Health
In Adamawa, rural PHCs rely on volunteers due to staffing shortages
At Damare Primary Health Centre (PHC) in Girei LGA, Adamawa State, volunteer health worker Godiya Deborah Umaru was on duty alongside only one permanent staff member when several patients arrived.
They included a woman in labour and an accident victim. Outpatients crowded the waiting area, while admitted patients also required care.
“We could not attend to all of them,” Ms Umaru recalled.
The experience is familiar across rural PHCs in Adamawa State, where a shortage of health workers has left facilities unable to meet growing demand for services.
Across communities in Girei LGA, health workers say they routinely perform multiple roles simultaneously, moving between antenatal care, deliveries, outpatient consultations, immunisation services, and emergency response, often within the same shift.
Findings by this reporter show that PHCs in this LGA depend on volunteers to fill critical workforce gaps. In some facilities visited, volunteers assist with immunisation, antenatal care, labour and delivery, wound dressing and other essential services alongside permanent staff.
Interviews with facility managers, volunteers, health workers and government officials, as well as a review of state health sector documents, reveal a primary healthcare system under pressure from persistent staffing shortages, limited equipment and uneven distribution of health workers.
While the Adamawa State Government says it has recruited additional personnel and is improving service delivery, findings from rural facilities suggest many remain heavily reliant on volunteers to keep their doors open and maintain basic healthcare services for thousands of residents.
A system stretched beyond capacity
In Nigeria’s rural communities, PHCs serve as the first point of contact for medical care. Residents depend on them for immunisation, antenatal services, childbirth, treatment of common illnesses and emergency care.
But visits to health facilities in Girei LGA reveal a system operating under intense pressure, sustained by a small workforce and an increasing reliance on volunteers.
At Njobbore PHC, facility manager Pafinus Linus said staff shortages have long been one of the clinic’s biggest challenges.
The facility provides immunisation, antenatal care, family planning, outpatient services and delivery care for the surrounding communities. Yet the number of health workers available has often fallen short of the workload.
According to Mrs Linus, the facility currently operates with a mix of permanent staff and volunteers spread across different units. However, the staffing arrangement remains fragile because workers are frequently required to abandon their assigned duties to respond to emergencies elsewhere in the clinic.
She explained that a staff member assigned to antenatal care may be called into the labour ward. “During night shifts, a single health worker may simultaneously function as a nurse, midwife, records officer and emergency responder,” she said.
“As a staff, you cannot depend only on your unit,” Mrs Linus said. “You have to do everything.”
The result is a system built around constant task-shifting.
At Damare PHC, health workers described similar conditions.
The facility serves an estimated population of 6,596 people. According to its officer-in-charge, Aishat Musa, the clinic operates with a combination of permanent staff, hired workers and volunteers who are integrated into a 24-hour duty roster to ensure services remain available round the clock.
“The facility serves a population of 6,596, and the staffing structure includes 10 permanent staff, eight hired staff and 15 volunteers,” she said.
On paper, it might sound like a crowded workforce, but in practice, it is a workforce that depends on a delicate mix of permanent workers, contractual staff and volunteers to keep the clinic open round the clock.
“We mix the permanent staff and the hired staff in the roster,” Mrs Musa said.
While the arrangement helps keep the facility running, it also reflects a reality faced by many rural clinics: maintaining services often depends on workers stretching beyond their formal responsibilities and volunteers filling critical gaps in the workforce.
Nigeria’s PHC system is guided by minimum staffing standards set by the National Primary Health Care Development Agency (NPHCDA), which outlines the basic human resource requirements for functional facilities.
Under the framework, a standard PHC is expected to have a mix of skilled personnel, including at least one Community Health Extension Worker (CHEW) or Junior CHEW, a midwife or nurse, a pharmacy technician, and a laboratory assistant, alongside environmental and support staff. Larger or upgraded facilities are expected to have additional staff depending on population size and service demand.
These benchmarks are intended to ensure that even the most basic rural clinic can provide essential services such as antenatal care, safe delivery, immunisation, disease surveillance and emergency response without over-reliance on a single cadre of workers.
However, field findings from these PHCs suggest that many rural facilities fail to meet these minimum requirements.
The volunteers holding clinics together
Ms Umaru, the volunteer at Damare PHC, represents a growing group of health workers who now form an informal but essential part of Adamawa’s rural healthcare system.
