Despite billions budgeted for primary healthcare in Ogun State, many health centres remain neglected. In this investigation, DAUD OLATUNJI, exposes the stark gap between government spending and the realities confronting patients at the grassroots.
Across communities in Ogun State, patients continue to arrive at primary healthcare centres only to encounter broken equipment, unreliable electricity, and inadequate health workers.
While successive budgets earmarked billions of naira for primary healthcare infrastructure, an investigation by PLATFORM TIMES found that only a small portion of the approved funds was eventually released, raising concerns over the impact of poor budget implementation on healthcare delivery.
A PLATFORM TIMES investigation across four local governments in the state – Odeda,Ikenne,Imeko-Afon and Abeokuta-South – revealed a gap between government spending commitments and the state of primary healthcare facilities.
Nine primary healthcare centres were visited during this investigation. While conditions of the facilities varied, they all showed signs of a healthcare system under severe strain. In many facilities, critical infrastructure was either inadequate or deteriorating, medical equipment were lacking, staffing levels fell far below demand, and essential services were limited.
Budget records deepen concerns
According to Ogun State’s 2024 Budget Implementation Report, the Ogun State Primary Healthcare Development Board spent just ₦3.96million of its ₦ 10.55 billion capital budget by the end of the fiscal year, representing approximately 0.04 per cent of the revised allocation.
The figure was cross- checked against the state’s approved budget document. In practical terms, for every ₦1,000 budgeted for constructing, equipping and maintaining primary healthcare facilities across the state, less than 50 kobo was spent.
The Network On Paper
While the government failed to release the funds meant for the primary health centres; the centres are in horrible condition. Data obtained from the National Primary HealthCare Development Agency dashboard paints a mixed picture of Ogun State’s primary healthcare system.
Of the state’s 520 primary healthcare facilities, only 47 percent are classified as functional. Infrastructure gaps remain widespread. Only 157 facilities have backup power, 117 provide staff accommodation, while just 57 have been renovated through government or development partner interventions.
The availability of essential health services is similarly uneven. Whilst 505 facilities provide malaria screening and 497 offer routine immunisation. Family planning is available in only 232 facilities, HIV services were in 199, tuberculosis screening in 204, sexually transmitted infection screening in 162, while TB treatment is available in just 125 facilities. Basic eye care services are the scarcest to fall, offered in only 19 facilities, less than four per cent of the state’s primary healthcare network.
ODEDA: Low Awareness, Lower Capacity
The challenges confronting Ogun State’s primary healthcare system are immediately evident at Aaya Health Centre in Odeda. The facility struggles with both low public awareness and limited capacity to provide comprehensive care.
“Only a few people know we are here,” a health worker who preferred anonymity told Platform Times, attributing the low patient turnout partly to poor public awareness of the facility’s existence.
It was gathered that the centre provides basic services, including HIV testing, malaria screening, blood sugar monitoring and blood pressure checks.
Because the centre lacked diagnostic equipment, patients were routinely referred to private hospitals for diagnostic tests, thus increasing the cost of healthcare for residents.
A health worker, who requested anonymity because she was not authorised to speak to the media about the state of the healthcare centre, said deliveries are done through torchlights. “We still use torchlights to take deliveries,” she said. She said electricity is a major challenge facing us at this hospital.
It was observed that at the hospital, apart from a small solar-powered bulb, the facility has no other power supply.
The visit to the hospital showed that its original eight- bed capacity has remained unchanged since it was established almost 15 years ago. Parts of the compound are overgrown with bushes, while two staff members said they, alongside other colleagues, used their personal money to repaint sections of the building because funds were not provided for maintenance.
One of the nurses who also pleaded anonymity said, no nurse is permanently stationed at the facility, while a single doctor serves the entire local government area, leaving routine patient care largely in the hands of community health officers.
A resident, Samuel Idowu, who walked for more than 20 minutes to reach the health centre on the morning of the visit, bemoaned the absence of health personnel at the centre.
“If anything serious happens to you or your child, they will tell you to go to the hospital. But, how? With what money? We travel far for what should be available here,” said Bola Gabriel, another patient.
The state of the health centres in nearby Osiele and Obantoko was not better. The centres were marked by inadequate staffing and ageing infrastructure that continue to affect service delivery.
At Obantoko PHC, the freshly painted white-and- grey exterior gives the impression of recent government intervention. However, some health workers who did not want their names in print, said the renovation was carried out by members of the community and some staff members of the facility government support.
PLATFORM TIMES’ visit to the three facilities highlights a recurring pattern: communities increasingly rely on personal sacrifices and local initiatives to keep public healthcare centres functional while awaiting government support that many residents say may not come.
