Morganable News / Communities
A new field investigation has exposed major gaps in Nigeria’s primary healthcare system, with only 22 of 290 facilities listed as revitalised found to have functional ambulances across six states.
Lagos —
A new field investigation has raised concerns about the readiness of primary healthcare centres (PHCs) listed as revitalised across six Nigerian states, with many facilities still lacking key equipment, services and emergency support.
The investigation by Orodata Science assessed 290 PHCs in Abia, Benue, Cross River, Kano, Osun and Taraba states. Researchers physically visited the facilities to compare government records with conditions on the ground.
The assessment examined infrastructure, water supply, electricity, staffing, equipment, services, accessibility and emergency response capacity.
One of the most striking findings was that only 22 of the 290 facilities had functional ambulances.
The finding is important because PHCs often serve as the first point of contact for residents, especially in rural and underserved communities. When a patient requires treatment beyond what a PHC can provide, a functional referral system can make a major difference.
Without an ambulance or another reliable emergency transport arrangement, patients may have to depend on family members, commercial vehicles or other options to reach a larger hospital.
This can cause delays, particularly when a patient requires urgent attention.
The investigation also found a major gap between facilities listed as revitalised and their actual condition.
According to the findings, only 85 of the 290 facilities met the benchmark used to assess whether a PHC qualified as revitalised. Another 170 partially met the benchmark, while 35 did not meet it.
The assessment therefore found that only about 29 per cent of the facilities met the required standard.
The researchers also identified problems with facilities where work was reported as completed.
Of the 153 facilities recorded as having completed work, 73 had visible defects. These included structural problems, poor finishing and faulty standard installations.
The investigation further showed that 91 facilities were either not started, stalled, abandoned or completed but not put into use.
Specifically, 17 facilities had not been started, 21 were stalled, five had been completed but remained locked or unused, while other facilities were affected by abandonment or delays.
These findings raise questions about the effectiveness of healthcare infrastructure projects after funds have been allocated and projects announced.
For communities, the issue is not simply whether a health centre has a renovated building. A functional PHC also needs adequate health workers, essential medicines, working equipment, electricity, water and a system for handling referrals.
A facility can therefore look new while still being unable to provide the services residents expect.
The organisation said the latest assessment used physical visits, photographs, geocoding, interviews with health workers and community members, and direct observation to document the conditions of the facilities.
The latest assessment shows why such field verification can be important.
When government records describe a facility as revitalised, residents may reasonably expect better healthcare services. If the facility is still poorly equipped or not fully operational, however, the community may continue to face the same healthcare challenges.
The investigation also identified equipment and supplies, as well as construction and renovation, as some of the weakest areas.
The shortage of functional ambulances adds another layer to the problem.
Emergency transportation is particularly important for pregnant women, children, accident victims and patients with serious illnesses. Delays in moving such patients from a PHC to a specialised facility can increase the risk of complications.
The situation can also place pressure on families. When local health facilities cannot provide adequate care, families may have to travel farther and spend more money seeking treatment. For low-income households, transportation costs can become another barrier to healthcare.
The findings also raised concerns about funding and accountability.
According to the investigation, 53 of the facilities listed as revitalised had no intervention at all, while 43 facilities had five or more funders.
The organisation said multiple funding sources could make accountability more difficult because it may become harder to establish which organisation was responsible for specific work.
The organisation called for greater transparency around PHC revitalisation, including the publication of contracts and payment records, as well as physical verification of completed projects.
It also urged communities, journalists and oversight bodies to demand information about facilities listed as revitalised.
Residents can observe whether a health centre is open, whether health workers are available and whether essential services are actually being provided.
Government officials who responded to the findings also provided context about funding and healthcare development.
The Executive Secretary of the Osun State Primary Health Care Development Board, Dr Shina Igbalaye, said not all PHCs were supported through the Basic Health Care Provision Fund.
He explained that Osun had about 800 PHCs, but only 332 were supported through the fund, leaving more than 500 dependent on state and local government funding.
The findings show that improving primary healthcare requires cooperation among federal, state and local authorities, development partners, health workers and communities.
Infrastructure is necessary, but it must be supported by funding, equipment and human resources.
Ultimately, the latest findings highlight the difference between completing a project on paper and making a healthcare facility work for the people it serves.
A revitalised PHC should mean more than a renovated building. It should mean that residents can walk into the facility and receive timely, safe and appropriate care.
For communities across Nigeria, the expectation is straightforward: public healthcare investments should produce visible improvements in the quality and accessibility of care.
The 290 facilities assessed by Orodata show that there is still a gap to close.
Bridging that gap will require stronger accountability, proper equipment, adequate staffing and sustained funding.
Most importantly, success should be measured by the people who use these facilities.
When a sick child receives treatment close to home, when a pregnant woman can access essential care and when an emergency patient can be transferred quickly, the value of PHC investment becomes clear.
Until then, revitalisation figures will remain incomplete without evidence that communities are actually receiving the healthcare services promised to them.