Unable to secure immediate employment after graduation in 2024, she turned to volunteering at Damare PHC in April 2025, where she was attached after submitting her application and credentials.
Since then, she has been integrated into the facility’s daily operations, working under supervision across immunisation, antenatal care, labour and delivery support, and wound dressing services.
In practice, her role goes beyond observation or assistance. On many days, she works alongside a single permanent staff member to manage multiple incoming patients.
“There was a day only myself and a permanent staff were on duty, and we had a labour case, an accident case and many outpatients and inpatients to attend to,” she said. “We could not attend to all of them. Some of them left because they felt the delay was too much.”
The officer-in-charge at Damare PHC, Ms Musa, said graduates of nursing and health-related disciplines frequently apply to volunteer while awaiting government employment.
“They come with their certificates and apply,” she said. “Most of them have completed their training but have not been employed, so they come here to practice and utilise their skills.”
But the waiting period for formal employment remains uncertain. According to her, only a small number of volunteers attached to the facility have been absorbed into the government workforce in recent years.
“In the last two years, just two volunteers were employed permanently, one after three years of service, and another after two,” she said.
While facility managers say volunteers are indispensable to keeping services running, the arrangement highlights a growing dependence on unpaid labour in essential healthcare delivery.
“The work that my permanent staff can do, volunteer staff can also do it,” said Mrs Linus, facility manager at Njobbore PHC. “Sometimes volunteer staff can even do better than permanent staff if you groom them well.”
However, public health experts caution that while volunteers help bridge immediate gaps, they are not a substitute for a properly staffed health system. They warn that prolonged reliance on unpaid workers risks weakening service quality and placing additional pressure on already overstretched facilities.
“One person can actually work in other units”
Beyond staff shortages, health workers say the problem also lies in distribution and task overload.
At Njobbore PHC, the facility operates with about two staff members per shift, but workers are expected to cover multiple units when necessary.
“You have to consult. If you consult, maybe there is delivery. Maybe there is an accident. You still go and watch the accident,” said Mrs Linus. “One person can actually work in other units.”
The system relies heavily on improvisation. Volunteers are integrated into daily operations because facilities cannot function without them.
But even this arrangement is strained by poor infrastructure.
Njobbore PHC has only one delivery bed, limiting its ability to manage multiple births. In some cases, deliveries have taken place under lantern light due to inadequate power supply.
“If we have enough delivery beds, one will be here, one will be here,” she said.
At Damare PHC, similar shortages exist.
“At the moment, we have one delivery bed,” said Ms Musa. “It is not enough with the number of deliveries. The labour room needs proper sterilisation tools, instruments, flashlights and tables.”
Volunteers are also expected to attend training alongside permanent staff, but facility managers sometimes cover transportation costs personally.
“I’m supporting that person with the transport to go there because they are volunteers,” Ms Musa said.
Progress on paper, shortages in practice
Adamawa State’s health planning documents acknowledge both progress and persistent gaps in the primary healthcare system.
The State Health Sector Medium Term Sector Strategy (2023–2025) records a total of 957 health facilities across the state, including 403 PHCs designed to provide frontline services in rural communities.
It also notes a major weakness in the health workforce, particularly the shortage of skilled personnel, including nurses, midwives, doctors, pharmacists, laboratory scientists, CHEWs, and JCHEWs.
To address these gaps, the document states that the government recruited about 1,200 personnel into the PHC system. However, it acknowledges that staffing levels remain inadequate for effective service delivery.
Overall, the health sector is reported to have about 6,789 staff. But less than 30 per cent are professional health workers, while the majority are support staff. The state also has only 55 doctors serving in the public health system.
On paper, these figures suggest ongoing investment in human resources for health. In practice, however, they also reveal the scale of the shortage in relation to the population and service demand.
The average number of health workers in PHC facilities is estimated at about 15 per facility, a figure that includes all categories of staff. In many rural centres, this translates into a situation in which a handful of workers are expected to provide antenatal care, deliver babies, run outpatient services, manage records, and respond to emergencies simultaneously.
At Damare and Njobbore PHCs, this imbalance is reflected in daily operations, where staff and volunteers must constantly rotate across roles to keep services running, often without adequate equipment or support.
