SPECIAL REPORT: Inside Sokoto’s neglected PHCs where patients receive drips on mats, women deliver on bare floor

On March 21, 2026, Badawa Primary Healthcare Centre in Bodinga Local Government Area (LGA) of Sokoto was eerily quiet. Under the scorching sun, the facility stood in ruins—unroofed buildings, broken structures, and visible neglect. Inside one of the few usable rooms, 65-year-old Muhammad Mande was lying on a mat spread on the bare floor, with a bag of drip hung up.

For several weeks, Mande battled a recurring fever and when it got worse, he journeyed from Rugga Munde, a community in Wamakko LGA, where he lives to the Badawa primary healthcare in Bodinga LGA. That was the nearest health centre he had access to.

The ward lacks a mattress, and he was forced to lie down with an old mat on the bare floor to receive a drip.

“We only came here because it is nearby and we are used to coming, ”he said in a pitiful tone, stating, however, that he was not happy lying on the floor. He described long waiting times due to staff shortages and said serious cases are often referred to hospitals in Sokoto or Bodinga.

 

As you approached the PHC, the tell-tale signs of neglect were visible from afar. The PHC, established during the administration of former governor Aliyu Wamakko, looks nothing like a hospital with abandoned staff quarters, a lack of roofing, trees and shrubs growing in the hospital’s building, making access to basic healthcare services very difficult.

Childbirth on the Floor

For women, the situation is even more dire. Rabi Abubakar, an elderly woman and community volunteer who assists women in accessing healthcare in Badawa community, said deliveries are often conducted on the floor.

“We spread mats in open rooms,” she explained, adding that “Recently, a woman delivered in a space covered only with a wrapper. I washed the baby myself.” This is a daily routine for women in Badawa and neighbouring communities.

With no labour room or equipment, many women in the Badawa community and its environs either deliver at home or in unsafe conditions at the PHC. Sokoto has one of Nigeria’s highest numbers of mortality in Nigeria, with a maternal mortality ratio estimated at 1,576 to 2,151 per 100,000 live births and a newborn mortality rate of 44 per 100,000, according to the United Nations Population Fund, Nigeria.

Community Efforts, Government’s Silence

The broken health system in Badawa did not begin yesterday. According to the district head of Badawa, Shehu Muhammad, the facility has been in dire condition for nearly five years, after a windstorm damaged parts of the building.

Residents say the situation has remained unchanged since  2015. When it persisted after several complaints to stakeholders in the area with no positive response, the community contributed money themselves to repair the roof. “Officials came, inspected, and promised to fix it—but nothing has been done,” the district head lamented.

 

Kabiru Giɗaɗo, a resident, described how patients are treated on mats due to lack of beds and electricity. He recalled a cholera outbreak incident when residents had to clean dirty rooms themselves to accommodate patients.

No Drugs, No Equipment, Few Staff

Apart from the lack of infrastructure at Badawa PHC, another major concern that cripples health service delivery in the area is that the centre has been struggling for years with shortages of medicines, equipment, infrastructure, and personnel, as it has 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,” said a health worker at the facility, who requested anonymity. According to the health worker, only basic supplies such as malaria test kits and family planning materials are occasionally provided. Essential tests like blood grouping and PCV are unavailable.

This is visible and obvious to anybody who visits the facility. Now, only two rooms are in use: the officer-in-charge’s office and the other one, which is not even fully functional. During the rainy season, many services are conducted outside.

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 effectively.

Zangalawa PHC: A Hospital Reduced to One Room

 

 

In the Zangalawa community, also in Bodinga LGA, what was once stood as a fully functional primary healthcare centre has been reduced to a shadow of itself.

More than six years ago, a windstorm destroyed most of the facility’s structures. Since then, no meaningful reconstruction has taken place. Today, the entire hospital operates from a single overcrowded room.

 

A health worker at the facility explained that all departments have been collapsed into that one space. Everything is being managed in a single room. “Normally, a hospital has different units—medical records, laboratory, outpatient department (OPD), routine immunisation (RI), family planning, antenatal care (ANC), and delivery. But all these units are no longer functioning independently. We have merged everything”, he explained.

Despite having beds, mattresses, and other equipment, they remain unused because there is nowhere to put them. All the buildings have collapsed. In the hospital’s damaged rooms, expensive equipment wastes away.

 

 

Although the hospital still receives support in the form of drugs from the government and assistance from non-governmental organisations, the lack of infrastructure has rendered these efforts largely ineffective, and it has only two active staff.

