From crumbling buildings and empty drug shelves to the absence of equipment, water, electricity and trained personnel, PUNCH Healthwise investigation reveals how many Primary Healthcare Centres in Ebonyi State have fallen into disrepair and are being run by unskilled health workers, leaving already vulnerable rural communities — especially pregnant women and children without access to basic healthcare services. EDWARD NNACHI reports
Despite the critical role functional primary healthcare centres play in reducing Nigeria’s high maternal mortality rate by providing accessible and affordable care to underserved communities, many PHCs in Ebonyi State are in a state of decay.
A PUNCH Healthwise investigation found facilities plagued by crumbling buildings, cracked walls, empty drug shelves, and a severe shortage of trained health workers, medical equipment, and essential medicines.
Findings from several visits to the PHCs by our correspondent reveal that most of them lack basic amenities, including water and electricity.
Our correspondent also sighted several PHCs in the state whose survival is threatened by years of neglect.
PUNCH Healthwise gathered that the deteriorating condition of these health centres has continued to deny pregnant women access to skilled care during childbirth and has disrupted routine immunisation services for children.
Health post without water, electricity
At Abina Health Post in Ndufu Amagu community, Ikwo Local Government Area of Ebonyi State, PUNCH Healthwise observed a facility surrounded by filth, with cracked walls and a rundown structure.
The health centre had neither a functional toilet nor access to potable water or electricity.
Even more alarming, the facility was being run by an unskilled health worker, Mr. Oke Cornelius.
Cornelius admitted that the last time he received any form of medical training was in 2017.
Another worker at the facility, who asked not to be named but guided our correspondent around the premises, described working conditions at the health post as harrowing.
“I know the truth is hard to say, but it’s not easy working here. The situation of this health centre is worrisome, but we can’t do anything about it.
“This place has nothing befitting of a hospital. There’s no light, no water, no toilet, and there are not enough workers. So how can this place be called a primary healthcare centre?” he said.
He urged authorities to urgently intervene, saying, “If something can be done to make this place functional, it should be done now. This is not how a hospital should be.”
N98bn released to strengthen PHCs in 2025
These PHCs continue to fail pregnant women and children, even as President Bola Tinubu recently disclosed that his administration injected over N98 billion into the nation’s primary healthcare system last year through the Basic Healthcare Provision Fund, which Ebonyi State is also a beneficiary, although PUNCH Healthwise could not ascertain the amount allocated to it.
Established under section 11 of the National Health Act (NHAct) 2014, the BHCPF aims to support the Basic Minimum Package of Health Services (BMPHS) and improve overall health sector financing. It is financed by an annual grant of not less than one percent of the consolidated revenue fund from the federal government, as well as grants from international donor partners, the private sector, or other sources.
The fund is jointly managed by the National Primary Health Care Development Agency, the Federal Ministry of Health, and the National Health Insurance Authority.
Before the recent disclosure by President Tinubu, the Coordinating Minister of Health and Social Welfare, Prof. Ali Pate, in October 2025, announced the release of N32.9bn by the Federal Government through the BHCPF to strengthen primary healthcare nationwide in a “Red Letter” statement, noting that it marks the third disbursement of the fund in 2025.
Pate urged Nigerians to track the utilisation of the funds to ensure transparency and impact at the community level.
He said the government has observed that communities do not demand accountability on how the money is used, adding that silence leads to loss. “This money is not sitting in Abuja. It has already begun its journey into the commercial bank accounts of primary health care facilities in every ward across Nigeria,” Pate said.
Elugwu Ettam PHC without equipment
The story was not different at the Elugwu Ettam Primary Health Centre, which had an influx of not less than 28000 patients annually, but lacked basic medical equipment.
Speaking about the decrepit condition of the health centre, the Officer-in-Charge, simply identified as Mrs Nworie, said the facility was basically surviving on the interventions extended to it by Ananda Marga Universal Relief Team (AMURT), a humanitarian organisation that focuses on improving community healthcare and reducing maternal and infant mortality in Nigeria.