When delays become dangerous
For many patients in Adamawa’s rural communities, the consequences of understaffed health facilities are not abstract statistics — they are lived experiences marked by delay, frustration and risk.
One of such patients is Dozie Kasundi, a post-basic nursing student who experienced severe abdominal and back pain while attending class sometime in early 2025.
She had left home feeling well that morning, but her condition worsened rapidly within hours. What began as mild discomfort escalated into severe pain that left her unable to sit or stand.
Alarmed by her condition, her husband rushed her to the accident and emergency unit of the Federal Medical Centre, Yola (now Modibbo Adama University Teaching Hospital).
But according to her account, her condition was not immediately treated as an emergency due to limited staff availability at the time.
“One of the nurses on duty said it’s not an emergency. So they left me standing there,” she said.
She remained at the facility for more than an hour, standing in pain and waiting for attention. Eventually, her husband took her to another hospital where she was treated promptly.
While her experience occurred in a tertiary health facility in the state capital, it reflects a broader reality across the health system — where delays in response, whether in rural clinics or urban hospitals, can have serious consequences for patients in urgent need of care.
In rural PHCs, however, health workers say such delays are often linked directly to staffing shortages and the need to manage multiple responsibilities simultaneously.
With too few workers on duty, emergencies can overlap with routine services, forcing staff to make difficult choices about which cases to attend to first.
Public health experts warn that in conditions such as postpartum haemorrhage, eclampsia or obstructed labour, even short delays can significantly increase the risk of severe complications or death.
A public health physician, Owen Omo-Ojo, said the implications of such shortages are significant, particularly for maternal and emergency care.
Mr Omo-Ojo noted that in many PHCs, one health worker is often required to function simultaneously as nurse, midwife, records officer and emergency responder.
“That often leads to fatigue, burnout, delayed and suboptimal care, and avoidable medical errors,” he said.
He warned that delays in recognising or managing complications such as postpartum haemorrhage can quickly become life-threatening in understaffed facilities.
“In emergencies, every second matters,” he added. “When facilities are understaffed, patients are likely unable to receive timely lifesaving interventions.”
Government response and the distribution gap
Officials at the Adamawa State Primary Health Care Development Agency described improvements in the health system but acknowledged that challenges remain, particularly in the distribution of health workers.
James Wasson, director of Disease Control and Immunisation at the agency, said the state has undertaken recruitment exercises and facility upgrades in recent years as part of efforts to strengthen PHC delivery.
According to him, the government has conducted two rounds of employment, with another recruitment exercise expected. He also noted that some health facilities have been renovated, while service uptake across PHCs has improved.
However, he argued that the issue is not only about numbers but also about how health workers are distributed across facilities.
“When you talk of human resource gaps, sometimes we don’t talk about only the number, we talk about the equity in the distribution of the human resource,” he said.
He added that community-based volunteers also play a role in supporting health education, immunisation and referrals, particularly in underserved areas.
But field findings from rural health facilities suggest that the reliance on volunteers goes beyond supplementary support, with many clinics depending on them to maintain daily operations.
Health workers and facility managers in Girei Local Government Area describe a system in which staffing shortages lead to constant task-shifting, with one worker often covering multiple units during a single shift.
READ ALSO: Inside Katsina PHCs, where night services falter amid staffing and power gaps
Budgets, policy implementation
Budget documents further highlight the gap between policy intent and implementation.
Adamawa State’s 2025 second-quarter budget implementation report shows that N1.05 billion was allocated to PHCs, with year-to-date performance of N197.69 million, representing 17.9 per cent implementation.
The report states that the sector’s objective includes providing the right number and skill mix of competent, motivated and productive health workers. However, the low level of budget performance raises questions about how far these objectives are being translated into improved staffing and service delivery at the facility level.
Taken together, recruitment efforts, budget allocations and policy statements point to an intention to strengthen the PHC system. Yet in practice, rural clinics continue to operate with limited staff, heavy workloads and a growing dependence on volunteers to bridge critical gaps.
Across facilities visited, the pattern is consistent: while basic buildings exist, infrastructure is often poor, and clinics still lack the minimum staffing and essential equipment needed for safe service delivery.
This reporting was completed with the support of the Centre for Journalism Innovation and Development (CJID)
The World Health Organisation (WHO) has urged African countries to strengthen patient safety in the care of people living with noncommunicable diseases (NCDs).
