•ACOMIN seeks increased community involvement in health initiatives
The Civil Society in Malaria Control, Immunisation and Nutrition (ACOMIN) has warned that acute shortages of healthcare workers, frequent commodity stock-outs and poor infrastructure are severely undermining service delivery in Primary Health Centres (PHCs) across the country.
The group said Nigeria’s healthcare system is strained, as persistent staff shortages, supply gaps and infrastructural decay continue to weaken the delivery of essential services, including HIV, tuberculosis and malaria interventions.
Speaking at an Advocacy-Focused Media Dissemination meeting in Abuja, ACOMIN’s Senior Programme Manager, Mrs Fatima Kolo, said findings from the organisation’s Community Engagement and Strategic Initiative (CE-SI) activities showed that multiple challenges are limiting the capacity of PHCs to provide quality care. She noted that these gaps are eroding public confidence and negatively affecting health outcomes in both urban and rural communities.
Kolo observed that Nigeria’s health workforce density remains below global benchmarks, falling short of the World Health Organisation’s recommended doctor-to-patient ratio of one doctor per 600 people. She added that the “japa” phenomenon and poor working conditions have further depleted the workforce, leaving many primary healthcare facilities critically understaffed.
According to her, the staffing crisis has resulted in excessive workloads, burnout among health workers, longer waiting times and declining quality of care. “The impact is not abstract. It affects availability, accessibility, affordability and quality of services,” she said. “This is felt daily by mothers who walk long distances only to find no health worker on duty, patients turned away due to stock-outs, and communities steadily losing confidence in their local health systems.”
She also raised concerns over reported shortages of essential commodities, including antimalarial drugs, HIV and TB medicines, as well as diagnostic tools such as malaria rapid diagnostic tests and HIV and TB test kits. These shortages, she said, are directly affecting service uptake and continuity of care.
Kolo explained that ACOMIN, with support from the Global Fund through Impact Santé Afrique (ISA), is implementing the CE-SI project under the Global Fund’s Grant Cycle 7, using a customer lifecycle management strategy across 10 states—Adamawa, Anambra, Delta, Enugu, Kebbi, Kwara, Niger, Ogun, Ondo and Oyo. The initiative, she said, empowers communities to identify service delivery gaps, advocate for solutions and hold duty-bearers accountable.
She added that weak last-mile distribution systems are worsening disease outcomes, forcing patients to abandon treatment or seek care far from home, while rising out-of-pocket spending remains one of the biggest challenges in Nigeria’s health financing landscape.
Kolo further highlighted the impact of dilapidated health facilities, inadequate or poorly maintained equipment, lack of potable water and unreliable power supply, noting that many PHCs fail to meet minimum operational standards. This, she said, contributes to underutilisation of primary care services, overcrowding at secondary and tertiary facilities, and avoidable delays in treatment.
“When healthcare systems are strained, the consequences go far beyond shortages,” she said. “Communities suffer from disrupted essential services, worsening health outcomes, increased morbidity and mortality, and wider socio-economic burdens. These challenges are not just technical failures; they are human crises.”
She stressed that strengthening healthcare delivery is both a social obligation and a foundation for national development, economic productivity and social stability. Kolo called on government agencies, the private sector, philanthropists, as well as traditional and religious leaders to collaborate in rebuilding and strengthening Nigeria’s community health system for improved outcomes nationwide.
Also, ACOMIN stressed the need for increased community involvement in health initiatives, particularly at the primary healthcare level, to promote ownership and improve health outcomes.
The National Coordinator of ACOMIN, Mr Ayo Ipimoye, noted that communities play a critical role in extending the reach and impact of health systems, especially in tuberculosis (TB), malaria and HIV prevention and care. He explained that community participation helps bridge gaps in access, improves trust in health services and strengthens accountability at the grassroots.
Ipimoye observed that the Global Fund currently supports Community-Led Monitoring (CLM) under its GC7, with Catholic Relief Services serving as the principal recipient. He added that beyond service delivery, the CLM approach empowers communities and civil society organisations to participate actively in policy formulation, decision-making and accountability processes through the generation and use of community-driven evidence across Nigeria.