According to Nworie, who is a Community Health Officer, “Here, we don’t have enough drugs, there’s no electricity, we don’t have enough workers. This is worrisome.”
She called on the relevant authorities to intervene, adding that the facility was in a precarious state.
Our correspondent further observed that, besides an overwhelming number of pregnant women patronising the health centre, over 2000 nursing mothers bring their babies to Elugwu Ettam Primary Health Centre weekly for immunisation.
This explains the critical healthcare role the facility plays in the area. However, the debilitating nature of the health centre threatens its survival. These nursing mothers and pregnant women come to the clinic to access medical services from no fewer than 13 villages.
A 42-year-old woman from Elugwu Ettam community, Florence Nwomeh, told PUNCH Healthwise that accessing healthcare services in the centre was difficult, as only three medical personnel were deployed at the only facility in the area to attend to over 2000 patients daily.
While also lamenting the absence of basic medical equipment in the clinic, Nwomeh called on the relevant authorities to intervene.
“In this village, we have one primary healthcare centre, which is where over 2000 people go for their treatment. But most worrisome is that there are only two or three health workers in this place who attend to the day-to-day clinical needs of the people here. Government needs to engage more hands, because two or three healthcare personnel here is not enough.”
Functional PHCs bedrock of healthcare
Experts say functional PHCs will attract doctors, nurses, midwives, laboratory scientists, and other qualified health workers to provide services to patients in rural areas.
A functional PHC system should provide services to most of the people, breaking the barriers of geography, social or financial standing.
The Harvard Public Health Review, a peer-reviewed medical periodical, describes it as “the foundation of the healthcare system,” ideally, the first level of contact of individuals, families, and communities with the national health system.
The World HealthOrganisation insists that “accelerating progress towards universal health coverage relies on greater investment in PHC.
But findings by PUNCH Healthwise investigation showed that Ebonyi State’s dysfunctional PHC system has effectively deprived the majority, especially the poor and rural dwellers, of effective health care services.
Amuda Health Post in ruins
When our correspondent visited Amuda Health Post, which is still located in the Ikwo council area, he met with a semblance of a graveyard with no sign of ‘life’ in it. The absence of its OIC, Mrs. Agnes Nwoba Nkpa, was daunting. But the Chief Cemetery Keeper, Mrs. Nwoba Regina, was handy to interact with PUNCH Healthwise.
Nwoba admitted the health centre was a shadow of itself. According to her, the facility was neither fulfilling its responsibility nor meeting the healthcare needs of the community.
She said, “We lack a lot of things. This place is not meeting its obligations to the poor masses of Amuda in the Ikwo LGA, and this is affecting us a lot. You can see things for yourself, and nobody, including my OIC here, is happy with the situation of the health post.”
She continued, “Just check around, you would find out that we have nothing. No scissors, no injection ampoules, no hospital beds , no light, no water , and we don’t even have drugs. So, you people should tell the government that we are suffering here.”
A nursing mother at the Amuda Health Post, Margaret Onyeka, narrated how she almost lost her second baby during labour at the facility owing to obsolete medical equipment. She said, “There is no delivery bed, drip stand , or even syringes here. Most of the equipment used here is improvised locally by the health attendants here. Here, there’s no delivery plan or even drugs — most of the drugs are procured by the head of the health workers here.”
The ugly experience narrated by another healthcare worker, Mr Nkoko Joseph, a Community Health Extension Worker at the Ndiechi MDGs Health Centre, was both debilitating and hair-raising. He cited a case where drugs administered at the health facility were procured by himself and the facility’s OIC. Aside from the absence of drugs, water, and other basic amenities at the PHCs, the healthcare workers lamented the near neglect of medical facilities by the state government.
Maternal mortality reduction
Experts say scaling up investment in PHCs will drastically reduce maternal, newborn, and child mortality.
The 2025 Nigeria Health Statistics Report, released by the Federal Ministry of Health and Social Welfare, revealed that Nigeria recorded an estimated 20,811 maternal, neonatal, and under-five deaths between January and September 2025.
