<blockquote><b>Despite Anambra States celebrated recognition as Nigerias best-performing state in primary health care (PHC) delivery, a grim reality tells a different story on the ground.</b> <br><br><b>Investigations by SaharaReporters revealed that many PHCs across the state remain woefully under-equipped, forcing healthcare workers to personally fund basic medical supplies to keep their healthcare facilities operational.<br></b><br>In December 2024, Anambra State was awarded $1.2 million at the Primary Health Care Leadership Challenge Awards in Abuja, clinching the overall winners prize of $700,000 and an additional $500,000 as the South-East zonal champion. <br><br>The award, hailed by the state government as a testament to its commitment to health care, was received by Governor Chukwuma Soludo, accompanied by top health officials.<br><br>But this supposed success has been met with disbelief and frustration by frontline health workers and residents in the state.<br><br>At Achalla, in Awka North Local Government Area, the Officer-In-Charge (OIC) of one of the local PHCs painted a sobering picture. <br><br><b>Speaking to SaharaReporters, she said, It is not only that we do not have enough equipment and medical supplies in this facility, I also use my salary to pay the rent of this house we are using. </b><br><br>It is a rented apartment and I am the one who pays the rent, not the state or local government. Even though my salary is not enough, I still have to use it to pay the rent because I cant even complain to the government.<br><br><b>Listing the deficiencies, she added, We dont have gloves, GV ink, personal protective equipment, not even a working pair of scissors, blood pressure apparatus, drip, artery forceps, and many other things needed here. </b><br><br><b>In fact, we dont have any delivery materials for mother and child here. I use my personal money to buy things like ink, gloves, methylated spirit, disinfectant, and sometimes, medications.<br><br>SaharaReporters tour of 11 PHCs across at least five local government areas in Anambra State revealed similarly dire conditions. </b><br><br>None of the healthcare centres visited had a functioning ambulance; the closest was a broken-down tricycle (Keke Napep) that had once been repurposed as an ambulance in one of the PHCs visited in Ekwusigo Local Government Area. <br><br><b>Basic amenities such as labour wards, pharmacies, amongst others were absent in most of the PHCs visited. </b><br><br>In fact, none of the 11 PHCs SaharaReporters visited has a pharmacy; instead, in place of pharmacies, tiny cupboards held the few drugs that staff could afford to stock, mainly bought out of pocket.<br><br>This is what we face every day, said Mrs. Ifeoma, a community health extension worker at a PHC in Njikoka Local Government Area. <br><br>We are supposed to be the first point of call for health emergencies, but most times, we refer patients immediately because we dont even have a thermometer or basic painkillers. <br><br>I have personally spent over N20,000 this month alone buying gloves, syringes and some medications. Meanwhile, most times, patients dont even pay for the treatment they receive here.<br><br>Patients and community members are bearing the brunt of these deficiencies. <br><br>In Achalla, a commercial motorcyclist, Mr. Chinedu Eze, recounted his near-death experience after a road accident. <br><br><b>I was rushed to three clinics, but none had anything to treat me. No drips, no injections. I had to be taken to a private hospital in Awka after hours of delay. I could have died, he said.</b><br><br>Mrs. Jane Nwankwo, a pregnant woman from Dunukofia Local Government Area, recounted her experience in one of the PHCs in her area: When I came here for antenatal care, they didnt even have gloves to examine me. <br><br>The nurse (referring to the OIC) of the PHC went outside a pharmacy to buy a glove before she could attend to me. <br><br>How can they win awards when we are suffering like this'<br><br>For many residents, the states award win feels like a slap in the face. <br><br>Its all politics, said Mr. Patrick Uzochukwu, a trader in Awka, who hails from Awka South Local Government Area. <br><br><b>The government shows the good side only when outsiders come to inspect. They sweep the dirt under the carpet. But we, the people, know the truth. These health centres are dead.</b><br><br>Despite the situation, health workers say they are afraid to speak out publicly due to fear of victimisation by the government authorities. <br><br>One OIC who spoke with SaharaReporters on the condition of anonymity said, We are scared. If you talk too much, they will transfer you to a worse place or even suspend you. We just manage and pray every day.<br><br>Meanwhile, the Commissioner for Health, Dr. Afam Obidike, had hailed the award in December as a monumental achievement, pledging that the prize money would be reinvested into strengthening the PHC system in the state. <br><br>However, five months later, frontline workers say they have not seen any improvements.<br><br>Its like nothing changed, said Mrs. Okafor. We were hopeful when the award was announced, but here we are, still using our money to buy gloves and bandages.<br><br>Dr. Simeon Onyemaechi, Managing Director of the Anambra State Health Insurance Agency (ASHIA), had also promised expanded health insurance coverage at the award ceremony. <br><br>But residents say those promises feel distant and disconnected from the daily realities of PHCs in their communities.<br><br>Whats the point of insurance if the health centre has nothing' asked Mr. Uzochukwu.