Most Primary Healthcare Centres in Nigeria Fail to Meet Staffing Standards

A new assessment of 1,480 Primary Healthcare Centres (PHCs) across 16 Nigerian states shows that 97 per cent did not meet the national minimum staffing requirement. This raises serious concerns about the ability of these health facilities to provide essential services.

The PHC Operational Capability Report was produced by Orodata Science and Civic Tech. It looked at facilities in 277 local government areas across Nigeria’s six geopolitical zones.

The assessment took place from October 2023 to June 2025. It examined staffing, infrastructure, equipment, electricity, water supply, and accessibility using the CheckMyPHC Digital Scorecard.

According to the report, only three per cent of the facilities met the national minimum staffing requirement. Eleven out of the 16 states had no PHC that met this standard.

What the Staffing Standard Requires

The national PHC framework says adequate staffing is key to delivering quality primary healthcare.

The National Primary Health Care Development Agency’s (NPHCDA) Ward Minimum Health Care Package, developed with the World Health Organisation (WHO), outlines the minimum staff needed for ward-level PHCs.

For a PHC, the recommended staff should include a community health officer, one public health nurse, three community health extension workers, six junior community health extension workers, and four nurse/midwives. A medical assistant is optional.

The same framework says that basic essential obstetric care centres should have at least four midwives or nurse/midwives for 24-hour maternal and newborn care.

Against this staffing framework, the Orodata assessment found that only three per cent of the surveyed facilities met the national minimum requirement. The report said this shortage is worrying because about 75 per cent of the assessed PHCs are in rural areas. These facilities often serve as the first and sometimes only formal healthcare option for residents.

Staffing Gaps, Other Deficiencies

The staffing issue is not the only problem.

The assessment found that many facilities struggling with staffing also faced inadequate infrastructure and unreliable utilities. According to the report, 40 per cent of the PHCs had broken ceilings or leaking roofs, while 38 per cent operated without electricity.

Water supply is another major issue, with 39 per cent of the facilities relying on unsafe water sources. Orodata said these deficiencies are connected. Poor infrastructure, lack of staff, unreliable electricity, and water supplies often happen together in the same facilities.

The report warned that these combined issues could raise risks for patients and add pressure on the available health workers.

Newborn Care Faces Major Equipment Gaps

The assessment also highlighted gaps in the ability of PHCs to handle childbirth complications.

It found that 75 per cent of the facilities lacked essential equipment for neonatal resuscitation. This equipment is critical for emergency care for newborns facing complications during or right after delivery.

The report noted that the lack of newborn-care equipment, along with staffing shortages and infrastructure problems, could limit the ability of facilities to provide safe maternal and newborn services. Accessibility is also a big concern.

According to the assessment, 66 per cent of the PHCs did not have provisions for persons with disabilities and people with mobility challenges.

State-Level Differences Emerge

While the overall findings showed widespread problems, the severity varied across states.

The report pointed out that Kano and Sokoto have serious gaps in safe water, reliable electricity, and essential newborn-care equipment. In Gombe, 80 per cent of the assessed PHCs lacked accessibility for persons with disabilities and people with mobility issues.

The assessment also looked into how residents view the services at their local facilities. It found that 51 per cent of surveyed community members rated services at their local PHCs as poor.

PHC Challenges

These findings match concerns raised by PREMIUM TIMES in a recent investigation into rural PHCs in Osun State. The investigation found that even with government investments in health and efforts to improve primary healthcare, challenges like inadequate staffing and poor infrastructure still exist in some rural facilities.

At one of the facilities visited, only one health worker attended to pregnant women, children, and other patients while also handling emergencies outside normal hours. The facility lacked a functional lab and had insufficient delivery equipment.

The investigation also revealed that some patients had to travel outside their communities for basic services because local facilities could not provide them.

Coordinated Interventions

Orodata said improving PHCs needs coordinated efforts, not just isolated repairs. It urged state governments to create facility-specific plans with clear targets, responsibilities, resources, and timelines, along with regular monitoring.

The organisation also called for repairs to damaged infrastructure, safe water supply, reliable electricity, solar or hybrid power systems, recruitment of health workers, and essential neonatal equipment for PHCs that provide delivery services.

The assessment involved facility visits, direct observation, interviews with health workers and community members, photographs, GPS coordinates, and facility records. Orodata said its CheckMyPHC Digital Scorecard follows NPHCDA minimum standards and urged authorities to use verified evidence to guide resource allocation and interventions.