WHO Regional Director for Africa, Mohamed Janabi, made the call on Thursday in a message to mark World Patient Safety Day 2026, themed “Safe care for noncommunicable diseases”, with the slogan “Safe care for life!”
NCDs include conditions such as diabetes, cancer, heart disease and chronic respiratory diseases.
“For a person living with diabetes, cancer, heart disease or a chronic respiratory condition, health care is rarely a single encounter,” he said.
“It may involve years of consultations, tests, medicines, referrals and treatment. Each interaction should improve health, yet each can also expose a patient to avoidable harm.”
NCDs in Africa
Mr Janabi said NCDs caused at least 43 million deaths globally in 2021 and accounted for 37 per cent of all deaths in the WHO African Region in 2019.
He said the proportion had increased from 24 per cent in 2000.
“Nearly two-thirds of NCD deaths in the Region are premature, compared with 41.7 per cent globally,” he said.
According to WHO, NCDs are also a major cause of long-term disability and loss of function in the region.
“Their growing burden is linked to risk factors including unhealthy diets, physical inactivity, hypertension, obesity and air pollution,” he noted.
Patients face several safety risks
Mr Janabi said patients living with NCDs could suffer harm from delayed or missed diagnoses, medication errors, adverse drug interactions, poor follow-up and inadequate communication when they move between health services.
He said the risks could occur at different stages of care, including diagnosis, treatment, rehabilitation, palliative care and self-management.
He added that stigma, discrimination and difficulties accessing essential medicines and health technologies could further increase the risks faced by patients.
“Expanding access to NCD services must therefore go hand in hand with improving their safety and quality,” Mr Janabi said.
Stronger primary healthcare
Mr Janabi further said stronger primary healthcare could improve continuity of care, enable earlier identification of health problems and help coordinate services across different levels of the health system.
READ ALSO: Ebola outbreak spreads to 61 health zones in DRC — WHO
He also called for health workers to receive practical guidance, reliable supplies and supportive workplaces where errors can be reported and used to improve care without fear of blame.
He urged African countries to integrate patient safety into NCD policies and programmes, strengthen systems for reporting and learning from harm, and invest in health worker training and the safe use of medicines and technologies.
He also called on patients and families to ask questions and raise concerns whenever aspects of their care are unclear.
“Every person should be protected from avoidable harm throughout their health journey,” Mr Janabi said.
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In April 2026, Anaor Saawuan laid her eight-month-old granddaughter on a thin mattress inside their makeshift shelter at the Anyiin Internally Displaced Persons (IDP) camp in Logo Local Government Area of Benue State, Central Nigeria.
The infant had been vomiting and stooling for two days. She also had a fever. Grandma thought it was a teething problem, so she gave her a cough syrup and tablets she bought at a patent medicine shop across the road.
But when the vomiting and diarrhoea returned, she took the child to a hospital outside the camp, where health workers said she needed a blood transfusion.
“I had no money,” she said. “And there was nobody to help me.”
She resorted to a traditional remedy. However, at about 9 p.m. on 2 May, the child died. She believes the child might have survived if the nearby clinic within the camp had still been operational.
“There used to be a clinic here,” Mrs Saawuan said, pointing towards a building inside the camp. “Medicines were available, and treatment was free, until everything stopped.”
Her case illustrates the healthcare crisis at settlements for people displaced by conflicts in Benue State, where clinics are closed or poorly equipped, medicines are in short supply, referral systems are weak, and many families cannot afford healthcare costs.
Another health burden
Mrs Saawuan also has a young grandson, who was diagnosed with an inguinal hernia and referred for surgery at a general hospital. “We barely feed,” she said. “How can I pay for an operation?”
Mrs Saawuan has again resorted to herbs to manage his condition.
A risky pregnancy
A few shelters away in the same camp lives a pregnant 32-year-old woman, Naomi Teryen.
Her previous pregnancies were difficult, she said, involving prolonged labour and Caesarean sections.
But five months into her current pregnancy, she has little money for regular antenatal care at a health centre outside the camp and has not had an ultrasound scan.
“I don’t have a job, and there is no proper healthcare service in this camp,” she told PREMIUM TIMES.
Mrs Teryen said she previously relied on the health facility in the camp.
