Audit finds 31% of 290 facilities in six states were never started, stalled or abandoned
By Bunmi Yekini
An independent assessment of 290 primary healthcare centres (PHCs) listed by Nigeria’s government as revitalised has found that only 29.3% met the benchmark for a functioning upgraded facility, raising fresh questions about the delivery and oversight of billions of naira earmarked for strengthening basic healthcare.
The community-led audit, conducted by Orodata Science in collaboration with Africa Data Hub across Abia, Benue, Cross River, Kano, Osun and Taraba states, found that 85 of the 290 facilities met the assessed benchmark, while 170 partially met it and 35 failed to meet it at all.
The findings was presented at the TownHall meeting assessing PHC Service Delivery Across Nigerian States and Physical Lunch of the PHC Operational Capability Report 2026 held in Lagos
The findings showed that more than three in 10 facilities, 91, or 31.4%, were either not started or had stalled or been abandoned, according to the assessment.
The findings offer a sharp contrast between official records and conditions documented by community volunteers on the ground. All 290 facilities visited appeared in the National Primary Health Care Development Agency (NPHCDA) database as revitalised or renovated.
But field verification showed that 70 projects, or 24.1%, had not started, while another 21, or 7.2%, were stalled or abandoned. Five facilities had reportedly been completed but remained locked and unused.
The assessment is significant because the NPHCDA’s Level 2 standard for a revitalised PHC requires the facility to be functional, with a defined package of services, working equipment, water, power and adequate staff.
Yet the reality documented by the auditors was often different.
Work completed, but defects remain
Of the 153 facilities where work was reported as completed, 73 – 47.7% -still had visible defects, including structural problems, poor finishes and substandard installations.
Overall, 152 of the 290 facilities assessed, or 52.4%, showed visible defects or substandard work.
That means the problem was not limited to projects that never got off the ground. Even where construction or renovation had been completed, the quality and functionality of some facilities did not match the government’s revitalisation claim.
Data Analyst at Africa Data Hub, Hannah Naiyeju, said the assessment was based on physical inspections, photographs, geocoding, interviews with health workers and community members, digital scorecards and direct observation.
The volunteers examined construction, water, electricity, staffing, equipment, services, accessibility and operational readiness before scoring each facility across eight domains.
Naiyeju said the exercise was not intended to suggest that government was not working, but to enable citizens to become the “eyes and ears” of the healthcare system and strengthen accountability through evidence.
The assessment, however, points to serious weaknesses in some of the facilities patients may rely on for first-line and emergency care.
Only 22 of the 290 facilities, or 7.6%, had a functional ambulance.
Just 147 facilities, or 50.7%, had a functional water source, while 153, or 52.8%, had functional solar power. Only 119 facilities, or 41% had a functional waste-disposal facility.
Twenty-four facilities listed as revitalised were not operational or open to patients.
The money trail
The assessment also raises questions about whether funding for PHC revitalisation translated into work at the facilities listed for intervention.
It found that 53 facilities, or 18.3%, had no intervention at all despite being listed as revitalised. Of those, 51 projects had never started.
Another accountability challenge emerged where several funders were involved. The report said 43 facilities had five or more named funders, making it difficult to establish who was responsible for specific interventions.
For 50 of 105 facilities identified as funded through the Basic Health Care Provision Fund (BHCPF), the assessment team could not confirm the disbursement gateway.
The report also found high defect rates among facilities attributed to federal funding channels, with 74.6% of Federal Ministry of Health-funded facilities and 70.7% of NPHCDA-funded facilities recording defects. Even among BHCPF-funded facilities, 59.4% had a critical or major gap.
Country Operations Lead at Orodata Science, John Eromosele, said the findings raised questions about whether funds released for PHC revitalisation were reaching the facilities for which they were intended.
He said monitoring teams found that some visible improvements, including painting and provision of equipment, had been carried out by state governments rather than through the interventions reflected in federal records.
Eromosele urged the government to clarify the status of Basic Health Care Provision Fund resources released for PHC revitalisation and called for greater public scrutiny of funds released, projects assigned and work delivered.
He warned that inaccurate information about the functionality of a PHC could have serious consequences for patients, particularly those seeking emergency care.
Wide differences between states
The assessment also found striking differences among the six states.
Benue recorded the highest level of critical or major gaps, with 86% of facilities affected and no facility assessed as having no significant gap. None of the facilities had a functional ambulance.
Taraba recorded critical or major gaps in 78% of facilities, despite relatively strong solar coverage, while Abia recorded a 71% rate and only 25% of its facilities had functional solar power.
Cross River recorded critical or major gaps in 64% of facilities, with 44% showing no work started at all.
Osun fared better, with 43% of facilities recording critical or major gaps, while Kano had the lowest rate at 34%. Kano also had the highest proportion of facilities meeting the benchmark, at 63%.
Government response
Responding to the findings, Executive Secretary of the Osun State Primary Health Care Development Board, Dr Shina Igbalaye, said it was important to distinguish between facilities supported through the BHCPF and those funded through other channels.
Osun has about 800 facilities, he said, with 332 supported through the BHCPF and more than 500 dependent on state and local government funding.
He said revitalisation work involved funding from the state government, BHCPF and UNICEF, while some facilities remained unequipped because of funding constraints.
Igbalaye described the BHCPF as an important source of support but said delays in releasing funds remained a problem. As of September 2026, he said, Osun was only receiving its first-quarter disbursement for the year.
In Lagos, which was not included in the assessment, Permanent Secretary of the Lagos State Primary Healthcare Board, Dr Ibrahim Mustafa, said the state was open to independent assessment of its facilities.
Mustafa said Lagos had about 346 PHCs and renovated at least 72 in 2025, while continuing to upgrade others.
He also identified health-worker shortages as a major national challenge but said Lagos had introduced a system allowing managers to immediately replace workers who leave without waiting for separate approval from the governor.
The state employed at least 970 medical staff at the primary healthcare level in 2025, including doctors, nurses, pharmacists, environmental officers and community health officers, he said.
The assessment’s central finding, however, remains difficult to reconcile: nearly three-quarters of the facilities recorded as revitalised did not fully meet the benchmark used to define a functioning upgraded PHC.
For communities that depend on those facilities, the distinction between a project recorded as completed and a health centre that actually works may be more than a matter of paperwork.