The first point of contact for Nigerians seeking medical attention ought to be the nearest primary healthcare centre. That is how every functional health system is designed. Primary healthcare is the foundation upon which effective disease prevention, maternal and child healthcare, routine immunisation, and early treatment rest. Sadly, Nigeria’s primary healthcare system has become a symbol of neglect rather than hope.

The scale of the decay is alarming. BudgIT’s 2025 assessment of 5,099 primary healthcare facilities across the 36 states and the Federal Capital Territory (FCT) exposed a system in deep crisis. About 85 per cent of the facilities had no doctor, while 61 per cent operated without a nurse or midwife. Nearly four in every 10 lacked a reliable water supply, 40 per cent had no functional laboratory, and only about half had electricity.

Such conditions are indefensible in a country struggling with one of the world’s highest maternal mortality rates, persistent infectious diseases, and a growing burden of non-communicable illnesses. The findings merely confirm what Nigerians already know. Although over 30,000 primary healthcare centres constitute about 85 per cent of the country’s health facilities and are spread across 8,810 wards in the 774 local government areas, many exist only on paper.

Dilapidated buildings, obsolete or non-existent equipment, chronic drug shortages, and severe manpower deficits have rendered countless centres incapable of delivering even the most basic healthcare services.

The consequences are devastating. Women continue to die from preventable pregnancy complications, while children succumb to diseases that should have been prevented through immunisation or treated promptly. Patients are forced to bypass dysfunctional local facilities and overwhelm secondary and tertiary hospitals, resulting in overcrowding, higher healthcare costs, delayed treatment, and avoidable deaths.

This deplorable situation persists despite repeated government promises and billions of naira spent on revitalisation programmes intended to upgrade infrastructure, provide essential medicines, recruit health workers, and strengthen emergency response services. Poor governance, weak accountability, corruption, inadequate monitoring, and irregular funding have undermined these initiatives.

Local governments, constitutionally responsible for primary healthcare, have largely abdicated their responsibilities, while many state governments have failed to provide effective leadership.