HFN seeks involvement of private sector in management of PHCs

In a bid to reverse Nigeria's high maternal mortality rate and rebuild its collapsing grassroots medical network, the Healthcare Federation of Nigeria (HFN) has urged the Federal Government to officially turn over the management of Primary Healthcare Centres (PHCs) to the private sector through structured Public-Private Partnerships (PPPs).

The coalition of private healthcare stakeholders warns that the public sector can no longer shoulder the operational weight of primary care alone. HFN argues that bringing corporate efficiency, tech innovation, and accountability to the local clinic floor is the fastest way to save lives at the community level.

Here is a detailed report on the policy shift being demanded from the capital.

Speaking on the state of local infrastructure, the President of the HFN, Mrs. Njide Ndili, highlighted the human cost of struggling public clinics. Nigeria currently ranks among the most dangerous places globally to give birth, contributing approximately 34 percent of all global maternal deaths.

According to national health indices, **a Nigerian woman dies every seven minutes from pregnancy-related complications**—a crisis HFN directly links to non-functional, under-equipped local clinics that force rural patients to bypass primary options entirely.

While the government has rolled out initiatives like the *Nigeria Health Sector Renewal Investment Initiative (NHSRII)* to revitalize thousands of community structures, institutional gaps persist.
┌───────────────────────────────────┐
│ THE GRACEROOTS COLLAPSE: PHC DATA │
└─────────────────┬─────────────────┘
│
┌─────────────────────────────┼─────────────────────────────┐
▼ ▼ ▼
┌─────────────────┐ ┌─────────────────┐ ┌─────────────────┐
│ TOTAL NETWORKS │ │ DECAYED CENTERS │ │ PATIENT BYPASS │
│34,076 facilities│ │Only ~20% are │ │60%-90% of rural │
│account for 85.3%│ ───► │fully functional │ ───► │patients go to │
│of all hospitals.│ │nationwide. │ │tertiary hubs. │

HFN’s core argument centers on shifting the management paradigm away from a broken public bureaucratic template. Ndili, who also serves as the Country Director for PharmAccess, emphasized that true primary care transformation relies on adding four specific private sector attributes into the PHC management framework:

| PPP Intervention Target | Public Sector Status Quo | Proposed Private Framework |

| *Operational Transparency* | Systemic financial delays and funding leaks. | Audit-backed accounting and targeted spending. |
| *Technology Integration* | Manual paper charting and broken supply lines. | AI-driven patient tracking and electronic medical records. |
| *Capacity Building* | Severe nurse-to-doctor shortages and clinical burnout. | Continuous performance-based training and competitive welfare. |
| *Supply Chain Security* | 75% of centers lack basic diagnostic toolkits. | Direct pharmaceutical partnerships to stop stockouts. |

A major driver behind the federation's emergency call is the sharp decline in foreign donor support that historically kept Nigeria's vaccine and maternal programs afloat.

The group stated that the era of relying on international health aid is coming to an end. To survive this transition, the country must embrace **"health sovereignty"**—the institutional ability to manufacture drugs, train workers, and manage health networks using only domestic talent and capital.

"Now that foreign aid has declined, we have to look inward and make the best use of the resources and people we already have. That is what we refer to as health sovereignty. Health sovereignty means producing the healthcare solutions you need within your own borders. That’s where we need to be."*
*Mrs. Njide Ndili, President, HFN*

The government has already made strides by backing multi-donor funding pools like the *HOPE-PHC* program, but as HFN points out, cash alone will not fix a broken machine. Moving forward, the Federal Ministry of Health must decide if it is ready to hand the car keys of public clinics over to private administrators, turning these rural outposts from empty buildings into functional lifelines.