By Fatima Saka
A severe shortage of frontline health workers is undermining primary healthcare delivery in Nigeria, with only three per cent of 1,480 assessed Primary Healthcare Centres (PHCs) across 16 states meeting the national minimum staffing standard.
The finding is contained in the PHC Operational Capability Report produced by Orodata Science after assessing facilities across 277 Local Government Areas in Nigeria’s six geopolitical zones.
The assessment, conducted between October 2023 and June 2025 using the CheckMyPHC Digital Scorecard, examined staffing, infrastructure, equipment, electricity, water supply and accessibility across the facilities.
According to the report, 11 of the 16 states assessed had no PHC that met the minimum staffing requirement, highlighting what it described as a major capacity gap at the frontline of the country’s healthcare system.
The report further showed that about 75 per cent of the assessed PHCs were located in rural communities, where shortages of health workers and basic infrastructure could have greater consequences for vulnerable populations.
Beyond staffing, the assessment exposed widespread deficiencies in the physical and operational condition of the facilities.
It found that 40 per cent of the PHCs had broken ceilings or leaking roofs, while 38 per cent operated without electricity and 39 per cent relied on unsafe sources of water.
The report also raised concerns over maternal and newborn care, revealing that 75 per cent of the facilities lacked essential neonatal resuscitation equipment needed to provide emergency care to newborns experiencing complications during childbirth.
It added that 66 per cent of the PHCs lacked accessibility provisions for persons with disabilities and people with mobility challenges.
Orodata said the deficiencies were interconnected, with poor infrastructure, inadequate staffing, unreliable power and water supply, limited medical equipment and accessibility barriers frequently occurring within the same facilities.
According to the organisation, the combination of these challenges could increase risks to patients while placing additional pressure on already overstretched health workers.
The assessment also captured the experiences of communities using the facilities, with 51 per cent of surveyed community members rating services at their local PHCs as poor.
It noted significant variations across states, with some locations recording challenges considerably worse than the overall assessment figures.
Kano and Sokoto were identified as having particularly serious challenges involving unsafe water, inadequate electricity and shortages of essential newborn-care equipment.
Gombe, the report added, recorded an 80 per cent rate of PHCs without accessibility provisions.
Orodata said the findings demonstrated that strengthening primary healthcare required more than isolated renovation projects, stressing the need for coordinated interventions based on verified facility-level data.
It recommended that state governments develop clear intervention plans specifying affected facilities, identified problems, responsible institutions, required resources and implementation timelines.
The organisation also called for measurable targets, regular monitoring and evaluation, accessibility-compliant renovations and the integration of community feedback into monitoring processes.
It urged authorities to urgently repair damaged roofs and ceilings, provide safe water and improve electricity supply to affected facilities.
For PHCs without reliable grid electricity, the report recommended the deployment of solar or hybrid power systems to ensure continuity of essential healthcare services.
On staffing, Orodata urged the National Primary Health Care Development Agency (NPHCDA) and state PHC agencies to address frontline health-worker shortages through recruitment, effective deployment and retention, particularly in underserved communities.
It further called for all PHCs offering delivery services to be equipped with essential neonatal resuscitation equipment.
The assessment involved physical visits to facilities, direct observation, interviews with health workers and community members, photographs, GPS coordinates and reviews of facility records.
Orodata said the CheckMyPHC Digital Scorecard was developed with reference to NPHCDA minimum standards and relevant inclusion requirements.
It explained that the exercise was designed not merely to document deficiencies but to generate facility-level evidence that could guide implementation, resource allocation and monitoring of interventions.
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The organisation stressed that investment decisions in primary healthcare should be based on verified needs rather than assumptions.
It said the ultimate measure of progress should be whether PHCs become safer, adequately staffed, properly equipped, functional and trusted by the communities they serve.
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