“When the hospital was available, we used to get medicine free of charge there,” she said. “But now that the hospital has been closed, when we go to the health centre, we pay for medicine.”
Cost of a closed clinic
Mrs Teryen showed PREMIUM TIMES the medicines she received during an antenatal visit. They consisted of paracetamol and Multiple Micronutrient Supplements (MMS), which contain vitamins and minerals intended to prevent micronutrient deficiencies and improve maternal and birth outcomes.
The MMS supplements are distributed through Nigeria’s public health system with support from the government and development partners, including UNICEF.
They are intended to be dispensed free of charge. But Mrs Teryen alleged pregnant women from the camp are charged for medicines, including MMS, during antenatal visits to the health centre outside the camp.
She said that an antenatal visit to the European Economic Community Health Clinic (CHC) in Anyiin, a government-owned primary healthcare facility in the community, typically costs her about ₦3,000. She recalled an occasion when she arrived at the centre with only ₦1,000. “They told me to go back,” she said.
Mrs Teryen’s husband makes wooden crafts inside the camp. But he often sells nothing.
“Every time she gives birth, it is difficult. Sometimes we spend more than a week in the hospital,” he said.
Terrence Akighir, a medical doctor and UNICEF consultant, told PREMIUM TIMES the supplements should not be sold to patients.
“MMS is supposed to be free,” he said. “If somebody is taking advantage of that to sell the medicine, it should be looked into and stopped. These women do not have money. If they are paying for medicines that should be free, how will they meet their other healthcare needs?”
A UNICEF humanitarian report corroborates Mr Akighir’s claims amid the humanitarian crisis.
In its Humanitarian Situation Report No. 3, published on 18 March 2026 and covering January to December 2025, the agency said that 8.8 million people, including 4.9 million children, required humanitarian assistance, while 2.9 million people were internally displaced.
UNICEF reported that, under its First 1,000 Days Initiative, 489 pregnant women in Benue IDPs received free MMS between June and December 2025.
Clinic declines comment
PREMIUM TIMES contacted the European Economic Community Health Clinic in Anyiin for a response to the allegation. An official on duty said she was not authorised to comment on whether MMS were being sold to patients and declined to provide further information before walking away.
When the clinic closed
The healthcare crisis at the Anyiin IDP camp did not begin this year. It followed the closure of a health facility inside the camp that had once provided basic medical care to displaced residents.
Helen Tsavwua, a former worker at the facility, said the clinic was established by Médecins Sans Frontières (MSF), which provided medical services to displaced communities in Anyiin IDP at the height of the displacement crisis in 2018.
“When MSF was leaving, Victim Support Fund (VSF) took over until January 2021,” she said. “When they left, the hospital was closed down.”
According to Ms Tsavwua, VSF continued to provide some medicines to support patients, but the absence of medical personnel meant that residents could not reliably access treatment.
“They were giving medicines, but there was no doctor to attend to patients,” she said. “When children or women were sick, they would go there, but there was nobody to give them medicine.”
She said the limited treatment available at the time was also inadequate for some patients.
“Sometimes only malaria medicine or paracetamol would be given without even testing,” she said.
A community health worker at the Community Health Clinic, Anyiin, who previously worked at the camp facility, also attributed its closure to a lack of funding. The worker asked not to be named because of concerns about possible victimisation.
According to the health worker, MSF had provided substantial support to the facility, including medical personnel. Some of the doctors and other health workers who had worked under the organisation were retained when its support ended, but sustaining the facility became increasingly difficult.
“When MSF left, it became difficult to sustain the hospital,” the worker said. “Medicine stopped coming in, and we were asked to return to our former posts.”
The worker said the camp’s health services had depended heavily on support from humanitarian organisations and other non-governmental groups.
“Most of the activities in the camp, especially health and food, were supported by NGOs,” the worker said, adding that the government’s role through the Benue State Emergency Management Agency (SEMA) was largely supervisory.
An abandoned clinic
PREMIUM TIMES visited the former clinic located within the NKST Primary School, Anyiin, where internally displaced people still live. The facility appeared deserted, with its rooms locked and no health workers or patients present. Its beige-and-black walls were chipped and peeling, while faded chalk inscriptions remained on the dark metal doors. The concrete walkway was cracked and stained, bordered by bare reddish soil, while children moved through the surrounding school grounds.
