New coat, persistent issues: The incomplete tale of a Kaduna medical facility

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Across Nigeria, billions of naira have been invested in revitalising primary healthcare centres as part of efforts to strengthen healthcare delivery, reduce maternal and child deaths and bring essential medical services closer to communities. In Kaduna State, the Narayi Primary Health Care Centre stands as one of the beneficiaries of this intervention, with residents and health workers pointing to improved infrastructure, expanded services, increased staffing and round-the-clock healthcare delivery as evidence of progress, DEBORAH TOLU-KOLAWOLE writes

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Balancing her three-month-old baby carefully on her back, Tina Julius navigated the muddy road leading to Narayi Primary Health Care Centre in Chikun Local Government Area of Kaduna State.

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The morning rain had left deep puddles along the route, forcing mothers carrying babies to tread cautiously towards the facility.

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For Tina, however, the difficult journey was still preferable to what she endured a few years ago.

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Back then, accessing healthcare often meant travelling long distances, waiting for hours at overcrowded facilities and sometimes returning home without receiving the care she needed.

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Today, she visits a renovated primary healthcare centre that now operates round the clock and serves thousands of residents across Narayi and neighbouring communities.

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“We are grateful for the renovation. There is improved service delivery. There are more health workers. The renovation really helped,” she told our correspondent.

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Like many residents, Tina has witnessed how investments in primary healthcare have transformed access to medical services in her community.

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Yet as she approached the freshly painted buildings, another reality came into view.

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Behind the facility, a widening erosion channel cuts through the landscape. Nearby, a stagnant river carrying refuse emits an unpleasant odour that drifts into parts of the hospital compound.

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For residents, the contrast is impossible to ignore.

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Inside the facility are visible signs of progress — solar-powered electricity, expanded services and increased staffing.

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Outside are environmental and infrastructure challenges that many fear could undermine those gains if left unaddressed.

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“I want my children to come to a clean and safe hospital,” Tina said.

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“A hospital should look clean and inviting.”

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Among those who have benefited from the improvements is 32-year-old mother of four, Aisha Musa, who regularly visits the facility for child immunisation and family planning services.

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Sitting outside the maternity unit while waiting for her appointment, she recalled the difficulties women in the community faced before the renovation.

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“Before the renovation, many of us did not come here regularly because there were not enough services and sometimes you would come and not find what you needed,” she said.

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According to her, women often travelled to other facilities for family planning services, while routine immunisation could be stressful due to limited personnel and inadequate infrastructure.

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“Now things are better. We bring our children for immunisation here and the nurses attend to us well. Women can also get family planning services without going far,” she said.

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Aisha added that the availability of healthcare workers at all hours had increased confidence among residents.

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“If a child becomes sick at night or a pregnant woman has a problem, there are people here to attend to them. Before, many people would rush to bigger hospitals or private clinics because this place was not fully functional.”

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For her, the biggest benefit is peace of mind.

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“We feel safer knowing there is a hospital nearby that can help us when we need care.”

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A Lifeline Reborn

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By mid-morning, the waiting area of Narayi Primary Health Care Centre was filled with mothers carrying babies wrapped tightly against their backs.

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Some waited for immunisation appointments. Others sought treatment for fever, cough and other ailments.

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Nurses moved briskly between consulting rooms and immunisation wards while health workers attended to a steady stream of patients.

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For many residents, the scene represents a remarkable turnaround.

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The facility, revitalised under the Basic Healthcare Provision Fund, now bears little resemblance to what existed a few years ago.

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Fresh paint covers the buildings. Solar panels provide electricity alongside power from Kaduna Electricity Distribution Company and a standby generator. Essential equipment has been provided and staffing strengthened.

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The Officer-in-Charge of the facility, Phebe Joseph, said the impact has been significant.

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“The impacts of the renovation on the people in the community have been significant,” she said.

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Before the intervention, she explained, the facility struggled with inadequate infrastructure and limited services.

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“Before, the facility was not well equipped.

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“Our services were limited and could not adequately meet the healthcare needs of the community.”

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Today, the situation is markedly different.

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“As a result of the renovation, the services have now expanded to 24-hour service.

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“At all times now, we have staff on duty to render services to people in the community.”

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The facility now serves residents from Narayi, Banawa, High Cost, Shagari Low Cost, Karji and neighbouring communities.

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Healthcare workers say more women are accessing antenatal care, family planning and child health services, while immunisation uptake has improved due to easier access to care.

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Environmental Challenges Threaten Progress

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Despite the improvements, significant environmental challenges remain.

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Behind the facility lies a large erosion channel that has continued to expand during successive rainy seasons. Parts of the surrounding land have already been affected, while residents worry about the long-term implications for the facility.

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The stagnant river behind the hospital also emits an unpleasant odour, particularly during periods of heavy rainfall.

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Tina expressed concern about the environmental conditions surrounding the facility.

