Over 6,500 Primary Healthcare Centres Non-Functional Across Nigeria, Despite Government Reporting Billions Spent

Reported by: Oahimire Omone Precious | Edited by: Oravbiere Osayomore Promise.

Despite years of federal and state government investments running into billions of naira to revitalise Nigeria's primary healthcare system, at least 6,516 Primary Healthcare Centres (PHCs) across the country remain non‑functional, exposing millions of Nigerians—particularly those in rural communities—to severely limited access to basic medical services. An analysis of data obtained from the National Primary Health Care Development Agency (NPHCDA) reveals that Katsina and Osun states account for the highest number of inactive facilities, while the crisis is even deeper in conflict‑ravaged Borno, where hundreds of PHCs destroyed by insurgency are yet to be rebuilt.

According to the NPHCDA Primary Health Care Dashboard, Katsina State tops the list with 442 non‑functional facilities, followed by Osun with 406, Benue with 343, Enugu with 335, and Adamawa with 286. Other states with significant numbers of inactive PHCs include Jigawa (282), Delta (278), Yobe (248), Lagos (246), Ogun (246), Bauchi (229), Edo (221), Rivers (218), and Borno (159). The list also includes Bayelsa (120), Kwara (87), the Federal Capital Territory (68), Nasarawa (58), Sokoto (45), Oyo (40), Niger (35), Imo (34), Kebbi (32), Cross River (30), Kano (26), Zamfara (23), Plateau (18), Kogi (14), and Akwa Ibom (10). These figures paint a grim picture of a healthcare system that continues to fail the majority of Nigerians at the grassroots level, where PHCs are meant to serve as the first point of contact for medical care.

However, separate findings indicate that the situation in Borno State may be significantly worse than reflected on the national dashboard. While the NPHCDA dashboard lists 159 non‑functional PHCs in the state, the Director of Community and Family Health at the Borno State Primary Health Care Development Board, Dr Mala Wahab, disclosed that 358 primary healthcare facilities were destroyed during more than a decade of Boko Haram insurgency. According to Wahab, Borno had 735 PHCs before the insurgency but now has only 377 functioning facilities. He credited the administration of Governor Babagana Zulum with increasing the number of operational PHCs from fewer than 100 to 377, with three additional facilities nearing completion. “Before insurgency, we had 735. Insurgency destroyed a lot of primary healthcare facilities,” he said. Despite these efforts, Wahab admitted that brain drain continued to undermine healthcare delivery, as the state had lost many workers, especially in hard‑to‑reach areas.

The report also reveals that beyond dilapidated infrastructure, chronic shortages of health workers, insecurity, poor funding, and weak maintenance continue to undermine years of revitalisation efforts. Health experts say several challenges continue to weaken primary healthcare services across Nigeria, including poor and aging infrastructure, a shortage of qualified healthcare workers, insecurity in affected communities, inadequate funding, weak maintenance culture, brain drain among medical professionals, lack of medicines and essential medical equipment, and limited electricity and water supply in many facilities. In Bauchi State, for instance, facilities rely heavily on unremunerated volunteer personnel to maintain basic operations due to severe shortages of permanent civil service staff.

The NPHCDA dashboard further indicates that Nigeria currently has 3,128 functional Level 2 PHCs, 3,275 revitalised PHCs, and 5,141 facilities supported through the Basic Health Care Provision Fund (BHCPF). However, these numbers fall far short of the estimated 34,076 PHCs across the country, meaning a significant majority remain either non‑functional or severely under‑resourced. Public health experts emphasise that physical renovation alone will not solve the crisis. They are calling for stronger governance, direct disbursement of the Basic Health Care Provision Fund to local facility levels, and improved welfare packages to retain healthcare professionals in rural areas.

State governments have responded with varying measures to address the gaps. Officials in Kano report the rehabilitation and equipping of 320 PHCs over the past three years alongside plans to recruit 7,000 healthcare workers. Similarly, Cross River and Anambra states have reported recent recruitment drives aimed at ensuring basic staffing levels across political wards. Zamfara State maintained that its PHCs remain operational despite security challenges but acknowledged a shortage of personnel. However, critics argue that these efforts are insufficient and lack the coordination and sustained funding necessary to reverse the decades‑old neglect of primary healthcare.

The consequences of this crisis are profound. Primary Healthcare Centres are meant to provide services such as routine immunisation, antenatal and postnatal care, childbirth support, treatment for malaria and common illnesses, family planning, nutrition programmes, tuberculosis and HIV screening, disease surveillance, health education, and referrals to higher‑level hospitals. When these facilities become non‑functional, residents are often forced to travel long distances for treatment or rely on unqualified healthcare providers, increasing the risk of preventable illnesses and deaths. The failure of PHCs also places an enormous burden on secondary and tertiary hospitals, which become overcrowded with patients who should have been treated at the primary level.

Over the years, the Federal Government has introduced several initiatives aimed at strengthening primary healthcare, including the Primary Health Care Revitalisation Programme, the Basic Health Care Provision Fund, and the PHC Under One Roof policy. The Tinubu administration has also announced plans to upgrade thousands of PHCs, recruit additional healthcare workers, improve access to medicines, expand digital health services, and increase funding for grassroots healthcare. However, the scale of the challenge far outstrips current interventions, and the persistence of over 6,500 non‑functional PHCs suggests that past efforts have failed to achieve their intended impact.

The revelation that over 6,500 primary healthcare centres remain non‑functional despite billions of naira in investment is a damning indictment of Nigeria's healthcare governance. It exposes the gap between policy pronouncements and on‑the‑ground realities, and it underscores the urgent need for a more accountable, transparent, and results‑oriented approach to health sector reform. For the millions of Nigerians who depend on these facilities for their most basic health needs, the crisis is not a matter of statistics but of life and death. Until the government addresses the root causes of the PHC crisis—poor funding, inadequate staffing, weak infrastructure, and insecurity—the dream of universal health coverage will remain a distant hope.

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