Camp residents said medicines supplied by non-profit organisations were still kept inside the locked facility. They said the drugs remained inaccessible because the building was closed and no health workers were available to attend to patients.
MSF exits Benue
PREMIUM TIMES contacted Abdulkareem Yakubu, field communication officer and spokesperson for MSF in Nigeria, for clarification on the organisation’s withdrawal and its implications for communities previously served by its teams.
Mr Yakubu said he could not comment on the current situation in communities where MSF had ended its activities because the organisation had closed its project in Benue. He referred PREMIUM TIMES to MSF’s formal statement on the closure, which he shared with the newspaper, saying the statement contained the organisation’s position on its decision to leave the state.
In the statement, MSF said it had decided to phase out its medical humanitarian activities in Benue after six years of providing healthcare to internally displaced people and host communities. The organisation said basic healthcare and decentralised activities would conclude by the end of June 2024, while family planning and sexual and reproductive healthcare activities would cease by the end of Jul,y and comprehensive sexual and gender-based violence care would end in August the same year.
“MSF operations’ core mission is to provide urgent medical humanitarian assistance in emergency contexts, and we have a responsibility to ensure this capacity to provide assistance at a moment’s notice is maintained,” the statement said.
The organisation said the decision was made after considering medical needs across Nigeria and the need to reinforce MSF’s response in other parts of the country.
“We remain concerned for the safety of women and girls in Benue,” the statement read. “We will continue to advocate for more action by the Nigerian government and the newly arrived international organisations present in the area, to recognise the threat that SGBV poses to displaced people and to provide survivors with the necessary care.”
MSF said that between May 2018 and March 2024, its medical teams conducted 412,832 consultations and treated 223,871 patients in Mbawa, Ortese, Naka and Agagbe camps and host communities. The organisation also said it admitted 1,731 people following instances of sexual and gender-based violence in 2023.
“The arrival of international organisations is a hopeful signal that MSF’s drive to recognise the plight of displaced people in Benue state is being heard,” the statement added.
According to MSF, a new clinic supported by UNICEF and WHO began operating in three camps in late 2023. The organisation said the development offered some prospect of continued healthcare support for displaced communities after its withdrawal.
After MSF’s exit
At the Anyiin IDP camp, the effects of MSF’s departure have continued to be felt by displaced residents. Julius Tema, chairman of the Anyiin IDP camp, said the withdrawal of the organisation and the subsequent closure of the camp’s health facility had left residents struggling to access basic healthcare.
“Our biggest challenges now are food and health,” he said. “There are many sick people in this camp.”
He said malaria remained widespread, alongside cases of hepatitis and other illnesses.
“There was a hospital here before,” Mr Tema said. “Today, that hospital is no longer functioning. We don’t have medicines anymore.”
With no functioning clinic, residents must seek treatment outside the camp, a burden many cannot afford.
“When there is no medicine and no hospital inside the camp, people suffer,” he said. “Some simply resort to herbs because they don’t have money to seek treatment elsewhere.”
Mr Tema said pregnant women, children and older residents were particularly affected and appealed to the government and humanitarian organisations to restore healthcare services.
“We need medicines. We need medical personnel. We need intervention before more lives are lost,” he said.
Officials stay silent
The agencies responsible for managing the IDP camps and providing healthcare to Benue residents did not respond to PREMIUM TIMES’ requests for comments on the findings of this investigation.
During a telephone conversation on 7 July, James Iorpuu, executive secretary of the Benue State Emergency Management Agency (SEMA), which oversees IDP camps, scheduled a meeting at the agency’s headquarters in Makurdi for 9 a.m. the following day.
The reporter arrived before the scheduled time and waited for more than three hours. But when, at about noon, Mr Iorpuu emerged from his office, he ignored the reporter’s presence, entered his vehicle, and drove away without granting the interview or proposing another time.
PREMIUM TIMES subsequently sent questions to SEMA about the closure of the health facility within the IDP camp, the shortage of medicines and medical supplies, healthcare costs borne by displaced residents, emergency referral arrangements, and support for health workers serving the camps.
As of the time of this publication, the agency has not responded.
The Benue State Commissioner for Health, Paul Ogwuche, also did not respond to repeated requests for comment. During a visit to the ministry at the Benue State Secretariat, Mr Ogwuche’s secretary requested a formal written interview request, which was done.