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“Behind the hospital, all kinds of things are being dumped into the river, and the smell is drifting into the hospital compound,” she said.

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“Right now, both the staff and people coming for treatment are not safe because of the environmental conditions around the facility.”

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During a visit to the facility, sections of the surrounding area showed visible signs of erosion, while residents said flooding becomes more severe during the rainy season.

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“The back of the hospital has already been badly ravaged by erosion,” Tina said.

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“And now that we are in the rainy season, something urgent needs to be done.”

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Healthcare workers share similar concerns.

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Joseph disclosed that flooding had previously damaged important records within the facility.

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“We lost many of our documents as a result of the floods,” she said.

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“It created a lot of havoc in the facility and affected our ability to render effective services during the rainy season.”

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Water supply remains another challenge.

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“We don’t have a proper borehole,” she explained.

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“Sometimes we have challenges with water, and it affects our services.”

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Residents also identified the poor condition of the access road leading to the facility as another major challenge.

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Another resident, Alheri Yakubu, praised the renovation but said accessing the hospital can become difficult during the rainy season.

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“The renovation really helped. You can now come to the clinic anytime and receive treatment. Drugs are always available,” she said.

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“The road becomes almost impassable during the rainy season.”

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For pregnant women, nursing mothers and elderly patients, residents say the poor road network can become an additional barrier to healthcare access.

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Why Primary Healthcare Matters

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For residents like Tina and Aisha, the importance of Narayi PHC goes beyond convenience.

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It means being able to immunise children without travelling long distances. It means access to antenatal care, family planning services and treatment for common illnesses close to home.

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Across Nigeria, primary healthcare centres remain the foundation of the country’s healthcare system and the first point of contact for millions of citizens seeking medical care.

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According to the Federal Ministry of Health and Social Welfare, PHCs provide essential services including immunisation, maternal and child healthcare, antenatal care, family planning, treatment of common illnesses, disease surveillance and health promotion.

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Health experts argue that Nigeria’s ambition to reduce maternal and child mortality and achieve universal health coverage depends largely on the strength of its primary healthcare system.

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Speaking during a National Health Summit in Abuja, the Coordinating Minister of Health and Social Welfare, Muhammad Ali Pate, described primary healthcare as “the bedrock of universal health coverage.”

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“You cannot build an effective healthcare system without strong primary healthcare,” Pate said.

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“This is where most Nigerians first seek care. If the PHCs are functional, people will not need to overcrowd tertiary hospitals for basic health services.”

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Similarly, the Executive Director of the National Primary Health Care Development Agency, Muyi Aina, said revitalising PHCs remains central to reducing maternal and child mortality nationwide.

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“Our goal is to ensure that every Nigerian has access to quality healthcare services within walking distance,” Aina said.

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Mrs Alheri Yakubu

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“We are revitalising thousands of PHCs across the country because primary healthcare is central to reducing maternal deaths, improving immunisation coverage and strengthening disease surveillance.”

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For communities such as Narayi, where many residents depend on public healthcare facilities, those goals are already translating into tangible benefits.

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Billions behind PHC revival

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The transformation witnessed at Narayi PHC forms part of a wider national effort funded through the Basic Healthcare Provision Fund.

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Established under the National Health Act, the BHCPF was created to strengthen primary healthcare delivery, expand health insurance coverage for vulnerable populations and provide funding for essential healthcare services across the country.

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Federal budget documents show that the BHCPF received about N44.4bn in 2020.

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Although allocations declined to N35.03bn in 2021 amid fiscal pressures associated with the COVID-19 pandemic, funding increased to N54.05bn in 2022.

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The fund received approximately N44.5bn in 2023 before rising significantly to N125.74bn in 2024.

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In the 2025 budget, the Federal Government further increased the allocation to about N138.17bn, representing one of the largest investments in primary healthcare since the programme became operational.

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The fund supports facility upgrades, procurement of medicines and equipment, expansion of health insurance coverage for vulnerable Nigerians and the provision of basic emergency healthcare services.

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Revitalisation Drive Gathering Momentum

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The transformation witnessed at Narayi is part of one of the most ambitious efforts to strengthen primary healthcare services in Nigeria’s recent history.

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Under the Nigeria Health Sector Renewal Investment Initiative, the Federal Government, through the National Primary Health Care Development Agency, is working towards ensuring that every political ward in the country has at least one fully functional primary healthcare centre.

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Nigeria has approximately 17,600 political wards, many of which have historically lacked adequately equipped healthcare facilities.

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According to data from the NPHCDA, 1,163 PHCs had been fully revitalised nationwide by mid-2025, while another 2,774 facilities were undergoing renovation and upgrade.

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The agency also reported that 3,624 PHC projects had completed planning and approval processes through various intervention programmes.

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The figures represent significant progress compared to previous years when many primary healthcare centres across the country suffered from dilapidated infrastructure, inadequate staffing, poor electricity supply and shortages of essential equipment.

