Inside Ogun PHCs where health workers demand N2,000 before child immunisation

An undercover investigation by PUNCH Healthwise has exposed a widespread syndicate of extortion across several Primary Health Centres (PHCs) in Ogun State, where health workers are forcing mothers to pay illegal fees before their children can receive routine immunizations.

Despite explicit directives from the Federal Government of Nigeria stating that all childhood vaccinations are completely free, the investigation revealed that healthcare workers have weaponized the system, denying care to babies whose mothers cannot afford the bribes.

How the Extortion Scheme WorksThe investigation covered major local government areas, specifically highlighting routine extortion at facilities in Magboro, Ibafo, and Mowe. Health workers have introduced a series of non-negotiable, out-of-pocket charges masked as "administrative fees": The Newborn Toll ($\approx$ ₦2,000–₦3,000): Mothers bringing in newborns face the highest financial barriers. They are forced to pay a flat ₦2,000 fee—frequently justified by staff as the cost for Chlorxy-G gel (an antiseptic gel for umbilical cord care)—alongside an additional, unspecified cash demand of ₦1,000 or more by the attendants administering the actual vaccine.

The Immunization Card Fee (₦1,200): First-time visitors and mothers of newborns are forced to buy the officially government-issued immunization card for ₦1,200. If a card is lost, replacing it for older children can cost anywhere from ₦5,000 to an astronomical ₦10,000.

Per-Visit "Tax" (₦500–₦1,000): For every single follow-up appointment in the 12-month vaccination schedule (such as Pentavalent, OPV, Rotavirus, or PCV shots), mothers are charged a mandatory fee ranging from ₦500 to ₦1,000, plus an extra ₦100 just to weigh the baby.

The Human & Public Health Toll
For women relying on these facilities, the financial burden is staggering. For a mother completing the full 7-visit routine immunization schedule, the cumulative illegal fees can surpass ₦4,200—which amounts to roughly two full days of work under Nigeria’s ₦70,000 monthly minimum wage.

The consequences of this extortion are already proving dangerous:

Denial of Service: The report highlighted cases where vulnerable mothers were publicly humiliated and their infants denied life-saving vaccines on days they couldn't produce the exact cash amount demanded by nurses.

Rising "Zero-Dose" Risks: Public health experts warn that these illicit financial barriers are driving up the number of "zero-dose" children in Ogun State, leaving infants entirely unprotected against fatal but preventable diseases like measles, tetanus, and whooping cough.

Why is This Happening?
While the Chief Medical Directors and state health authorities explicitly maintain that demanding fees for routine immunizations is a criminal act, the practice has thrived due to deep systemic failures within Ogun State’s primary healthcare sector:

Severe Underfunding & Negligence: Many PHCs suffer from a lack of running water, erratic power supply, and an absence of basic operational logistics.

Incentivizing Informal Revenue: Because the facilities are poorly funded and under-supervised, workers frequently resort to creating informal revenue streams under the guise of "purchasing logistics or transport" during vaccine stock-outs.

The "Japa" Effect & Brain Drain: An acute shortage of motivated, full-time personnel has left many PHCs heavily reliant on poorly paid community health extension workers and volunteers who face zero accountability mechanisms.