By Shehu Muhammad Shehu
Primary healthcare centres across rural Sokoto State are in a state of collapse, a situation that forced patients to receive treatment on mats and compelled pregnant women to give birth on bare floors, WikkiTimes reports.
Despite billions of naira allocated to the sector in recent years, many facilities remain dilapidated, understaffed, and unequipped—leaving residents with little or no access to basic healthcare services.
On 21 March 2026, Badawa Primary Healthcare Centre in Bodinga Local Government Area presented a grim picture of neglect. The facility, partly unroofed and overgrown with weeds, had only a few usable rooms.
Inside one of them, 65-year-old Malam Muhammad Mande lay on a mat spread across the bare floor, receiving intravenous treatment.
Malam Mande, who travelled from Rugga Munde in neighbouring Wamakko LGA after battling a prolonged fever, said the facility was his only option.
“We came here because it is close, but there are no beds. I am not comfortable lying on the floor,” he said.
He added that staff shortages often lead to long waiting times, while more serious cases are routinely referred to hospitals in Sokoto or Bodinga towns.
The facility, built during the administration of former governor Aliyu Wamakko, now bears little resemblance to a functional health centre. Its structures are damaged, staff quarters abandoned, and access routes obstructed by overgrown vegetation.
Women forced to deliver on floors
For women, the situation is even more dire.
Rabi Abubakar, a community volunteer, while recalling her experience in the facility said childbirth in Badawa often takes place in unsafe conditions.
“We spread mats in open rooms. Recently, a woman delivered in a space covered only with a wrapper in this hospital. I washed the baby myself,” she said.
With no labour room or essential equipment, many women either deliver at home or in unsafe conditions at the Badawa PHC facility.
Sokoto has one of the highest maternal mortality rates in Nigeria. According to the United Nations Population Fund (UNFPA), the state records between 1,576 and 2,151 deaths per 100,000 live births, with a neonatal mortality rate of 44 per 1,000.
Years of neglect, failed promises
Residents say the decline of Badawa community PHC dates back several years.
The district head, Alh. Shehu Muhammad, said a windstorm damaged parts of the facility about five years ago, after which it was abandoned.
“We reported the situation, and officials came to inspect and promised repairs, but nothing has been done,” he said.
Community members eventually contributed funds to fix parts of the roof, but the intervention proved insufficient.
Mal. Kabiru Gidado, a resident, said patients are routinely treated on mats due to lack of beds and electricity.
“During a cholera outbreak, we had to clean the facility ourselves before admitting patients,” he said.
No drugs, staff shortages worsen crisis
A health worker at the facility, who asked not to be named for fear of victimisation, said the centre operates with only two staff members while this reporter met one staff member during the visit.
“There are no beds to admit patients. Even pregnant women cannot be properly attended to,” the worker said.
He noted that only basic supplies such as malaria test kits and family planning materials are occasionally available, while essential diagnostic services like blood grouping and packed cell volume tests are absent.
The facility currently uses just two rooms—one serving as the officer-in-charge’s office and the other as a makeshift treatment area.
The worker explained that despite these challenges, the facility attends to about 70 patients daily, adding that if properly equipped, it could serve over 2,000 people including in the neighbouring community.
Zangalawa: A hospital reduced to one room
In Zangalawa community, also in Bodinga LGA, a once-functional PHC has been reduced to operating from a single overcrowded room.
A windstorm destroyed most of the buildings over six years ago, and no reconstruction has taken place since then.
“All departments have been merged into one room,” a health worker who preferred to remain anonymous said. “Laboratory, antenatal care, immunisation—everything is done here.”
Despite having beds and equipment, they remain unused due to lack of space, while damaged structures continue to deteriorate.
Mal. Balan Bardo, a 70-year-old patient, said the situation has had tragic consequences. The father of 11 who was receiving treatment at the facility said patients are often discharged quickly due to a lack of space.
“Last year, my wife fell sick. We brought her here, but they couldn’t handle the case. We moved her to Sokoto, spent a lot of money, but she died eventually,” he said.
Community leaders say the situation has persisted for years without government intervention. Alh. Umaru Dikko, the district head of Zangalawa, expressed frustration, saying that his people are suffering because the hospital is no longer functioning properly. The government keeps promising to fix it, but nothing has been done.
He noted that with the facility serving dozens of surrounding villages, the pressure on the limited space is immense. As a result, residents are forced to travel to Bodinga or other distant towns for treatment—a journey that is often costly and, in emergencies, life-threatening.
Kandeza: Facility without staff
In Kandeza community, Binji LGA, the problem is not infrastructure but the complete absence of healthcare workers.
The PHC has wards, a laboratory, and staff quarters but has remained non-operational for over a decade.
“We have a hospital, but no personnel,” said the district head, Alh. Nasuru Muhammad.
Residents now travel long distances to access care, often at great cost.
Alh. Muhammad recalled the death of an infant due to lack of medical attention. “There is a woman in this community whose baby died because there was no hospital to take the child to, and there is not even a chemist’s shop here,” he said.
“There is not even a chemist here,” he said.
He added that some equipment has been removed under the pretext of borrowing and never returned.
In the absence of medical personnel, residents rely on informal solutions. “I have become like a doctor here,” Nasuru said, explaining that he sells paracetamol, diclofenac, and other basic drugs, noting that sometimes he even gives them for free if people cannot afford them.
Immunisation services are also irregular and poorly coordinated. For other vaccines, residents are forced to make their own arrangements. If they need immunisation, they have to go to Tangaza, bring the vaccines themselves, and even pay those who administer them.
He also alleged that staff posted there have absconded while still collecting salaries for work not done.
Even those previously employed at the facility have been abandoned, Malama Jimma Dandare, a 60-year-old cleaner, said. She worked at the PHC when it was operational, but stopped receiving her salary years ago. “I started working here when the hospital was built. I was earning ₦20,000 monthly, but they stopped paying me after the administration that employed me left,” she said.
For Malam Gado Atto, a 52-year-old resident, the situation remains difficult particularly for pregnant women, whose available means of transport is motorcycle which is not suitable for such situations.
He recalled that his younger sister had once faced a complication at childbirth that necessitated referral to Sokoto. “I hired a car for ₦30,000 to take her to Sokoto… it was a very difficult experience.”
It’s also the same story with Garin Magaji PHC in Silame Local Government Area, the situation mirrors that of Kandeza but with more visible decay. The large facility is deteriorating, with damaged structures and empty wards. During a visit, no healthcare personnel were present, leaving patients unattended
System-wide failure
The conditions observed across these facilities reflect systemic challenges in the state healthcare system.
In 2024, the state government reportedly allocated about ₦10 billion for the renovation of 244 PHCs. However, many remain in poor condition.
A report by Orodata Science found that only 28 out of 53 surveyed PHCs had been renovated in the past decade, while 11 had never undergone any renovation.
The report also noted that about half of the facilities lack essential medical supplies, including oxygen and vaccine refrigerators.
Out of 416 assigned health workers, only 291 are active, creating a workforce gap of about 30 per cent. Most facilities lack doctors, and only 31 operate on weekends.
A report showed that only five per cent of the ₦9.42 billion allocated to the Primary Healthcare Development Agency in the 2025 budget had been spent.
Efforts to obtain comments from the Sokoto State Commissioner for Health, Dr Faruk Wurno, were unsuccessful, as calls were not answered.
Across Sokoto’s rural communities, the collapse of primary healthcare is no longer a policy issue—it is a daily reality where survival often depends on distance, luck, and the ability to pay for care elsewhere.
