•A primary health care center in Nigeria
Whenever Mr. Peter Obi, the Labour Party’s presidential candidate in the 2023 general elections, emphasises the need to invest in critical sectors such as primary health care, I find myself nodding in agreement not because of political affiliation, but because, as a public health professional, I understand the profound truth in his assertion.
Quoting him during an interview with Arise TV’s Charles Aniagolu, “70% of Nigeria’s primary health care centres are not functional.”
That single statistic lays bare the tragedy of a health system that has long abandoned its most vulnerable citizens; those in rural areas, the poor, the forgotten. It is no exaggeration to say that Nigeria’s health system is failing and has been for decades. And this failure is not without consequences. A sick nation cannot be a productive one. A population riddled with preventable illnesses, high maternal and child mortality rates, and weak health infrastructure cannot contribute meaningfully to national development. The ripple effect of poor health care is economic stagnation, social disintegration, and ultimately, national decline.
The role of primary health care: Primary Health Care (PHC) is the cornerstone of any effective health care system. It is the first level of contact between individuals and the national health system. It is supposed to offer essential, affordable, and accessible health services; from disease prevention and health promotion to curative and rehabilitative services. PHC should be the safety net that catches people before their conditions worsen, before a simple infection becomes a fatal disease, before pregnancy becomes a death sentence, and before malnutrition permanently stunts a child’s development.
But that is not the reality in Nigeria. Instead, what we see is a skeletal PHC framework, often reduced to empty buildings without personnel, equipment, or essential drugs. Health workers are underpaid and overworked. Corruption siphons off funds meant for rural clinics. Oversight is weak, and policies, though often well-written, are rarely implemented with fidelity.
The human cost of health system failure: Imagine a woman in labour in a remote village with no midwife, no ambulance, and no hospital within a 20km radius.
Imagine a farmer with malaria forced to rely on herbs because the local PHC has been non-functional for years. Imagine a toddler with diarrhoea, a treatable condition, dying because the mother had no access to oral rehydration therapy. Now multiply these individual tragedies by the millions, and you begin to grasp the scale of the crisis. According to the World Bank, Nigeria loses over $1.5 billion annually due to reduced productivity linked to preventable illnesses. Maternal mortality remains among the highest in the world, with an estimated 512 deaths per 100,000 live births, while child malnutrition continues to threaten the lives of millions under age five.
Each one of these statistics represents a life cut short, a family thrown into despair, a dream unrealised. Health Is Wealth, literally!
We cannot continue to chant economic diversification and human capital development while ignoring the health of our people. Sick individuals cannot work. Sick children cannot learn. A sick population cannot build a strong, self-reliant nation. Health is the foundation upon which productivity is built, and no country has achieved sustainable development without investing significantly in its health care system.
When health care is dysfunctional, everything else is at risk – education, agriculture, industry, even national security. We must stop treating health care as a peripheral issue and begin to see it for what it is—a critical pillar of national development.
What needs to be done? The road to revamping Nigeria’s health care system, especially at the primary level, is neither short nor easy. But it is possible with the right political will, ethical leadership, and focused investment.
1. Restore and equip PHCs: There must be a nationwide audit and rehabilitation of all Primary Health Care centres. Equip them with modern facilities, ensure regular drug supply, and establish reliable electricity (preferably solar) and water systems.
2. Strengthen the health workforce: Recruit, train, and retain health workers, especially in rural areas. Offer incentives—housing, hazard allowances, career progression for rural service.
3. Curb corruption and improve accountability: Transparent allocation and monitoring of health budgets are essential. Establish citizen-based monitoring groups to track PHC service delivery.
4. Integrate ICT and telemedicine: Incorporate technology to bridge the health access gap. Mobile health apps, digital consultations, and health records systems can enhance reach and efficiency.
5. Prioritise maternal and child health: Ensure every PHC is equipped to provide antenatal care, skilled birth attendance, immunization, and nutrition counselling. No woman should die giving life. No child should die of hunger.
6. Community engagement:
Empower communities to take ownership of local health initiatives. Engage traditional and religious leaders in promoting healthy practices and health-seeking behaviour.
7. Invest in health education and promotion: Awareness is the first step toward prevention and early treatment. Many Nigerians suffer or die needlessly because they do not recognize early warning signs of disease or delay seeking care.
Investing in nationwide health education through schools, radio, community outreach, and digital platforms can empower individuals to take charge of their health. Communities should be regularly educated about early signs and symptoms of common illnesses such as: Cancer unexplained weight loss, persistent fatigue, lumps or swellings, especially in the breast or neck, non-healing sores, changes in bowel or bladder habits, abnormal bleeding or discharge, diabetes, frequent urination, especially at night, excessive thirst, unexplained weight loss, fatigue and irritability, slow healing of wounds blurred vision.
Hypertension (high blood pressure) often called the “silent killer” because it has no symptoms in early stages in some cases: headaches, chest pain, vision problems, or difficulty breathing may occur, routine blood pressure checks are key to early detection, malaria, fever and chills, sweating, headaches, body aches and general weakness, typhoid, persistent fever, abdominal pain, diarrhoea or constipation, loss of appetite.
By promoting health literacy and encouraging routine screening and health checks, especially in rural areas, we can detect diseases early, reduce complications, and save lives.
Health education must become as routine as school lessons or market announcements.
A wake-up call
We must stop living in denial. We are not progressing if the majority of our population is unwell. We are not developing if rural dwellers who feed the nation are neglected. We are not succeeding if childbirth becomes a death sentence. What we need now is empathy-driven leadership. Leadership that sees health not just as a political promise, but as a moral imperative. We need leaders and policymakers who see the faces behind the statistics and act accordingly.
Let us begin to build a Nigeria where being healthy is not a privilege but a right. Let us create a future where every Nigerian, no matter how poor or remote, has access to basic health care. Only then can we truly say we are on the path to national productivity, prosperity, and pride.
*Anyanwu-Akeredolu, MPH, PhD, is a former First Lady of Ondo State.
