SPECIAL REPORT: Dying for Care: How Neglect of FCT PHCs is Failing Mothers, Babies
By Kabir Abdulsalam
In the still, dark hours of a cold February night, Fatima Yahaya, a 29-year-old mother of two from Tango village, woke her husband with a quiet urgency. The sharp pangs in her abdomen had grown unbearable. It was time. Her third baby was coming.
But for Fatima, childbirth was never just about bringing life into the world, it was about surviving a dangerous journey that many rural women in Nigeria know all too well. The closest health facility was Mawogi Primary Health Centre (PHC), a structure hidden beyond rivers and hills in the hard-to-reach terrain of Abaji Area Council in Nigeria’s Federal Capital Territory (FCT).
There were no cars. No ambulances. Only a bush path and faith.
A Night of Pain and Panic
Fatima’s husband helped her onto a neighbour’s motorcycle. With every bump and turn along the narrow, rocky trail, she winced in pain. They crossed a shallow river barefoot and afraid, then climbed the rugged slope that led to the health post.
By the time they arrived at Mawogi PHC, her labour had worsened.
“They told me they had no tools to help,” Fatima recalls, her voice trembling. We have few drugs. No doctor. The bed in the labour room wasn’t even fit for childbirth.
They said I had to be referred to the Comprehensive Clinic in Abaji. She was given a temporary injection to stabilize her and told to find another facility 40 kilometers away.
Mawogi PHC: A Shell of a Health Facility
Mawogi PHC is supposed to serve over 2,000 people across several villages, including Tando, Nahalati Sabo; Nuku, and others. But it is no more than a hollow structure, an abandoned promise.
On a recent visit, this reporter observed that the delivery bed was broken beyond use. The walls of the maternity room were peeling. No running water. The toilet was non-functional. Only two health workers were on duty, both visibly overwhelmed.
“We’re doing our best to make sure the clinic provides minimal care, but it’s terrible,” said one of the community health extension workers, speaking under condition of anonymity. “We have no electricity, proper beds, or even gloves sometimes. We need a functioning labour ward. This place is not safe for delivery.”
He pointed to a not fit metal bowl once used to sterilize delivery tools. “This has not worked in over a year,” she said.
Fatima eventually delivered her baby via cesarean section at a private clinic in Abaji town, after her family sold their only motorcycle and borrowed N40,000 from a cooperative. Her baby girl is healthy, but Fatima has yet to fully recover. The trauma still lingers.
“There are many women like me in Tango. Some didn’t make it,” she said, cradling her newborn. “I was lucky, but it should not be about luck.”
The Broader Crisis
The story of Fatima Yahaya is not isolated. It is one of many. From the rocky paths of Mawogi to the riverbanks of Abaji, pregnant women across rural FCT face dangerous odds just to receive basic healthcare.
Nigeria remains one of the most dangerous places in the world to give birth. According to UNICEF, the country accounts for 10% of global maternal deaths, with 104 deaths per 10,000 live births in rural areas, largely due to delays in accessing emergency obstetric care.
Latest figures show a maternal mortality rate of 576 per 100,000 live births, the fourth highest on Earth. Each year approximately 262,000 babies die at birth, the world’s second highest national total. Infant mortality currently stands at 69 per 1,000 live births, while for under-fives it rises to 128 per 1,000 live births.
“Mothers are dying from preventable complications like obstructed labour and postpartum hemorrhage,” said Dr. Tolu Falana, a maternal health advocate. “When a woman in labour has to cross a river at midnight because there’s no ambulance or midwife nearby, the system has already failed her.”
FCT Health Budget vs. Reality on Ground
Despite repeated government assurances, primary healthcare in the Federal Capital Territory remains critically underfunded and neglected, especially in rural councils like Kuje, Abaji, and other local councils that are not close to city centers.
In the 2024 national budget, over ₦12.6 billion was allocated for healthcare infrastructure development in the FCT. Of that, only ₦1.3 billion was set aside for revitalization of PHCs, according to the Budget Office of the Federation. But implementation remains a concern.
“Funding is one thing, execution is another,” says Dr. Emmanuel Aigbe, a public health expert. “You find facilities listed for upgrade on paper, but when you visit them, you’ll see cracked walls, no equipment, and no staff.”
A 2023 survey by the National Primary Health Care Development Agency (NPHCDA) found that only 20% of PHCs in the FCT met minimum functionality standards—meaning they had trained staff, basic equipment, and consistent drug supply.
Mosquitoes, Malaria, and Fear of Health Centres
Beyond maternity services, basic hygiene and environmental control are lacking in many facilities. Several women interviewed from Tango and Yawule, Nahalati Sabo; Nuku villages said they avoid Mawogi PHC at night due to mosquito infestations.
“We lie down and mosquitoes bite us from all corners. You’ll leave with a fever,” said Aisha Ibrahim, a mother of four. “Now I prefer to use herbs or go to one woman in the village who knows how to deliver.”
The World Health Organization (WHO) confirms that poor facility hygiene contributes to declining trust in PHCs, especially among mothers and children. Malaria remains a leading killer of children under five in Nigeria.