IKENNE: Open Doors,Empty Setvices
At Ikenne Local Government the PHCs suffer from adequate staffing and lack of medical equipment. At Ilisan Primary Health Centre, in the local government, the facility was open when PlatformTimes visited, but, no health worker was present throughout our stay. The centre was neither under renovation nor officially closed.
At Ikenne Itumoro PHC in Agberiodo Community, only one staff member was on duty.
“There is no doctor. There is no nurse. Any time something serious happens in this area, we have to take the person to somewhere else before he or she can get proper treatment. Yet, there is a government health Centre here. What exactly is it meant for?”, said James Ajayi, a resident.
The PHCs at Iperu and Ogere were in similar dilapidated conditions. Residents say they have resorted to travelling long distances to access quality.
IMEKO-AFON: Demand Outpaces Capacity
In Imeko-Afon Local Government Area, the challenge is not the availability of healthcare facilities but their ability to cope with the needs of the communities they serve.
At Imeko PHC and Afon Health Clinic, health workers provide a range of basic services despite severe resource constraints. However, both facilities operate with insufficient personnel and limited infrastructure, making it difficult to meet growing demand. Although the centres remain functional, health workers said poor staffing and ageing infrastructure continue to affect the quality and speed of service delivery.
The findings reinforce a pattern observed across the facilities visited: primary healthcare workers are often expected to meet increasing healthcare needs with limited resources and little sustained government investment.
ABEOKUTA-SOUTH : Evidence That Investment Works
Unlike many of the facilities visited during this investigation, Kuto Health Post in Abeokuta-South Local Government Area presents a different picture.
The facility is cleaner, better maintained and more functional. Health workers reported an increase in patient turnout following improvements to the centre’s infrastructure.
Kuto is among the 57 primary healthcare facilities renovated through a combination of Ogun State Government and development partner interventions, including support from IMPACT, UNICEF and the Basic Health Care Provision Fund.
Where infrastructure has been improved and resources invested, community confidence appears to have increased, translating into higher utilisation of the facility. However, the gains are far from universal. At Iporo Sodeke Primary Health Centre, also located in Abeokuta South, the investigation found conditions similar to those documented in other parts of the state: inadequate infrastructure and limited capacity to meet patients’ healthcare needs.
Community Voices
For many residents in the state, the shortcomings of the primary healthcare system have become personal and costly.
A 37-year Tunde Adeyemi said he stopped taking his 68-year-old mother, who lives with hypertension, to Aaya Health Centre two years ago after repeatedly finding no drugs and non-functional equipment.
He now travels to a private clinic located two communities away, spending about ₦4,000 on every visit, including transportation. “We stopped going,” he said.
For Sade, a resident of Obantoko who requested that only her first name be used, the consequences were even more frightening. She had gone to Aaya Health Centre in Odeda Local Government Area for routine antenatal care in late 2024 but found neither a doctor nor electricity at the facility.
She said she was referred elsewhere and had to borrow money to cover transportation costs. “I was afraid,” she recalled. “I should not be afraid at a government health centre.”
Across the four local government areas visited, residents shared a common concern: facilities intended to serve as the first point of care are increasingly unable to meet even basic healthcare needs, forcing patients to spend more time and money seeking treatment elsewhere.
Tracking The Funds, Questioning The Outcomes
The findings of this investigation raise serious concerns about how funds meant for primary healthcare were managed in Ogun State.
Official budget documents and the 2024 Budget Implementation Report show that the Ogun State Primary Healthcare Development Board was initially allocated ₦23.89 billion for capital projects.
The amount was later reduced to ₦10.55 billion. However, by December 31, 2024, only ₦3.96 million had been spent on capital projects. Out of this, ₦2.96 million was released only in the last three months of the year.
The 2025 figures are even more confusing. Documents reviewed by Platform Times show that the board’s capital budget was initially ₦295.02 million but was later increased to ₦3.76 billion.
However, the same documents state that ₦31.85 billion was spent on capital projects—almost nine times the approved budget.
Government Response
The Executive Secretary of the Ogun State Primary Healthcare Development Board, Dr. Elijah Ogunsola, disputed several of the findings of this investigation.
Responding to questions about the budget figures, Dr. Ogunsola said he was unfamiliar with the data and directed this reporter to the Ministry of Budget and Planning.
“There must have been an error somewhere,” he said. The figures cited in this report were obtained from Ogun State’s official approved budget and Budget Implementation Report.
The Executive Secretary also challenged data from the NPHCDA dashboard, which indicates that only 47 per cent of Ogun State’s primary healthcare facilities are functional. According to him, the state currently has 477 functional primary healthcare centres.
