Nigeria’s primary healthcare system is facing a major staffing and infrastructure crisis, with only three per cent of 1,480 primary healthcare centres (PHCs) assessed across 16 states meeting the national minimum staffing requirement.
The alarming finding was contained in the PHC Operational Capability Report produced by Orodata Science and Civic Tech after an assessment of facilities across 277 local government areas in Nigeria’s six geopolitical zones.
The assessment, conducted between October 2023 and June 2025, used the CheckMyPHC Digital Scorecard to examine staffing levels, infrastructure, equipment, electricity, water supply and accessibility.
According to the report, 11 of the 16 states assessed had no PHC that met the minimum staffing standard, highlighting the depth of the manpower shortage confronting the country’s frontline healthcare system.
The report further revealed that about 75 per cent of the facilities assessed were located in rural communities, where access to quality healthcare is already a major challenge.
It found that 40 per cent of the PHCs had broken ceilings or leaking roofs, while 38 per cent operated without electricity.
Another 39 per cent of the facilities depended on unsafe sources of water, raising concerns over sanitation, infection prevention and the overall safety of patients and health workers.
The report also identified serious gaps in maternal and newborn care, noting that 75 per cent of the assessed facilities lacked essential neonatal resuscitation equipment required for emergency interventions when newborns develop complications during childbirth.
Accessibility was another major concern, as 66 per cent of the facilities lacked provisions for persons with disabilities and people with mobility challenges.
The report said the problems were interconnected, with poor infrastructure, inadequate staffing, unreliable electricity and water supply, limited medical equipment and accessibility barriers often occurring in the same facilities.
It warned that the combination of these challenges could increase risks to patients while placing additional pressure on the few health workers available.
The situation was also reflected in community perception, with 51 per cent of respondents rating the services provided by their local PHCs as poor.
According to the report, Kano and Sokoto recorded particularly serious shortages of safe water, reliable electricity and essential newborn-care equipment, while Gombe recorded an 80 per cent rate of PHCs without accessibility provisions.
Orodata Science said the findings showed that improving primary healthcare would require more than isolated renovation projects, stressing the need for coordinated interventions based on verified facility-level data.
The organisation urged state governments to develop clear intervention plans identifying affected facilities, specific challenges, responsible institutions, required resources and implementation timelines.
It also called for measurable targets, regular monitoring and evaluation, accessibility-compliant renovations and the inclusion of community feedback in assessing interventions.
The report recommended urgent repairs of damaged roofs and ceilings, provision of safe water and improvement of electricity supply to affected PHCs.
For facilities without reliable power from the national grid, it recommended the deployment of solar and hybrid electricity systems.
Orodata further urged the National Primary Health Care Development Agency and state PHC agencies to tackle frontline manpower shortages through the recruitment, effective deployment and retention of health workers, particularly in underserved communities.
It also called for all PHCs offering delivery services to be equipped with essential neonatal resuscitation equipment to improve emergency care for newborns.
The assessment involved physical visits to facilities, direct observation, interviews with health workers and community members, photographs, GPS coordinates and examination of facility records.
Orodata said the CheckMyPHC Digital Scorecard was developed with reference to the minimum standards of the National Primary Health Care Development Agency and relevant inclusion requirements.
The organisation said the assessment was designed not only to document deficiencies but also to provide facility-level evidence that could guide implementation, resource allocation, monitoring and evaluation.
It stressed that investment decisions in primary healthcare should be based on verified needs rather than assumptions, adding that the ultimate measure of progress should be whether PHCs become safer, adequately staffed, properly equipped, functional and trusted by the communities they serve.