Lack of Skilled Personnel and Tools
At Mawogi PHC, the two full-time staff are Community Health Extension Worker (CHEW) only one was trained to conduct basic deliveries and administer immunizations. But without the necessary tools like a sterile delivery kit, blood pressure monitor, suction machine, or even clean gloves his training means little.
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“He knows how to tie the umbilical cord and resuscitate babies, but without the tools, it’s just theory,” said a senior official at the FCT Primary Health Care Board who asked not to be named. “We have over 400 such facilities in the FCT, but fewer than 60% are adequately staffed.”
Immunization Setbacks and Preventable Child Deaths
Due to transport barriers and fuel costs, outreach for immunization campaigns is sporadic. Children in remote communities like Tando often miss crucial vaccines.
According to UNICEF Nigeria, failure to fully immunize a child puts them at risk of measles, polio, diphtheria, and pneumonia, all leading causes of under-five mortality.
A recent FCT health review (2023) showed that only 58% of children in rural area councils completed their basic immunization schedules. In some hard-to-reach areas like Bago, that figure drops below 40%.
“We need at least one mobile ambulance and fuel support to reach villages monthly,” the CHEW at Mawogi PHC said. “Without it, children die silently.”
A Promised Building, An Abandoned Hope: The Story of Gawu PHC
While the story of Tando village and Mawogi PHC reveals how neglect affects maternal care, the case of Gawu Primary Health Centre (PHC), still in Abaji Area Council, underscores a different yet equally troubling reality: abandoned infrastructure and stalled development.
The old facility, which serves over 3,500 residents across surrounding communities, is barely functioning from a deteriorated structure that looks more like a temporary shelter than a medical post. According to the head of the facility, the only reason services are still being rendered is because of Basic Healthcare Provision Fund (BHCPF) support.
“We’re able to buy some drugs and run essential services because of the BHCPF,” he said. “But the environment we’re operating from is not fit for a health facility.
A New Building, But No Completion
Behind the worn-out clinic stands a newer structure—unpainted, plastered, silent. It was meant to be the salvation of healthcare in Gawu. According to the staff, the project was initiated some years ago but stopped over two years ago, intended to provide a modern health facility with improved space, clean water, and better delivery rooms.
But it has since been abandoned.
“The contractor left around 2022 when the project was halfway done,” the health worker explained. “They reached the plastering and plumbing stage and just stopped showing up. We don’t know why.”
Now, weeds have started growing through the floor. The window spaces are open to the elements. No equipment. No personnel. No answers.
“This kind of neglect is worse than not building anything,” a community elder said. “It gives us false hope. And it wastes government money.”
Overcrowding, Poor Hygiene, and Limited Power
Inside the old structure still being used, conditions are far from ideal. The delivery room is cramped, the walls are stained, and the only source of power is a small solar unit donated by a community member. It barely lights the waiting area and does not reach the delivery room or the staff quarters.
At night, health workers rely on torchlights and mobile phone flashlights to assist with labour cases. “It’s not safe,” said one nurse. “But what choice do we have?”
The equipment is also outdated. We just got the only resuscitation machine for newborns. The sterilizing tools are inadequate. Essential items like blood pressure cuffs and fetal heart monitors are either unavailable or defective.
The Road Ahead: Recommendations and Accountability
The stories of Fatima, Mawogi PHC, and Gawu PHC are symptoms of systemic neglect that continue to claim mothers’ and babies’ lives in the FCT’s rural communities.
Experts and community leaders alike recommend urgent, coordinated interventions:
- Immediate rehabilitation of at least 50 dysfunctional PHCs in FCT rural councils, prioritizing labour wards and sanitation facilities.
- Recruitment and deployment of skilled midwives and nurses with hazard and rural posting allowances to retain talent.
- Solar electrification and water supply for off-grid clinics, to ensure safe, hygienic, and 24/7 services.
- Dedicated budget tracking and transparency mechanisms to ensure funds allocated for PHCs are fully utilized, with public accountability on contractors’ performance.
- Strengthening community-based health insurance schemes to reduce the out-of-pocket costs that force families into poverty when emergencies arise.
- Provision of essential equipment and regular supply of drugs and consumables, including vaccines and delivery kits.
- Deployment of mobile ambulances with fuel and maintenance budgets for timely referral and outreach immunization campaigns.
“We’re not asking for luxury,” Fatima’s husband told me as we stood by the broken gates of Mawogi PHC. “We just want a place where our wives and children can be safe.”
The neglect of primary health centres in the FCT’s rural communities like Tando and Gawu is not only a failure of infrastructure but a betrayal of trust. Mothers continue to die, babies are lost, and families are pushed deeper into poverty all because the most basic healthcare services remain out of reach.
If the Federal Capital Territory is to live up to its promise as the seat of Nigeria’s government, it must start by caring for its most vulnerable citizens. That means funding and maintaining functional PHCs, holding contractors accountable, and empowering healthcare workers with the tools they need.
For Fatima and many others, time is running out. But with political will and community action, change is still possible before more mothers die waiting for care.
This investigation was produced under the Frontline Investigative Program and supported by the Africa Data Hub and Orodata Science.
