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97% of PHCs in 16 states fail national staffing standards – Report

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A new assessment of 1,480 Primary Healthcare Centres (PHCs) across 16 Nigerian states has found that 97 per cent failed to meet the national minimum staffing requirement, raising fresh concerns about the capacity of the country’s frontline health facilities to provide essential services.

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

The assessment, conducted between October 2023 and June 2025, 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 assessed met the national minimum staffing requirement, while 11 of the 16 states had no assessed PHC that met the standard.

What the staffing standard requires

The national PHC framework recognises adequate staffing as essential to the delivery of quality primary healthcare.

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

For a PHC, the proposed workforce includes a community health officer, public health nurse, three community health extension workers, six junior community health extension workers and four nurse/midwives, with a medical assistant listed as optional.

The same framework recommends that basic essential obstetric care centres be adequately staffed with four midwives or nurse/midwives to provide 24-hour coverage for maternal and newborn care.

Against this staffing framework, the Orodata assessment found that only three per cent of the facilities surveyed met the national minimum requirement.

The report said the shortage was particularly concerning because about 75 per cent of the assessed PHCs were located in rural communities, where such facilities often serve as the first and sometimes only formal source of healthcare for residents.

Staffing gaps, other deficiencies

The staffing problem was not isolated.

The assessment found that many of the facilities struggling to meet staffing requirements were also dealing with inadequate infrastructure and unreliable basic 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 was another major concern, with 39 per cent of the facilities relying on unsafe water sources.

Orodata said the deficiencies were interconnected, with poor infrastructure, inadequate staffing, unreliable electricity and water supplies, limited equipment and accessibility barriers often occurring within the same facilities.

The report said the combination could increase risks for patients while placing additional pressure on the health workers available at the facilities.

Newborn care faces major equipment gaps

The assessment also exposed gaps in the capacity of PHCs to respond to complications during childbirth.

It found that 75 per cent of the facilities lacked essential neonatal resuscitation equipment.

Such equipment is required to support emergency interventions for newborns experiencing complications during or immediately after delivery.

The report said the absence of essential newborn-care equipment, alongside staffing shortages and other infrastructure deficiencies, could limit the ability of facilities to provide safe maternal and newborn services.

Accessibility was also a major concern.

According to the assessment, 66 per cent of the PHCs lacked provisions for persons with disabilities and people with mobility challenges.

State-level differences emerge

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

The report identified Kano and Sokoto as having particularly serious gaps in safe water, reliable electricity and essential newborn-care equipment.

In Gombe, 80 per cent of the assessed PHCs lacked accessibility provisions for persons with disabilities and people with mobility challenges.

The assessment also sought to establish how residents viewed the services provided by their local facilities.

It found that 51 per cent of surveyed community members rated services at their local PHCs as poor.

PHC challenges

The findings are consistent with concerns documented by PREMIUM TIMES in a recent investigation into rural PHCs in Osun State.

The investigation found that despite government investments in the health sector and efforts to revitalise primary healthcare facilities, challenges including inadequate staffing, deteriorating infrastructure, limited equipment and gaps in essential services persisted at some rural facilities.

At one of the facilities visited by PREMIUM TIMES, a single health worker was responsible for attending to pregnant women, children and other patients, while also responding to emergencies outside normal working hours. The facility also lacked a functional laboratory and had inadequate delivery equipment.

The investigation further found that some patients had to travel outside their communities for basic services because the facilities could not provide them.

READ ALSO: Over 30% of solar systems in PHCs fail within three years — Health Minister

Coordinated interventions

Orodata said improving PHCs would require coordinated interventions beyond isolated renovations.

It urged state governments to develop facility-specific plans with clear targets, responsibilities, resources and timelines, alongside regular monitoring.

The organisation also recommended repairs to damaged infrastructure, provision of safe water and reliable electricity, solar or hybrid power systems, recruitment and retention of health workers, and essential neonatal resuscitation equipment for PHCs offering 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 was based on NPHCDA minimum standards and inclusion requirements, and urged authorities to use verified facility-level evidence to guide resource allocation and interventions.


