strategy is needed, one that not only repairs buildings but also ensures adequate staffing, stable power, clean water, and regular supply of medicines.
Experts and civil society groups also call for greater transparency and accountability in the management of health funds. Without clear reporting and community engagement, it is difficult for citizens to hold officials responsible for the persistent neglect of foundational health services. Increased public participation and independent monitoring would help ensure that allocated resources translate into tangible improvements in healthcare delivery.
As Akwa‑Ibom’s rural communities contend with the consequences of neglected health infrastructure, the plight of those dependent on dysfunctional primary healthcare centres underscores a broader national challenge — one that demands concerted policy action, sustained investment, and an unwavering commitment from government, health professionals, and community stakeholders alike to ensure that no community is left without access to basic medical care.
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