“I can tell you in the affirmative that every ward in Ogun State has functioning infrastructure, fully functioning,” he said. He did not explain the basis for the difference between his figures and those published on the NPHCDA dashboard.
On infrastructure, Dr. Ogunsola said the state government has made significant progress in recent years.
According to him, the administration renovated more than 100 primary healthcare facilities between 2019 and 2024.
He added that the IMPACT Project renovated 75 facilities, while the Basic Health Care Provision Fund supported renovations in five others. UNICEF, he said, is currently funding renovation works in four additional facilities.
“If you look at where we were in 2019 and where we are today, you will see progressive improvement,” he said.
Reacting to reports that health workers at Aaya Health Centre sometimes rely on torchlights during deliveries, the Executive Secretary expressed scepticism.
“Not in this time and age will I agree with the fact that there is a health centre where they are using torchlight,” he said, suggesting that some health workers exaggerate conditions when speaking to journalists. The account, however, was provided directly to Platform Times by a health worker during a visit to the facility.
On staffing shortages, Dr. Ogunsola attributed the gaps partly to the migration of healthcare professionals. “As we are employing them, some of them would have gotten their ticket,” he said, referring to health workers leaving the country for opportunities abroad.
He disclosed that the state had employed nearly 1,000 nurses over the past two years and was developing a replacement policy to address workforce shortages.
He did not directly respond to the findings at Ilisan Primary Health Centre, where no health worker was present throughout the reporting team’s visit.
Dr. Ogunsola also said quarterly imprest allocations to primary healthcare facilities had recently been increased, from ₦300,000 to ₦600,000 for standard facilities and ₦800,000 for higher-level centres.
Experts Perspectives
Civil society advocate and Executive Director of the Community Education Advancement of Peace and Development Initiative, Mr. Sina Adefolahan, said Ogun State must urgently scale up investment in deteriorating primary healthcare infrastructure. While acknowledging ongoing renovation efforts, he argued that many communities remain underserved.
“There is a need to consider the massive renovation of the health centres at Iro and Olowokojebi in Obafemi-Owode Local Government Area because of the dilapidated structures at the centres, which have been keeping clients away,” he said.
Adefolahan also described staffing shortages as one of the most pressing challenges confronting the state’s healthcare system. “The reality and magnitude of the staff gap remain worrisome. There is a need to recruit more nurses and other health workers to meet the staffing needs of our health centres,” he said.
He further called for stronger oversight of funds disbursed to facilities through Ward Development Committees. “There is a need to monitor the funding being made available to our PHCs through the Ward Development Committees to ensure value for money and guard against mismanagement,” he said.
The Ogun State Chairperson of the National Association of Nigerian Nurses and Midwives, Adejoke Bello, said the shortage of nurses continues to undermine service delivery across primary healthcare facilities. “Where you expect four or five nurses to work but only one is available, there is no way that person can perform optimally or give their best,” she said.
According to Bello, the association has repeatedly engaged the state government through meetings and formal correspondence to advocate for increased recruitment.
She acknowledged efforts to procure medical equipment but stressed that equipment alone cannot improve healthcare outcomes. “It is not enough to procure equipment. Those who will use the equipment must also be properly trained,” she said.
Prof. Olununmi Ashimolowo, Chairman of the Association for the Promotion of Community Women and Girls Rights and Executive Director of the Gender Development Initiative, said primary healthcare centres must receive greater federal investment if they are to function effectively as the first point of care.
“We have to equip our primary healthcare centres properly so that people will have confidence in them and will not need to rush to tertiary hospitals for conditions that should be treated at the primary level,” she said.
She also referenced conditions similar to those documented during this investigation. “In many of these facilities, health workers still rely on torchlights during deliveries. Properly equipping these centres would reduce the burden on tertiary hospitals,” she added.
From Odeda to Ikenne, Imeko-Afon and Abeokuta South, this investigation found different communities confronting variations of the same challenge: primary healthcare centres struggling to provide the level of care expected of the first tier of Nigeria’s health system.
While some facilities have benefited from recent renovations and increased funding, many others continue to operate with inadequate infrastructure, unreliable electricity, insufficient equipment and critical shortages of health workers.
Government officials insist progress is being made. Yet budget records, national data and observations from facilities visited during this investigation suggest that significant gaps remain between funding commitments and healthcare realities at the grassroots.
For thousands of Ogun residents who depend on primary healthcare centres, those gaps are measured not only in budget figures but also in delayed treatment, higher out-of-pocket expenses, avoidable referrals and declining confidence in a system designed to provide care closest to home.
This investigation was supported by the Centre for Journalism Innovation and Development (CJID).
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