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Health

Lagos students use art to open new conversations on mental health

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Twenty-five art students of the Yaba College of Technology (Yabatech), Lagos State, have explored mental health and emotional well-being through art in a workshop aimed at encouraging conversations around mental health.

The two-day Health Story Lab, organised by the Yemisi Shyllon Museum of Art (YSMA), Pan-Atlantic University, in collaboration with the Art for Health Initiative (AHI), was held on 2 and 3 October in Lagos.

The programme, titled “What We Carry: Stories of Mental Health and Resilience”, brought together art, public health, mental health and storytelling to help the students explore how creative expression can be used to communicate experiences that may be difficult to discuss openly.

The workshop was held ahead of World Mental Health Day (WMHD), marked annually on 10 October.

Using art to discuss mental health

The students participated in sessions on public health and art, mental health and resilience, creative expression and art for social change.

According to the organisers, the discussions gave the students an opportunity to reflect on issues such as stress, uncertainty, social pressure, family expectations, grief, fear and hope.

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Representatives of YSMA and AHI and Facilitators of the Workshop
Representatives of YSMA and AHI and Facilitators of the Workshop

The students subsequently developed creative concepts and received feedback from facilitators and their peers.

The students also examined the role of art in health communication during a session led by Olayinka Badmus, a public health strategist. The session explored how creative expression can communicate public health issues and make health conversations more accessible.

Another session, led by psychiatrist and psychotherapist Emmanuel Abayomi, focused on mental health and resilience, while Art Project Lead Temitope Oladeji guided students to express their experiences and emotions through art. The programme also included a museum tour focused on art for social change, led by a museum educator, Charles Udeh.

Solomon Nkwagu, Head of Corporate Communication and Visitors’ Services at YSMA, said the programme showed the potential of art to encourage conversations around public and mental health.

“They began to see the possibility of using their creative voices to start conversations around public and mental health, to tell stories that people can recognise themselves in, and perhaps even to create moments of reflection and healing for others. That shift in perspective was one of the most rewarding parts of the programme,” Mr Nkwagu said.

In her remarks, Chidera Aneke, Founder of AHI, said the initiative was designed to make health communication more participatory, culturally relevant and emotionally engaging.

Ms Aneke said health information could be communicated not only through statistics and clinical information but also through stories, images, symbols, emotions and lived experiences.

“We wanted to create a space where young artists could understand that health is not only communicated through statistics, campaigns or clinical information. It can also be communicated through stories, images, symbols, emotions and lived experiences,” she said.

“Working with the students showed us the possibilities that emerge when artists are given the knowledge, language and space to think about health through their own creative practice.”

Mental health burden

Mental health remains a significant public health concern in Nigeria.

A 2026 systematic review and meta-analysis of 53 studies involving more than 132,000 people estimated that 7.9 per cent of the general population had experienced suicidal thoughts, while 1.9 per cent had made suicidal plans and 1.3 per cent had attempted suicide.

Workshop Session at the Multipurpose Gallery of the YSMA
Workshop Session at the Multipurpose Gallery of the YSMA

The researchers said suicidal behaviour was more common among some groups, including adolescents, young people, and pregnant women.

This year’s World Mental Health Day theme is “Lived experiences heard: real voices, real change.”

The World Health Organisation (WHO) is calling for people who have experienced mental health conditions to have a meaningful role in shaping policies, services and decisions that affect them.

“World Mental Health Day is an opportunity to meaningfully engage with people with lived experience (PWLE) of mental health conditions and to recognise their knowledge as a vital form of expertise,” it noted.

READ ALSO: PT Health Watch: Why some pregnant women develop gestational diabetes

“This year’s campaign calls for their voices to shape the policies, services and decisions that affect their lives.”

From workshop to exhibition

The Yabatech students will develop artworks based on the issues explored during the workshop.

The works are expected to form a micro-exhibition in Lagos in November, giving members of the public an opportunity to engage with mental health and resilience through the perspectives of young artists.

The organisers said the initiative is intended to demonstrate how partnerships between the creative sector, museums and public health practitioners can create new ways of discussing mental health.


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Health

9.5m children received no routine vaccine in 57 countries in 2025

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Gavi, the Vaccine Alliance, says 9.5 million children in 57 supported countries received no routine vaccine in 2025, despite gains in global immunisation.