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The NPHCDA says the revitalisation programme extends beyond repainting buildings.

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A fully functional Level 2 PHC is expected to provide 24-hour services, safe delivery services, antenatal care, immunisation, laboratory services, pharmacy services, reliable electricity, water supply and adequate staffing.

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Additional interventions have included the installation of solar power systems, solar-powered boreholes and the deployment of medical equipment to underserved communities.

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According to the agency, maternal and newborn health commodities have been distributed to nearly 2,000 PHCs nationwide, while more than 1,600 solar-powered vaccine refrigerators have been deployed to strengthen routine immunisation services.

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The agency has also supported states to recruit additional healthcare workers to address longstanding manpower shortages.

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For residents of Narayi, many of these interventions are already visible.

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Solar panels now power the facility. More health workers are available. Immunisation services run more efficiently. Pregnant women can access antenatal care closer to home, while emergency cases can be attended to at night.

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Beyond buildings

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While experts have welcomed increased investments in primary healthcare infrastructure, they warn that renovation alone cannot guarantee quality healthcare delivery.

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Health financing expert Aminu Magashi Garba of the African Health Budget Network said governments must pay closer attention to sustainability and environmental conditions surrounding healthcare facilities.

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“Primary healthcare is where most Nigerians first interact with the health system,” he said.

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“When PHCs fail, the entire healthcare system suffers.”

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According to him, many preventable maternal and child deaths occur because people either cannot access functional PHCs or encounter delays in reaching them during emergencies.

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“If a pregnant woman cannot access a nearby PHC during an emergency, the consequences can become fatal very quickly.

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“That is why investments in primary healthcare are extremely important.”

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However, he cautioned that investments should not stop at refurbishing buildings.

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“You cannot renovate a facility and ignore the environment surrounding it.

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“If roads are inaccessible, if flooding destroys medical records, if erosion threatens the building itself, then healthcare delivery will still suffer.”

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Health economist Chioma Amajoh echoed similar concerns.

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“You cannot revitalise a healthcare facility without addressing water, sanitation, drainage and access roads,” she said.

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“These are not secondary issues. They directly affect health outcomes.”

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For residents of Narayi, those concerns resonate strongly.

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The healthcare facility may have been transformed, but challenges linked to erosion, flooding, water supply and road access continue to test the sustainability of those gains.

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The situation reflects a broader reality facing many PHCs across Nigeria: while healthcare infrastructure is improving, the wider environment needed to sustain those gains often lags behind.

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Mrs Tina Julius

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Hope amid unfinished work

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As another rainy season unfolds, mothers continue arriving daily at Narayi PHC carrying babies for immunisation and treatment.

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Inside the facility, nurses attend to patients beneath solar-powered lights. Consultations continue. Vaccines are administered. Families receive counselling on child health and family planning.

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For many residents, the renovated healthcare centre remains a source of hope and an example of what targeted investments in primary healthcare can achieve.

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Yet they say sustaining those gains will require addressing the environmental and infrastructure gaps that remain.

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“My appeal to the government is that they should come to our aid,” Joseph said.

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“Especially concerning the erosion because it is eroding the land seriously.

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“We also don’t have staff quarters here. We don’t have a proper borehole.

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“If the government can help us with these things — the erosion, water and road — I believe we will be able to give 100 per cent service delivery to the people in this community.”

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Outside the facility, mothers continued arriving with babies strapped to their backs.

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Some came for immunisation. Others sought antenatal care, family planning services or treatment for common ailments.

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For Tina, Aisha and hundreds of other residents who depend on the facility, Narayi PHC represents both progress and possibility.

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The renovation has brought healthcare closer to home.

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The challenge now is ensuring that the gains already achieved are protected from the erosion, flooding and infrastructure deficits that still threaten the future of a facility that has become a lifeline for thousands.

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When contacted, the Public Relations Officer of the Kaduna State Primary Health Care Board, Mariam Mohammed, said she would revert after consulting relevant officials on the concerns raised by residents and health workers regarding erosion, flooding, water supply and access roads at the facility.

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However, she had yet to respond to calls and messages sent to her mobile phone and WhatsApp number as of the time of filing this report.

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Efforts by our correspondent to obtain comments from officials of the Kaduna State Ministry of Health also proved unsuccessful. A visit to the ministry did not yield an official response on whether plans were underway to address the environmental and infrastructure challenges identified at the facility.

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Outside the facility, mothers continued arriving with babies strapped to their backs.

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Some came for immunisation. Others sought antenatal care, family planning services or treatment for common ailments.

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For Tina, Aisha and hundreds of other residents who depend on the facility, Narayi PHC represents both progress and possibility.

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The renovation has brought healthcare closer to home.

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Children are receiving life-saving vaccines within their community. More women now access antenatal care and family planning services. Patients who once travelled long distances for basic treatment can now find care much closer to home.

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