Assessing primary health care facilities in six prioritized Nigerian states: Linking facility readiness with service availability
11 affiliations
- 1Clinton Health Access Initiative (CHAI), Abuja, Nigeria
- 2Sector-Wide Approach Coordinating Office, Federal Ministry of Health and Social Welfare, Abuja, Nigeria
- 3Gombe State Primary Health Care Development Agency, Gombe, Nigeria
- 4Kaduna State Primary Health Care Board, Kaduna, Nigeria
- 5Ahmadu Bello University Zaria, Zaria, Nigeria
- 6Kano State Primary Health Care Management Board, Kano, Nigeria
- 7Katsina State Primary Health Care Development Agency, Katsina, Nigeria
- 8Lagos State Primary Health Care Board, Lagos, Nigeria
- 9Niger State Ministry of Primary Health Care, Minna, Niger State, Nigeria
- 10Department of Epidemiology and Medical Statistics, Faculty of Public Health, College of Medicine, University of Ibadan, Ibadan, Nigeria
- 11Population Training and Health Research Entity, North-West University, Mafikeng, South Africa
Abstract
Background: Nigeria’s poor health indicators have been linked to its dysfunctional Primary Health Care (PHC) facilities. Policy gaps remain in achieving sustainable and equitable provision of PHC for Nigerians. Therefore, this study examined the relationship between health facilities’ readiness and service provision in Nigeria. Methods: This was a cross-sectional assessment of 204 PHC facilities enrolled under the Basic Health Care Provision Fund program, in six prioritized states in Nigeria. The facilities were assessed for the provision of ≥80% of the three levels of primary healthcare services—Tier 1, Tier 2, Tier 3—as the outcome variables. The three tiers represent the minimum, intermediate, and comprehensive levels of essential PHC services, respectively, defined under Nigeria’s Minimum Service Package. Health Facility (HF) readiness (explanatory variable) was assessed across six domains, with five of the domains disaggregated into 3 levels (poor, fair, and good). Data were analysed using Principal Component Analysis (PCA) and multivariable logistic regression model (alpha = 0.05). Results: The majority (81.9%) of the HFs have a functional management committee, 54.4% have an updated BHCPF annual quality improvement plan, 81.9% have standard operating procedures. While 16.2% met the World Health Organization standard ≥2.3 Health Care Workers (HCWs)/1000 population, none met the Minimum Service Package standard for HCWs across all cadres. The proportion of facilities with good readiness in each domain was: management and finance (42.6%); Health Management Information System tools/registers, supply chain tools/registers, and guidelines (40.2%); infrastructure and utility (33.3%); tracer equipment (34.8%); and tracer drugs (29.9%). The percentage of HF that provided ≥80% services was: Tier 1 (65.2%), Tier 2 (46.6%), and Tier 3 (35.8%); while 31.9% met ≥ 80% across all the service Tiers. Common predictors of providing ≥80% across the service Tiers were tracer drugs and equipment availability. The likelihood of delivering all Tiers of services was higher in HF with fair (aOR=2.38, 95% CI = 1.92-11.14, p < 0.05) and good (aOR=3.93, 95% CI = 1.96-8.49) levels of tracer equipment readiness compared to the poor. Conclusion: Good PHC facility readiness supports the provision of health care services in Nigeria. Availability of tracer drugs and equipment predicts the provision of healthcare services in PHC facilities. Investment in PHC facility functionality and prioritization of funds for tracer drugs and equipment will therefore improve service availability and delivery in Nigerian public PHC facilities.
