Zamfara, Sokoto, 16 others are Nigeria’s worst performing states in primary health care delivery
“Findings from the report also blame Nigeria's deteriorating health care system on the weak governance structures and operational inefficiencies”

A new report has shown that Zamfara, a North-western state, is Nigeria’s worst performing state in Primary Health Care (PHC) service delivery.

The report titled; “The State of Primary Healthcare Service Delivery in Nigeria,” shows that Zamfara and 17 other Nigerian states are weak in healthcare service delivery, especially in public facilities.

The other states include Sokoto, Taraba, Kebbi, Katsina, Borno, Yobe, Kogi, Jigawa, Rivers, Gombe, Cross River, Edo, Bayelsa, Akwa-Ibom, Plateau, Imo, and Kaduna.

The research for the report, released recently at an event in Abuja, was carried out by ONE Campaign, in partnership with National Advocates for Health, Nigeria Health Watch, Public and Private Development Centre (PPDC), and other partners.

The report
According to a statement issued by ONE campaign, apart from ranking health system performance across 36 states, the report also provides an in-depth and systemic review of the implementation of the Basic Health Care Provision Fund (BHCPF) and the compliance of the states with the National Health Act and National Health Policy.


The research also includes recommendations for how state governments should strengthen their fragile health systems, enhance the existing implementation of the BHCPF, and raise strategic and operational planning for health in order to promote access to and utilisation of primary healthcare services.

The statement indicates that the report’s findings expose the precarious state of healthcare in Nigeria, where access to and utilisation of health services continues to be marred by systemic challenges across the states.

It also shows that public health facilities in all 36 states and the FCT are deficient, and the experiences of community members seeking health care at public facilities are consistently awful.


Findings from the report also blame Nigeria’s deteriorating health care system on the weak governance structures and operational inefficiencies.

The Managing Director of Nigeria Health Watch, Vivianne Ihekweazu, said the report “helps us understand where we are, the opportunities and gaps in state-level healthcare delivery.”

Ms Ihekweazu said the parties involved are determined to disseminate the findings widely and use them to hold policymakers, especially at the subnational level, accountable for improvements in healthcare delivery for all Nigerians.

Top performing states
The Federal Capital Territory (FCT), Enugu, and Anambra are some of the top performing states in primary healthcare service delivery, according to the report.

Others are Ekiti, Delta, Abia, Lagos, Nassarawa, Adamawa, Kwara, Benue, Ebonyi, Oyo, Bauchi, Ogun, Ondo, Kano, Niger and Osun states.



Speaking at the launch, the Chairman of the Senate Committee on Health, Ibrahim Oloriegbe, noted the need for continuous oversight checks to ensure the BHCPF works for Nigerians.

Mr Oloriegbe said the country has recorded successes at the federal level because of the independence and the interdependence between the executive and the legislative arms of government and because the National Assembly has been able to perform its oversight functions.


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He said this must be replicated across the different state houses of assembly to achieve great success.

L-R: Serah Makka-Ugbabe, Executive Director, Engagement and Mobilisation at The ONE Campaign; Senator Ibrahim Oloriegbe, Chairman, Senate Committee on Health; Singer and Celebrity, and ONE Ambassador, Waje; Hon. Henry Nwawuba, Deputy Chairman, House Committee on Niger Delta; and Edwin Ikhuoria, Executive Director for Africa at The ONE Campaign, during the unveiling of The State of Primary Healthcare Service Delivery in Nigeria report
L-R: Serah Makka-Ugbabe, Executive Director, Engagement and Mobilisation at The ONE Campaign; Senator Ibrahim Oloriegbe, Chairman, Senate Committee on Health; Singer and Celebrity, and ONE Ambassador, Waje; Hon. Henry Nwawuba, Deputy Chairman, House Committee on Niger Delta; and Edwin Ikhuoria, Executive Director for Africa at The ONE Campaign, during the unveiling of The State of Primary Healthcare Service Delivery in Nigeria report
“It is also important for citizens to join in this advocacy and call on their state governments to release appropriate funds and ensure adequate monitoring of the funds to improve public health facilities, especially at the primary health centres,” he said.

Mr Oloriegbe said state governments must ensure medical supplies and the required human resources are available in health facilities.

Weak Governance
In his remarks, ONE Campaign’s Nigeria Director, Stanley Achonu, said weak governance continues to pose a major obstacle to improved healthcare delivery in the country.

Mr Achonu said this hampers efficiency and effectiveness and results in weak infrastructure, poor user experiences, and poor health outcomes.

He explained that the burden of strengthening the healthcare systems and services lies heavily on governance and leadership.

“At all levels, the government needs to take responsibility as a building block of the health system, especially in system design, policy guidance, oversight, regulation, accountability, coalition building, monitoring, and enforcement,” he said.

Mr Achonu said the success recorded with polio eradication, containment of Ebola, and the COVID-19 pandemic has shown that Nigeria can deliver on critical health issues given the required political will and leadership commitment.

“We have to act quickly to avert primary healthcare collapse,” he said.

PHCs are meant to provide services to the majority of people based on need, without geographical, social, or financial barriers.

Unfortunately, only about 20 per cent of PHC facilities across Nigeria are functional. The rest cannot provide essential healthcare services.

PREMIUM TIMES, in a series of reports, showed how some PHCs are faced with a lot of problems, including poor distribution of health workers, poor quality of health care services, poor infrastructure, and lack of supply of essential drugs.

Improved leadership
The Chairman of National Advocates for Health Group, Muhammad Usman, urged the government to provide the required leadership to ensure the improvement of PHCs across the country.

Mr Usman said the federal government must ensure timely release of funds allocated for the BHCPF and effective utilisation of the same at the sub-national level to improve PHC performance nationwide.

About BHCPF
In 2014, the National Health Act established the BHCPF to address funding gaps hampering effective primary health care delivery across the country.

The BHCPF includes one per cent of the federal government Consolidated Revenue Fund (CRF) and additional contributions from other funding sources.

It is designed to support the effective delivery of PHC services, provision of a Basic Minimum Package of Health Services (BMPHS), and Emergency Medical Treatment (EMT) to all Nigerians.

https://www.premiumtimesng.com/news/headlines/544601-zamfara-sokoto-16-others-are-nigerias-worst-performing-states-in-primary-health-care-delivery.html?tztc=1

Well, to be a bit honest with Gburugburu, when it comes to Primary Health Care, he built quite a number of them across the state (can't say if they are fully equipped though) but there are still so many places in the state that lack primary health care...