Photos: Inside Kano’s Collapsing Primary Healthcare System: Mothers Deliver in Darkness as Clinics Crumble
A pregnant woman in a small village in Kano State once went into labour under conditions no mother should ever endure. The nearest primary health centre had no electricity. As her contractions intensified, the only health worker on duty held a torchlight in one hand while attempting to deliver her baby with the other. Economic Confidential reports that this was not an isolated incident but the daily reality for thousands of women across rural Kano.
In an investigative report by Economic Confidential, across dozens of Primary Healthcare Centres (PHCs) visited during this investigation, the situation is the same: collapsing buildings, empty drug shelves, no water, no electricity, and in many cases, only one exhausted health worker struggling to serve entire communities. These facilities—meant to be the backbone of Nigeria’s healthcare system—have become symbols of abandonment.
PHCs are supposed to provide essential services such as maternal care, immunisation, early diagnosis, and disease prevention. But in many parts of Kano, they barely function. Investigations across Sumaila, Shanono, Gwarzo and other LGAs reveal a system in deep crisis. At Jisai Health Post in Sumaila, resident Usman Yelwa described the facility bluntly: “The ceiling has fallen off and the roof leaks whenever it rains. There are no beds, no medicines. Patients sit on benches or the floor.” In Yan Shadu Health Post in Shanono, Officer‑in‑Charge Jamilu Atiku said the clinic becomes unusable during heavy rains because “rainwater enters the building and patients have nowhere to stay.” Many PHCs resemble abandoned structures more than medical facilities, with collapsed ceilings, missing windows, cracked walls and leaking roofs.
Clean water—one of the most basic requirements for any health facility—is absent in many PHCs. At Goron Dutse PHC, workers pay ₦100 per gallon for water fetched from a dam, used for washing equipment, cleaning delivery rooms, and maintaining the facility. Some clinics have no toilets at all, forcing patients to use nearby homes during immunisation campaigns. Electricity is equally scarce. Many PHCs operate in total darkness, with health workers relying on torchlights or phone flashlights during night deliveries. One health worker described the experience as “working blind,” adding, “When a woman comes at night, we sometimes use torchlight. You pray nothing goes wrong.”
The Economic Confidential reports that most PHCs visited had only three common drugs—paracetamol, anti‑malaria medication, and Flagyl. Diagnostic tools are almost non‑existent. Without equipment to run tests, health workers rely on guesswork or refer patients to distant hospitals. For many rural families, transportation alone costs around ₦5,000, an impossible sum for many.
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Staff shortages are severe. Several PHCs have only one worker responsible for all services. At Tumfafi Health Post in Gwarzo, the officer in charge said, “We don’t have equipment to assist pregnant women.” To repair parts of the building, staff used wooden planks taken from an abandoned mosque. At Burnabus Health Post, the only staff member travels from another town and appears mainly during vaccination campaigns. The result is burnout, exhaustion, and a sense of abandonment among health workers.
In many villages, residents maintain PHCs themselves. Near Burnabus Health Post, Malam Hudu Ali said the clinic was built over 30 years ago by community members: “Both men and women contributed to build it.” Since then, no government authority has renovated it. When parts collapse, villagers repair them with whatever materials they can afford. In one community, a PHC destroyed by fire five years ago now operates from a section of the village head’s house, with no reconstruction in sight.
Attempts to visit PHCs in Rimin Gado LGA were blocked by local officials, who insisted on permission from the Ministry of Health—permission journalists say is rarely granted.
On paper, Kano appears committed to healthcare, with ₦72 billion allocated to health in 2024 and ₦90.6 billion in 2025, exceeding the Abuja Declaration benchmark. Yet many PHCs have no water, electricity, staff, medicines, or equipment. Experts blame weak oversight, poor accountability, and inefficient use of funds. Local governments often lack capacity, donor programmes rarely strengthen infrastructure, and procurement processes lack transparency.
The human cost is devastating. Nigeria remains one of the most dangerous places in the world to give birth, with about 75,000 women dying from pregnancy‑related causes in 2023. Kano is one of the epicentres, with maternal mortality estimates ranging from 576 to 1,025 deaths per 100,000 births. Only 30% of pregnant women deliver in health facilities.
Kano State Commissioner for Health, Abubakar Labaran Yusuf, responded after multiple calls and messages. His statement outlined the administrative structure of the state’s healthcare system but did not address the specific failures uncovered in rural PHCs. The Ministry’s explanation focused on policy, funding sources, and supervisory mechanisms, leaving the on‑ground realities unaccounted for.
Primary healthcare is the most cost‑effective way to reduce maternal and child mortality. But in Kano, the system meant to save lives is itself dying. Unless urgent action is taken, thousands of rural families will remain trapped in a cycle where access to healthcare depends on distance, luck, or the goodwill of overstretched workers. For many mothers in Kano’s villages, childbirth still happens in darkness—not because medicine lacks the knowledge to save them, but because the system meant to deliver that care has been allowed to collapse.
By PRNigeria