Related
- Assessing the Capacity of Health Facilities to Deliver Concomitant HPV Vaccination and HPV-Based Cervical Screening Services to Vulnerable Populations – An Implementation Research Protocol
- Behaviorally prioritized entity-relation structure captures human visual cortical representations of natural scenes
- Transcriptome- and methylome-wide association studies prioritized lung cancer genes in East Asian populations
- Microscopic Characterisation and Pharmacological Evaluation of Nigerian Sabicea brevipes Leaves: A Step Toward Standardisation
- Comprehensive Review: Governance of Antimicrobial Resistance in Nigerian Healthcare Settings
BibTeX
@article{fasawe2026assessing,
title = {{Assessing primary health care facilities in six prioritized Nigerian states: Linking facility readiness with service availability}},
author = {Olufunke Fasawe and Abubakar Abba and Abubakar Yerima Mohammed and Cynthia Kukoyi and Kabiru A. Gulma and Ashiru A. Abubakar and Abdulrahman Shuaibu and Bello Jamoh and Mohammed Nasir Mahmoud and Yahaya Shamsudeen and Ibrahim A. Mustafa and Ibrahim A. Dangana and Abubakar Yakubu and Ahmed Sani and Babawale Peter and Oyewole Oladapo and Nazeef Mohammed and Nasir Umar and Lawrence N. Anyanwu and Adebowale S. Ayo},
journal = {PLOS One},
year = {2026},
month = oct,
doi = {10.1371/journal.pone.0360425},
url = {https://doi.org/10.1371/journal.pone.0360425},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Assessing primary health care facilities in six prioritized Nigerian states: Linking facility readiness with service availability
AU - Olufunke Fasawe
AU - Abubakar Abba
AU - Abubakar Yerima Mohammed
AU - Cynthia Kukoyi
AU - Kabiru A. Gulma
AU - Ashiru A. Abubakar
AU - Abdulrahman Shuaibu
AU - Bello Jamoh
AU - Mohammed Nasir Mahmoud
AU - Yahaya Shamsudeen
AU - Ibrahim A. Mustafa
AU - Ibrahim A. Dangana
AU - Abubakar Yakubu
AU - Ahmed Sani
AU - Babawale Peter
AU - Oyewole Oladapo
AU - Nazeef Mohammed
AU - Nasir Umar
AU - Lawrence N. Anyanwu
AU - Adebowale S. Ayo
PY - 2026
DA - 2026/10/13
JO - PLOS One
DO - 10.1371/journal.pone.0360425
UR - https://doi.org/10.1371/journal.pone.0360425
AB - Background: Nigeria’s poor health indicators have been linked to its dysfunctional Primary Health Care (PHC) facilities. Policy gaps remain in achieving sustainable and equitable provision of PHC for Nigerians. Therefore, this study examined the relationship between health facilities’ readiness and service provision in Nigeria. Methods: This was a cross-sectional assessment of 204 PHC facilities enrolled under the Basic Health Care Provision Fund program, in six prioritized states in Nigeria. The facilities were assessed for the provision of ≥80% of the three levels of primary healthcare services—Tier 1, Tier 2, Tier 3—as the outcome variables. The three tiers represent the minimum, intermediate, and comprehensive levels of essential PHC services, respectively, defined under Nigeria’s Minimum Service Package. Health Facility (HF) readiness (explanatory variable) was assessed across six domains, with five of the domains disaggregated into 3 levels (poor, fair, and good). Data were analysed using Principal Component Analysis (PCA) and multivariable logistic regression model (alpha = 0.05). Results: The majority (81.9%) of the HFs have a functional management committee, 54.4% have an updated BHCPF annual quality improvement plan, 81.9% have standard operating procedures. While 16.2% met the World Health Organization standard ≥2.3 Health Care Workers (HCWs)/1000 population, none met the Minimum Service Package standard for HCWs across all cadres. The proportion of facilities with good readiness in each domain was: management and finance (42.6%); Health Management Information System tools/registers, supply chain tools/registers, and guidelines (40.2%); infrastructure and utility (33.3%); tracer equipment (34.8%); and tracer drugs (29.9%). The percentage of HF that provided ≥80% services was: Tier 1 (65.2%), Tier 2 (46.6%), and Tier 3 (35.8%); while 31.9% met ≥ 80% across all the service Tiers. Common predictors of providing ≥80% across the service Tiers were tracer drugs and equipment availability. The likelihood of delivering all Tiers of services was higher in HF with fair (aOR=2.38, 95% CI = 1.92-11.14, p < 0.05) and good (aOR=3.93, 95% CI = 1.96-8.49) levels of tracer equipment readiness compared to the poor. Conclusion: Good PHC facility readiness supports the provision of health care services in Nigeria. Availability of tracer drugs and equipment predicts the provision of healthcare services in PHC facilities. Investment in PHC facility functionality and prioritization of funds for tracer drugs and equipment will therefore improve service availability and delivery in Nigerian public PHC facilities.
SN - 1932-6203
ER -