Nigeria’s efforts to expand and revitalise primary healthcare facilities should focus not only on infrastructure but also on the ability of the facilities to provide safe and reliable services to patients, stakeholders in the sector have said.
The National Primary Health Care Development Agency (NPHCDA) is working towards having functional primary healthcare centres across the country’s political wards, with its revitalisation programme covering infrastructure, staffing, medicines, equipment, operating costs, ambulance services and quality improvement.
The agency’s Level 2 requirements include the capacity to provide services such as skilled birth attendance, reliable electricity with solar backup, water and sanitation, consulting rooms, wards, delivery rooms, pharmacy services, laboratory services and secure premises.
According to figures released by the NPHCDA as of June 2025, 1,163 primary healthcare centres had been completed and fully revitalised, while 2,774 others were at various stages of the process.
The development has renewed discussions on how the success of the programme should be measured beyond the completion of construction works.
Oliver van Veen of Vannin Group said the readiness of a healthcare facility depended on several interconnected factors, including the clinical services available, workforce, infrastructure, supplies, referral systems and day-to-day management.
He said healthcare facilities needed to have clearly defined services, with appropriate arrangements for referring patients whose conditions could not be managed at the primary healthcare level.
According to him, the availability of trained health workers is also essential because infrastructure alone cannot provide clinical care.
He said electricity, water, ventilation, privacy, infection prevention measures, waste management and communication facilities should be considered part of the requirements for effective healthcare delivery.
Van Veen also identified the availability of medicines, vaccines, diagnostic services and other medical consumables as important components of facility readiness.
He said effective referral arrangements were equally important, particularly for patients requiring specialised treatment, noting that referral systems should provide communication between facilities, transportation and proper transfer of patient information.
He added that maintenance, stock management, data reporting, cleaning, quality assurance and community feedback were necessary to sustain healthcare services after facilities became operational.
The importance of facility readiness can be illustrated by emergency situations requiring immediate attention, including complications during childbirth.
A functional primary healthcare centre would be expected to have appropriate personnel, electricity, water, emergency medicines and basic equipment available, as well as a clear mechanism for transferring patients requiring higher-level care.
Similar considerations apply to cases involving children with severe illness, adults experiencing breathing difficulties and other emergencies that may initially present at the primary healthcare level.
Stakeholders have also called for greater emphasis on measuring the services patients actually receive at facility level.
Such measures could include the number of hours facilities are open, availability of health workers during scheduled shifts, reliability of electricity and water, availability of essential medicines, vaccine cold-chain performance, laboratory services, referral response times and frequency of medicine stock-outs.
However, such indicators would need to take account of the different circumstances facing facilities, particularly those in remote or underserved communities.
The Federal Ministry of Health’s 2025 review also reported an increase in visits to facilities supported through the Basic Health Care Provision Fund, while noting affordability as an ongoing concern.
With increased utilisation of primary healthcare facilities, stakeholders say ensuring that facilities have the personnel, supplies, equipment and referral systems required to provide services will remain important.
They further suggested that the transition from construction to service delivery should involve assessments of whether facilities can operate effectively under normal and emergency conditions.
Such assessments could include checking staffing arrangements, electricity and water supply, availability of medicines and equipment, referral communication, record management, waste disposal and maintenance responsibilities.
Nigeria’s primary healthcare expansion programme is aimed at improving access to essential health services across communities.
For the programme to achieve its intended impact, the performance of facilities will ultimately depend on whether patients can access the services they require when they need them, rather than solely on the completion of physical infrastructure.