The federal government has invested N130.8 billion over the past five years to equip primary healthcare centers (PHCs) across the nation.

In 2024, the government disbursed N25.8 billion, with an additional N12.9 billion set to be released.

This investment is part of the Basic Health Care Provision Fund (BHCPF), a strategic initiative aimed at reducing maternal and infant mortality while ensuring quality healthcare is accessible to all Nigerians, particularly the most vulnerable.

The funds have been allocated to 8,809 PHCs nationwide, ensuring that at least one center exists in every political ward within each Local Government Area (LGA).

The disbursement was carried out through key health agencies, including the National Primary Health Care Development Agency (NPHCDA), the National Emergency Medical Treatment Committee (NEMTC), and the Nigeria Centre for Disease Control and Prevention (NCDC).

During the same period, 1.96 million Nigerians were enrolled under the NHIA, broadening the scope of accessible health coverage.
According to Mukhtar Muhammad, Secretary of the Ministerial Oversight Committee (MOC), the BHCPF aims to expand its coverage, doubling the number of PHCs in every ward by 2027.

However, Muhammad emphasized that PHCs can only access these funds if they meet strict fund-tracking criteria and if the State governments contribute the required 25% counterpart funding.

During a recent BHCPF media engagement in Abuja, Muhammad highlighted the significant challenges hindering the implementation of mandates despite the significant milestones it has been able to achieve since its inception.
The BHCPF is designed to remove barriers to accessing primary healthcare, especially for those in remote areas.

These centers, being the closest healthcare facilities to the people, are intended to provide quality care with trained health workers and necessary equipment.

The fund is disbursed through four main gateways: the NHIA (48.75%), NPHCDA (45%), NEMTC (5%), and NCDC (1.25%).

According to Muhammad, the necessity of the BHCPF becomes clear when considering Nigeria’s alarming health statistics. Despite representing only 2.4% of the world’s population, Nigeria accounts for 10% of global maternal deaths.

He said the maternal mortality rate stands at 1,047 deaths per 100,000 live births, while approximately 262,000 newborns die at birth each year—the second highest rate globally, while infant mortality is currently at 69 per 1,000 live births, and for children under five, the rate is 128 per 1,000.

He said: “The strategic funding is essential to address these critical issues at the basic healthcare level.
“The initiative seeks to improve maternal and newborn care, to ensure that every LGA has at least one functional facility providing emergency obstetric and newborn services.
“This joint effort between the Federal and State governments is crucial in reducing maternal mortality rates across the country”.
Muhammad however acknowledged that though significant progress has been made since the BHCPF’s inception, it is still facing some challenges.

He said that overcoming the persistent issues is vital to achieving the desired goals of quality, accessible, and affordable primary healthcare services.
The most pressing challenges, according to him, include limited ownership of the BHCPF by state and local governments, and inadequate funding, “The reluctance of State governments to fully own and support the BHCPF is a significant barrier,” Muhammad stated.

Other challenges include governance and coordination issues, weak health infrastructure, and a lack of human resources, in addition to limited public awareness and participation, coupled with inadequate oversight and monitoring mechanisms, he noted.

In his presentation, Olusunkami Agboola, who represented NHIA said the national enrollment has gone up significantly rising by 11% under a year.

According to him, from the low base of an estimated 16 million enrolment into various schemes across the country in quarter 4 of 2023, total national enrolment now stands at about 18.7 million.

This translates to an increase of about 11% in less than one year, an indication that the ongoing efforts by NHIA and various State government institutions working in the health insurance space are yielding fruit.
“This enrollment figure has also already surpassed the Presidential target for the year by 8% demonstrating its capability of meeting and exceeding the 2027 target.

“The Coordinating Minister for Health and Social Welfare, Prof. Ali Pate had announced at the end of 2023 that an additional 750,000 Nigerians signed up for health insurance within the first 100 days of the Tinubu administration.

Since the beginning of 2023, the NHIA under its current management, has been working on various strategic measures to shore up the figures in pursuit of the administration’s target of universal coverage by 2030.

Among several measures targeted at improving synergies with public and private sector partners and ultimately enrolment figures, NHIA initiated and is leading the ongoing review of capitation fees paid to healthcare providers.

“The capitation fees are fixed payments to healthcare providers based on the estimated value of services to patients that constitute a key incentive for achieving improved quality of services and attracting enrollees.

“Already a temporary rate has been agreed, pending the announcement of a revised rate,” he added.
Ogbe Oritseweyimi, who represented the NPHCDA gateway said the agency is responsible for strengthening primary healthcare systems.

He said: “It allocates funds to improve infrastructure at Primary Health Care (PHC) centers, provides essential drugs and vaccines, and supports training for healthcare workers.
“This gateway also implements public health interventions such as immunization programs and maternal and child health services”

According to Saidu Ahmed of the NEMTC gateway, the focus is on emergency care, establishing and managing emergency medical response systems, and funding critical cases that cannot afford treatment.

“It supports the operational needs of emergency medical services nationwide, ensuring timely and effective response to urgent health crises,” he submitted.

On his part, NCDC representative, John Oladejo said the NCDC Gateway enhances the country’s capacity to manage public health emergencies and disease outbreaks.
“It conducts surveillance, provides funding for outbreak management, supports laboratory services, and implements public health campaigns to prevent disease spread.
“This gateway’s inclusion is crucial for improving Nigeria’s response to health emergencies and disease outbreaks,” he said.