For the Patients, the impact of the failing system is devastating. Balan Bardo, a 70-year-old father of 11, was found lying on a mat receiving treatment for a bladder-related illness after days of suffering at home. Bala said patients are often discharged quickly due to a lack of space.

He recounted a personal tragedy that highlights the consequences of the facility’s failure that cost the life of his wife. “Last year, my wife fell sick. We brought her here, but the case was beyond their capacity. We moved from Bodinga to Sokoto, spending a lot of money. In the end, she did not survive,” he said, adding that had their hospital been functional, they would not have gone through that stress and expenses.

Community leaders say the situation has persisted for years without government intervention. 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 the lack of a labour room has forced many women to give birth at home. 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 PHC: A Hospital Without Staff

In the Kandeza community of Binji local government, the situation presents a different but equally troubling picture.

Unlike Zangalawa, the primary healthcare centre in Kandeza is structurally intact. The facility has wards, a laboratory, staff quarters, and even a functional water source. However, it has remained non-operational for more than a decade, to the extent that it started to go to ruin.

 

The reason is simple: there are no healthcare workers. “Our biggest problem is that we have a hospital but no personnel,” said the district head of Kandeza, Nasuru Muhammad.

However, equipment meant for the hospital has gradually begun to disappear and ruin. “When there was a cholera outbreak in Binji, they took our mattresses, saying they were borrowing them. That was two years ago, and they have not been returned. Now, all the beds are without mattresses,” he explained.

 

 

With no functional healthcare services, residents must travel to other towns such as Binji, Maikulki, or Sokoto for treatment. For many, this journey is not only expensive but also dangerous. He recalled a tragic case of an infant who died due to a lack of access to medical care.

“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.

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 corruption within the system, noting that they heard that staff have been posted there, but they only show up during official inspections while still collecting salaries, and none of the residents knows them.

 

Even those previously employed at the facility have been abandoned, 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 Gado Atto, a 52-year-old resident, the lack of healthcare services has made emergencies difficult, particularly for pregnant women. For the community, a motorcycle is not suitable for such situations; people have to look for a car, but cars are not easily available.

 

He recalled a difficult experience with his younger sister, who faced complications during childbirth and had to be transported to Sokoto at a high cost. “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

 

A Wider Systemic Failure

The condition of these PHCs reflects broader systemic challenges in Sokoto’s primary healthcare sector. In 2024, the state government allocated about ₦10 billion to renovate 244 PHCs, yet many remain in critical condition.

A 2024 Orodata Science report indicates that only 28 of 53 surveyed PHCs were renovated in the past decade, while 11 had never been renovated. About half lack essential medical supplies, including oxygen and vaccine refrigerators.

Out of 416 assigned health workers, only 291 are active, creating a 30% workforce gap. Most PHCs lack doctors, and only 31 operate on weekends.

Moreover, a review of the 2025 budget by SolaceBase revealed that only 5% of the ₦9.42 billion allocated to the Primary Healthcare Development Agency was spent. Efforts to reach the Sokoto State Commissioner for Health for comments on ongoing reforms were unsuccessful, as calls were neither answered nor returned.

 

Yobe Gains, Sokoto Struggles

 

While Sokoto continues to struggle, In contrast, Yobe State has made significant strides. It won the 2025 Nigeria Governors’ Forum Primary Healthcare Leadership Challenge after upgrading 178 PHCs, strengthening workforce development, and improving supply chains.

According to Dr Umar Kokari, liaison officer of the Yobe State Primary Healthcare Board, the state’s success is built on three pillars: qualified personnel, reliable supplies, and conducive environments.

 

Yobe’s progress has been consistent. In 2023, it ranked fourth in a regional health challenge; in 2024, it secured $600,000 after placing second; and in 2025, it emerged national champion.

Baba Bunu Kekema, Secretary to the Damaturu Emirate Council, said primary healthcare centres in Damaturu are making significant efforts to improve access to services for residents.

He also highlighted facilities such as Kofan Fada and Nagonge, where women and children receive free healthcare services, adding that he personally visits these centres to monitor their performance.

 

 

A clear example of this is the Babuje Primary Healthcare Centre in Gashua Local Government Area of the state, which has been upgraded, renovated, and equipped with both staff and infrastructure. This has made it easier for residents to access primary healthcare services, especially for women and children.

At the Babuje PHC, services are well-organised, with staff across all units, including laboratory, antenatal care, and pharmacy. The facility is fully equipped and provides free care to vulnerable groups, encouraging more women to deliver in hospitals. According to Usman Muhammad, a resident and staff member of the facility..