The primary healthcare system in Nigeria faces a deepening crisis that extends well beyond failing infrastructure, according to Peter Obi, the presidential candidate of the Nigeria Democratic Congress (NDC).
Citing recent assessments across 16 states, Obi noted that 97 per cent of Primary Healthcare Centres (PHCs) fail to meet national staffing standards.
The figure should not be viewed in isolation. With approximately 80 per cent of PHCs nationwide reported as non-functional, the acute deficit of personnel points to a systemic breakdown in frontline healthcare delivery.
‘At the heart of the crisis is a simple reality: a health centre without qualified health workers is little more than a building,’ Obi said.
The foundational role of primary healthcare
Primary healthcare forms the foundation of any functional health system. It serves as the initial point of care where pregnant women receive antenatal treatment, children are immunised, common illnesses are managed early, and preventable deaths are averted before patients require costly secondary or tertiary care.
When facilities lack doctors, nurses, midwives, and community health workers, these basic medical functions become impossible to deliver.
‘Behind every understaffed PHC is potentially a pregnant woman travelling long distances in search of care, a newborn exposed to avoidable complications, or a child whose treatable illness becomes life-threatening because help is unavailable,’ Obi said.
The implications extend beyond public health. Inadequate healthcare access depresses workforce productivity, inflates household medical expenditures, and drives vulnerable families deeper into poverty.
Shift needed from physical infrastructure to operational capacity
The former Anambra State governor described the situation as both a public health emergency and an economic development challenge.
‘Health remains one of the clearest measures of a nation’s development,’ Obi said. ‘Roads, airports, flyovers, and transport infrastructure may improve mobility and commerce, but development ultimately has to be reflected in the quality and length of people’s lives. A country cannot build a healthy and productive population when its basic healthcare facilities are closed, poorly equipped, or operating without enough qualified personnel.’
The focus of governance must shift from the number of facilities constructed to the number that are fully operational and capable of delivering quality care. Government performance ought to be measured by tangible outcomes, including lives saved, functional health centres, worker retention, reductions in maternal and child mortality, and affordable access for ordinary citizens.
‘Healthcare cannot become a privilege available primarily to citizens who can afford private hospitals,’ Obi noted. ‘Government has a fundamental responsibility to ensure that access to essential healthcare does not depend on income or geographical location.’
Addressing systemic retention and rural deployment gaps
The staffing crisis highlights a recurring failure to establish sustainable systems to equip, staff, and maintain public infrastructure. Recruitment alone will not resolve the deficit.
‘Health workers must be properly remunerated, deployed where they are most needed, and given safe working conditions and opportunities for professional development,’ Obi stated, calling for urgent interventions to address the maldistribution of personnel between urban centres and rural communities.
Underserved populations should not bear the burden of weak healthcare delivery while qualified medical staff remain concentrated in major cities.
Strengthening primary healthcare requires direct investment in human capital, systematic retention, and robust public accountability across all tiers of government. The choice remains whether to measure national progress through physical structures or through the fundamental work of preserving human life.