Urgent Reforms Needed to Strengthen Nigeria’s Primary Health Care System
Health officials in Nigeria are advocating for immediate grassroots-led reforms to enhance the country’s primary health care (PHC) system. They caution that inadequate accountability measures and insufficient community involvement are hampering health service delivery nationwide.
This urgent call to action emerged during a policy dialogue titled “SCAPP Experience: Building Responsible PHC Systems from the Ground Up,” organized by the Health Sector Reform Coalition in partnership with BudgetIT and various development partners.
Conference participants noted that primary health centers, which serve as the first point of contact for millions of Nigerians—especially in rural areas—are plagued by chronic underfunding, poor infrastructure, a shortage of health professionals, and inconsistent access to essential medicines.
Salma Ibrahim Anas, Special Assistant to the President on Health, reaffirmed the federal government’s commitment to strengthening the PHC sector under the “New Hope” health agenda. She emphasized the fundamental role of primary health care, stating, “A collapse at the grassroots level puts a strain on the entire health care system.”
She highlighted that the government is increasing financial support for primary health care through the Basic Healthcare Delivery Fund (BHCPF), stressing that financial investments must be paired with transparency and accountability. “Resources allocated to health care must directly impact communities, improving the quality of services available to ordinary Nigerians,” she added.
Dr. Kolawole Oluwafemi, Executive Director of the Health Sector Reform Coalition, also stressed the importance of enhancing public involvement in the management of health facilities. He asserted that communities should not be seen as mere beneficiaries but as active participants who monitor health care delivery and hold officials accountable.
Despite repeated budget allocations, many primary health centers nationwide remain in disrepair, according to Mr. Oluwafemi. He pointed out that empowering the public with information and surveillance tools is essential for combating corruption, improving service delivery, and restoring trust in the health system.
Gabriel Okeowo, the BudgetIT Country Director, echoed these sentiments, stating that data transparency and community engagement are crucial for addressing Nigeria’s dysfunctional PHC system. “Health care reform cannot succeed without accountability. The public needs insight into how funds are utilized and whether health facilities are adequately funded,” he remarked. He noted that, despite various government initiatives, many rural areas still lack basic health services.
Representatives from civil society organizations and development partners present at the meeting expressed alarm over rising maternal and child mortality rates, attributing these challenges to the poor condition of primary health facilities. They urged state and local governments to prioritize health funding, hire additional frontline workers, and enhance monitoring systems to ensure effective service delivery.
Stakeholders concluded that revitalizing Nigeria’s primary healthcare system is critical for achieving universal health coverage and alleviating the burden on secondary and tertiary health care institutions across the country.