As of the time of publication, the commissioner had not responded to the questions.
A wider health crisis
The experiences documented in Anyiin are unfolding amid a prolonged conflict that has forced hundreds of thousands of people from their homes across Benue State.
The International Organisation for Migration’s Displacement Tracking Matrix (DTM) Round 18 recorded 464,543 internally displaced persons in Benue, the highest number across the North-central and North-west states covered by the assessment.
About 376,000, or 81 per cent, were living in host communities, while roughly 88,000 were in camps and camp-like settings.
Women and children account for most of the displaced population, increasing the need for maternal, reproductive and child healthcare in the camps.
For many families, displacement has also meant the loss of farms, businesses, and other sources of income.
An August 2025 assessment by the SEMA and the Internal Displacement Solutions Fund found that 96 per cent of displaced households surveyed wanted to return to their communities.
The healthcare challenges are particularly significant for pregnant women.
A study published in the National Library of Medicine’s PubMed Central (PMC), based on research among pregnant women visiting PHCs in Benue State, reported a maternal mortality ratio of 1,189 deaths per 100,000 live births.
The study drew on data from two cohorts covering 2015–2017 and 2020–2021. The reported ratio is more than double Nigeria’s national estimate and far above the Sustainable Development Goal target of fewer than 70 maternal deaths per 100,000 live births by 2030.
ALSO READ: Inside Benue IDP camp, where thousands live with stench
Infographic: Benue’s maternal mortality burden compared with Nigeria’s national estimate and the Sustainable Development Goal target
The 2021 Nigeria Multiple Indicator Cluster Survey (MICS) found that 59.1 per cent of births in Benue State were attended by skilled health personnel.
Traditional birth attendants assisted with 17.7 per cent of births, while relatives or friends assisted with another 17.2 per cent.
Health insurance coverage among women is also low. The same survey also found that only 2.5 per cent are covered by health insurance, leaving most families reliant on out-of-pocket payments for antenatal care, medicines, and emergency treatment.
For displaced women who have lost their livelihoods, those costs are compounded by transport expenses and limited access to functioning health facilities.
Newborns face significant risks as well. According to the 2021 MICS, one in every 56 children born in Benue dies within the first 28 days of life.
Preventable illnesses, delayed care
Mr Akighir, the medical doctor and UNICEF consultant, said many illnesses affecting displaced families can be prevented or treated if care is available early.
He identified malnutrition, malaria, and acute diarrheal diseases as the major health concerns, particularly among children.
“Malnutrition is one of the biggest problems we see,” he said. “When children are malnourished, their immunity drops, and they become vulnerable to infections.”
He said poor access to safe water and sanitation can compound those risks.
“Once they start drinking untreated water, acute diarrhoeal diseases become common,” he said. “Many children also walk barefoot, exposing them to hookworm infestation, skin infections and other preventable diseases.”
Pregnant women face additional risks when poverty and displacement delay their access to care.
“Health-seeking behaviour is generally poor,” Mr Akighir said. “Sometimes labour begins, and the woman delivers inside the camp because there is nobody to accompany her to a health facility. Others present very late, when complications have already developed.”
He said weaknesses in the referral system can create further barriers, particularly for displaced people who were not registered when they arrived at the camps.
“Some of them came into the camps after registration had been completed,” he said.
“When complications arise, and they are referred, they may face challenges accessing support because they are not captured in the system.”
Support, but gaps remain
Mr Akighir said humanitarian organisations continue to support maternal and child healthcare in some of Benue’s IDP camps, including antenatal care, nutrition services, treatment of childhood illnesses and referrals for emergency care.
He said one intervention had supported more than 250 successful deliveries.
However, such interventions have not eliminated gaps in access to healthcare across the camps.
UNICEF’s 2025 humanitarian reporting shows that its health response extended beyond nutrition support. By the end of the year, the agency said essential health services had reached displaced people in 10 IDP camps and two host communities in Benue, with more than 44,000 medical consultations and 16,000 childhood immunisations recorded.
The agency nevertheless identified gaps that continued to constrain the response, including limited government funding, shortages of essential supplies and weak coordination among government agencies.
For Mrs Teryen, whose baby is due in September, those gaps have immediate consequences.
This reporting was completed with the support of the Centre for Journalism Innovation and Development (CJID).
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