The Minister of State for Health and Social Welfare, Dr. Iziaq Salako, in November 2025, said Nigeria contributes about 14 per cent of global maternal deaths and nine per cent of global under-five deaths.
Salako disclosed this in his inaugural address during the second day of the 2025 Joint Annual Review Meeting in Abuja, with the theme, “All hands, one mission: Bringing Nigeria’s health sector to light.”
He said that although Nigeria has recorded improvements in key health indicators, the progress is still insufficient for a nation of its size and resources.
At Obeagu Primary Healthcare Centre in Enyibichiri community, Ikwo LGA, a pregnant woman, Mrs Marbel Nwobo, said the absence of electricity and drugs was making healthcare services inaccessible in the area.
According to her, “Apart from the lack of drugs and water in this clinic, both patients and health workers suffer from the absence of electricity. During emergency situations, the workers here find it difficult to do their work. So, we call on the state government to do something.”
The Officer-in-Charge of the clinic, Mrs Philomena Nweke, told our correspondent that the health centre was grappling with a shortage of manpower and drugs, calling on the state government to expedite efforts to revamp the system.
Nweke said the health centre, which caters to the medical needs of over 14,000 patients from more than 12 villages yearly, noting that the last time she received her salary was four months ago.
“We are here to give our best in this service, but we need the necessary support to do that. We are discouraged by the situation here. We don’t have the basic things to work with — no water, no basic medical equipment, no adequate security, no electricity, and not enough manpower. I am the only person in this health centre,” she noted.
It was observed that the last time most of the PHCs were renovated was about 10 years ago, a development that has exposed the facilities to cracked walls, leaking roofs, and dilapidated structures.
She called on the present government in Ebonyi State under Governor Francis Nwifuru to intervene.
The security guard at the facility, Mr Nwali Anyigor, said the poor treatment meted out to healthcare workers across the state had exposed them to hardship.
He added, “It has been over four months, and we have not been paid. So how do they expect us to cope? I am here through the Obeagu Community Development Union, which provides stipends to me from time to time. But for over four months now, nothing has come. It is like that across the state, and it is worrisome.”
Government response
Efforts to reach the Chairman of Ikwo Local Area, Mr. Sunday Nwankwo, for comments on what he is doing to provide basic medical tools and access to healthcare in the area failed.
He neither picked up calls nor responded to inquiries made by our Correspondent on the matter as of the time of filing this report.
However, speaking to PUNCH Healthwise, the Executive Secretary of the Ebonyi State Primary Healthcare Development Agency, Dr. Ovuoba Emeka Phillip, claimed that the state government had improved and revitalised the primary healthcare centres in the state.
Philip said the state government had revitalised and repositioned over 25 clinics in the state to serve as “specialist hospitals” for residents.
He said, “We have done enough to improve the services of primary healthcare centres in Ebonyi State. This is because the Governor, Bldr. Francis Nwifuru has done so much in the health sector. As I speak with you, a team from Abuja led by the World Bank IMPACT project visited Ebonyi State to assess the improvements so far at the PHCs. This World Bank team, alongside other key stakeholders, hailed what the Governor has done in the health sector, especially the PHCs.”The state government has revitalised the PHCs to the level that we currently operate at level 2 of the PHCs’ services.”
According to him, the Governor has revitalised 25 PHCs in the state with the IMPACT project, and this was the assessment “I told you was done by the World Bank team last week.”
Philip said the 25 PHCs were revitalised as full-fledged hospitals where they have hospital buildings, staff quarters, water, alternative power sources, and even fencing with gate men , among others.
“There are 25 of them, which have been completed and are ready for commissioning, and these are spread across the 13 local government areas of the state.” Apart from revitalising the PHCs, all the equipment needed for viable and functional clinics has been provided by the state government”, he explained.
He added, “This morning, before coming to the office, I was in an online meeting with the National Primary Healthcare Development Agency and other stakeholders, where we are discussing further steps and measures to be taken for the revitalisation of PHCs in the country, and Ebonyi State is benefiting from that.”