The figure, described as the number of “zero-dose” children, was contained in Gavi’s 2025 Annual Progress Report, which reviewed the alliance’s 2021-2025 strategic period.

Gavi defines zero-dose children as infants who have not received the first dose of a diphtheria, tetanus and pertussis-containing vaccine by the end of their first year.

Number falls from 2021 peak

According to the report, the number of zero-dose children in 2025 was 600,000 lower than in 2024 and 25 per cent lower than the peak recorded in 2021 following disruptions to routine immunisation caused by the COVID-19 pandemic.

However, the figure remained four per cent above the 2019 baseline, partly because of continued growth in the number of children being born.

Gavi said children living in fragile, conflict-affected and humanitarian settings remain among those most likely to be missed by immunisation programmes.

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Nigeria remains one of the countries with the highest number of zero-dose children. UNICEF estimated that about 2.2 million Nigerian children had never received a routine vaccine in 2025, the highest number in Africa.

Nigeria records gains in targeted areas

The report highlighted Nigeria, Ethiopia and Pakistan among countries where emerging data showed stronger immunisation coverage gains in sub-national areas that received greater Gavi focus and investment during the 2021-2025 period.

Gavi said the findings underscored the value of targeted, equity-focused investments in reaching communities that are being missed by routine immunisation.

The report also identified Nigeria among countries covered by Gavi’s Zero-Dose Learning Hubs, which examined what works and what does not in identifying and reaching zero-dose and under-immunised children.

The findings from Nigeria, Bangladesh, Mali and Uganda highlighted several issues, including gender-related barriers to immunisation.

73m children immunised in 2025

Despite the number of zero-dose children, Gavi said more than 73 million children were immunised through routine programmes with its support in 2025.

More than 351 million children were immunised during the 2021-2025 strategic period, “exceeding Gavi’s target of 300 million children.”

“By end 2025, Gavi-supported countries had immunised more than 1.3 billion unique children with Gavi support since 2000, exceeding our Investment Opportunity 2021-2025 commitment of more than 1.1 billion children immunised by 2025,” it noted.

Gavi said vaccination averted more than 2.2 million future deaths in 2025, bringing the total number of future deaths averted through its supported vaccination programmes to more than 7.8 million during the 2021-2025 period.

Generated economic benefits

The report said immunisation programmes generated more than $30 billion in economic benefits for Gavi-supported countries in 2025, the highest amount recorded in a single year.

The benefits were calculated from the costs of illness averted, including medical and associated costs, caretaker wages and productivity losses resulting from disability or death.

Gavi said the programmes generated more than $104 billion in economic benefits between 2021 and 2025 and more than $308 billion between 2000 and 2025.

Countries also contributed a record $301 million towards the co-financing of Gavi-supported vaccines in 2025, an 18 per cent increase from 2024.

About 80 per cent of the contribution came from domestic resources, while “approximately 20 per cent from low-interest loans from the World Bank.”

Gavi said countries had contributed a total of $2.2 billion towards vaccine co-financing since the policy was introduced in 2008.

More children

For its 2026 to 2030 strategic period, Gavi said it aims to protect another 500 million children through immunisation and avert between eight million and nine million future deaths.

READ ALSO:New TB vaccines could save 7.3m lives by 2050 – Gavi 

The Alliance also targets more than $100 billion in economic benefits during the period. Gavi said it would place greater emphasis on reaching zero-dose and under-immunised children while strengthening the sustainability of national immunisation programmes.

In her comments, Gavi Chief Executive Officer, Sania Nishtar, said the results showed that immunisation generates benefits beyond preventing disease. “However, when it comes to immunisation we know that the return on investment extends far beyond health to supporting sustainable, inclusive economic growth,” Ms Nishtar said.

WHO Director-General, Tedros Ghebreyesus, also said immunisation delivers massive gains in lives saved and diseases prevented, but also in terms of economic benefits.

“Countries understand that the cost of failing to vaccinate is far too great, while the benefits extend across families, communities, economies and future generations,” Mr Ghebreyesus was quoted to have said.


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