<br><br>Community leaders are now calling for urgent action. <br><br>One of the community stakeholders in Oyi Local Government Area, who simply identified himself as Mr. Fred said, We want Governor Soludo to visit these health centres himself, without giving them prior notice. <br><br>Let him see what our people are going through. The government must prioritise health. Its a matter of life and death.<br><br>For now, PHC workers stretch their meagre salaries to keep services running, even as patients hope for a day when the promise of quality primary health care becomes a reality.<br><br><b>As Mrs. Okafor put it, We are not asking for luxury. We just want the basic tools to do our jobs and save lives.</b><br><br>SaharaReporters contacted the Commissioner of Health, Obidike, for comments on why primary healthcare centres in the state are still grappling with shortages of major medical supplies and equipment, with healthcare workers using their meagre salaries to pay rent for the medical facilities they are using despite the $1.2 million prize award.<br><br>However, Obidike acknowledged that many primary healthcare centres in the state need well-built and maintained structures, medical supplies and equipment, but told SaharaReporters that no part of the prize award has been released to the state.<br><br>For the $1.2 million, the money we won, they have not released one naira because there are processes they will use to release the money. We are not complaining because we know that it is a United Nations process, Obidike said.<br><br>However, he said that there are a total of 326 wards in every local government area in the state and that some of the wards have three PHCs, adding that the state government decided to first rehabilitate one PHC per ward.<br><br>What Governor Soludo decided to do is that we are using our money to rehabilitate one PHC per ward. The government has not taken any loan for impact projects to revamp PHCs as other states are doing.<br><br>The commissioner identified some of the newly built PHCs, including Aguluzigbo Primary Health Care Centre, PHC Akwaeze, and a new clinic at Sokoto Road, Onitsha. These places are among the facilities SaharaReporters had reported operating in a community town hall and a tailor shop, respectively.<br><br>We have 326 wards in Anambra state; for each ward, we focus on one for this tenure because we cant finish everything now. <br><br>We know that there are PHCs in rented apartments, but we are looking for suitable locations that will be provided for them. We are also providing equipmen,t and some of them are in our warehouse.<br><br><b>The commissioner however did not deny that healthcare workers are using their salaries to pay rents, and buy medications and some other items they use for their service delivery in their PHCs and health posts.</b><br><br>Speaking with SaharaReporters on the heartbreaking state of many primary healthcare centres in Anambra state and across states in Nigeria, a community health expert, Mr. Benson Ignatius, blamed the poor state of primary health care centres in the country on underfunding by the state and federal government.<br><br>Primary healthcare centres are the first level of care in the health pyramid across the world, which is why they are situated as near to the people as possible, particularly in rural and remote areas, according to their population distribution, Ignatius said.<br><br>He added, As noted with PHCs in Anambra State, most of them are scantily equipped, seemingly neglected, and less poorly staffed. <br><br>This is not only an issue with Anambra alone, but is a nationwide problem.<br><br>Ignatius noted, Most of PHC centres in various communities are incomplete, not having dependable electricity or clean water, essential drugs, and operational medical equipment. <br><br>In certain cases, a single nurse or community health worker is left to manage the entire facility, serving hundreds or possibly thousands of people. <br><br>Healthcare, especially for maternal and child health, child immunisation programs, and management of common ailments, is not only inaccessible but also of poor quality.<br><br>He pointed out that the Nigerian government has made several policy commitments to strengthen primary health care in the country, including revitalising 10,000 PHCs and implementing the Basic Health Care Provision Fund (BHCPF). <br><br>However, the impact remains limited due to poor funding, weak governance, and lack of accountability at various levels of government, he said. <br><br>He said, There is an urgent need for increased investment in PHC infrastructure, human resources, and supply chains.<br><br>Also, community involvement and inter-sectoral collaboration must be enhanced to ensure these centres are responsive to local health needs. <br><br>Only by addressing these systemic issues can Nigeria achieve Universal Health Coverage and improve the health outcomes of its population. <br><br>Anambra State, with its vibrant communities and political will, has the potential to lead by example in transforming PHC delivery, but it must prioritise sustainable reforms, regular monitoring, and community engagement to do so effectively.<br><br><b>This story was produced for the Frontline Investigative Program and supported by the Africa Data Hub and Orodata Science</b>. Nlfpmod </blockquote><br><a rel=ugc href="https://saharareporters.com/2025/05/19/award-winning-failure-inside-anambras-crumbling-phcs-where-health-workers-buy-supplies">https://saharareporters.com/2025/05/19/award-winning-failure-inside-anambras-crumbling-phcs-where-health-workers-buy-supplies</a><br><br>Frame 1: Delivery ward<br>Frame 2: Pharmacy stand/table<br>Frame 3: Clinic bed.<br>Frame 4: A stretcher.
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