Stakeholders Demand Grassroots Reforms to Rescue Nigeria’s Primary Healthcare System

Michael Olugbode in Abuja

Health stakeholders have called for urgent grassroots-driven reforms to reposition Nigeria’s primary healthcare system, warning that weak accountability structures and poor community participation are undermining healthcare delivery across the country.

The call was made during a policy dialogue with the theme: ‘The SCAPP Experience: Building Accountable PHC Systems from the Ground Up’, organised by the Health Sector Reform Coalition in collaboration with BudgIT and development partners.

Participants at the meeting stressed that Primary Health Centres (PHCs), which serve as the first point of contact for millions of Nigerians, particularly in rural communities, have continued to suffer from poor funding, inadequate infrastructure, a shortage of health workers, and irregular supply of essential drugs.

Speaking at the event, the Special Adviser to the President on Health, Salma Ibrahim Anas, said the federal government remained committed to strengthening PHCs under the Renewed Hope health agenda.

According to her, “Primary healthcare remains the bedrock of an effective health system. If we fail at the grassroots level, the entire healthcare structure becomes overstretched.”

She noted that the federal government had increased funding support for primary healthcare through the Basic Health Care Provision Fund (BHCPF), adding that transparency and accountability must accompany increased investments in the sector.

“We must ensure that resources allocated to healthcare directly impact communities and improve the quality of services available to ordinary Nigerians,” she stated.

Also speaking, the Executive Director of the Health Sector Reform Coalition, Dr. Kolawole Oluwafemi, emphasised the need for stronger citizen participation in the management of healthcare facilities.

“Communities must not be treated as passive beneficiaries. They must become active participants in monitoring healthcare delivery and demanding accountability from duty bearers,” he said.

Oluwafemi lamented that many PHCs across the country remained in deplorable conditions despite repeated budgetary allocations to the health sector.

He explained that empowering citizens with information and monitoring tools would help reduce corruption, improve service delivery, and restore public confidence in the healthcare system.

Similarly, the Country Director of BudgIT, Gabriel Okeowo, said data transparency and community engagement were critical to fixing Nigeria’s failing PHC system.

According to him, “Healthcare reforms cannot succeed without accountability. Citizens must know how public funds are spent and whether healthcare facilities are receiving what is budgeted for them.”

He added that many rural communities still lacked access to basic healthcare services despite government interventions over the years.

Representatives of civil society organisations and development partners at the meeting also expressed concern over rising maternal and child mortality rates, attributing the trend partly to the poor state of primary healthcare facilities nationwide.

They urged state and local governments to prioritise healthcare funding, recruit more frontline workers, and improve monitoring systems to ensure efficient service delivery.

The stakeholders maintained that revitalising Nigeria’s primary healthcare system was essential to achieving Universal Health Coverage and reducing pressure on secondary and tertiary health institutions across the country.