At the renovated Sabon Tasha Primary Healthcare Centre in Chikun Local Government Area of Kaduna State, upgraded facilities and wards, better-staffed clinics, and a renewed culture of patient-centred care are restoring public confidence in the primary healthcare system, drawing more pregnant women to antenatal care, skilled birth attendance, facility-based deliveries and family planning services, while boosting routine immunisation among babies. DEBORAH TOLU-KOLAWOLE reports
Twenty-four-year-old Maryam Ibrahim still remembers the sleepless nights she spent worrying about how her labour would go.
As a first-time mother, she was terrified by the several stories she heard from neighbours about labour pain, and the attitudes of midwives during delivery.
Those stories haunted Ibrahim throughout the first trimester of her pregnancy.
“People used to tell me frightening things. They said labour was something every woman had to suffer through alone. Others warned me that hospitals would ignore poor people or ask for money before helping them.
“I became frightened each time I thought about giving birth. I kept asking myself, ‘What if something goes wrong?’” the young mother told PUNCH Healthwise.
But her fears began to ease after a health worker encouraged her to register for antenatal care at the renovated Sabon Tasha Primary Health Care Centre in the Chikun Local Government Area of Kaduna State.
On her first visit, Ibrahim was taken aback by how different the place she was terrified to step foot into now looked.
She watched with wonder how the healthcare workers calmly explained what she needed to do and where she could get them done.
“It was clean and organised. The nurses welcomed me warmly and patiently answered every question I asked. Nobody made me feel ignorant because it was my first pregnancy,” Ibrahim recounted.
This encounter encouraged her to attend every antenatal clinic.
Each visit, she says, strengthened her confidence and banished her fears.
With a smile, the new mum recalled, “They checked my blood pressure, monitored the baby’s growth and taught us about nutrition. They explained danger signs during pregnancy, what to expect during labour and even prepared us mentally for childbirth. I stopped seeing pregnancy as something to fear.”
On the evening when her labour pains began, there was no question as to where she would go to have her baby.
“My husband immediately brought me here because some health workers now live inside the staff quarters; they attended to me almost immediately,” Ibrahim said.
She vividly remembers the encouragement she received throughout labour.
“I was crying because I thought I couldn’t continue, but the nurses kept holding my hands; they kept telling me, ‘You are doing well. Keep breathing. Your baby is almost here.’ They never left me alone,” she recalled.
After several hours, Ibrahim was delivered of a healthy baby boy.
“I cried again, but this time because I was happy. I couldn’t believe everything had gone so smoothly.
“If this renovation had not happened, I honestly don’t know where I would have gone that night,” the new mum added.
Ibrahim has never missed her son’s immunisation schedule and postnatal care.
She also said that the nurses have introduced her and her husband to several methods of modern contraceptives and advised her to choose whichever one she wanted.
“They explained that child spacing is about protecting the health of both mother and baby. They answered every question we asked. Now my husband understands that planning our next pregnancy is actually part of taking care of our family,” the 24-year-old said.
Ibrahim now shares the good news of how her child’s delivery at the PHC went and encourages other expectant mothers to seek professional care.
“I tell every pregnant woman I meet not to wait until labour starts before coming to the hospital. Come early. Attend antenatal, ask questions. It can save your life,” the happy mother of one said.
Maryam’s experience is no longer an isolated story as a frequent user of the PHC, Patience Itodo, confirmed to PUNCH Healthwise, “They are now much better than before. The activities here are much better than before.”
What changed?
Barely a year ago, the waiting area of the Sabon Tasha PHC was one many women deliberately avoided.
The ageing buildings, leaky roofs and bad toilets, cramped consultation rooms, nonexistent accommodation for health workers who lived far away from the centre, gradually eroded the trust and confidence the residents had in the health facility.
As such, pregnant women who could afford it travelled long distances to hospitals in town, while others relied on traditional birth attendants or delivered at home.
Consequently, this contributed to Nigeria’s already high maternal and neonatal deaths.
Last year, seven LGAs in Kaduna State were identified as having a high maternal and neonatal death rate.
While the National Demographic and Health Survey, 2018 pegs the confidence interval for the 2018 MMR from 447 to 578 deaths per 100,000 live births, a 2023 report from the Evidence for Action, MamaYe, stated that Kaduna’s MMR is 452.6 deaths per 100,000 live births.
MamaYe noted that four out of every five women in the state give birth at home without skilled attendants.
But today, a visit to the PHC by our correspondents revealed that the freshly painted buildings, renovated labour wards, improved staff accommodation, and expanded maternal health services have transformed not only the appearance of the facility but also the confidence of the community it serves.
The improvements have significantly increased the number of patients patronising the PHC, particularly pregnant women and mothers bringing their babies for routine immunisation, with many of those who spoke to PUNCH Healthwise during the visit expressing their delight.
‘Nurses made me feel important’
Among those waiting patiently for her baby’s routine immunisation is Aisha Musa, who gently cradles her six-week-old daughter while smiling at another nursing mother seated beside her.
Her smile reflects relief more than excitement. Just weeks earlier, she had safely delivered her baby in the same health centre, a decision she believes changed everything.
“I attended every antenatal clinic here,” she says, carefully adjusting the sleeping infant in her arms.
Musa continues, “From the first day I registered, the nurses made me feel like I mattered. Every visit they explained something new: the right foods to eat during pregnancy, warning signs to look out for, how to prepare for labour and even how to care for my baby after delivery.”
Unlike many women in her neighbourhood who had previously delayed seeking care, the new mother never missed an appointment.
“I looked forward to coming. They didn’t just examine us; they taught us. Before I became pregnant, I didn’t know that regular antenatal visits could detect problems before they became serious,” Musa said.
When labour started late one evening, she and her husband knew exactly where she wanted to go.
“There was no confusion. My husband brought me here because we trusted the nurses. They had followed my pregnancy from the beginning, so I felt safe,” she said.
Hours later, she delivered a healthy baby girl.
“I kept thanking God because everything went well. When I look at my daughter today, I know choosing this health centre was one of the best decisions I made,” she said.
Rebuilding trust
For decades, Nigeria’s primary healthcare system, which forms the foundation upon which every strong health system is built, struggled under the weight of inadequate funding, deteriorating infrastructure and shortages of personnel and medical equipment.
Unarguably, many community health centres became little more than abandoned buildings as women bypassed them in favour of overcrowded general hospitals, unskilled birth attendants and traditional homes.
To revive and improve services in the PHCs, the Federal Government, through the Health Sector Renewal Investment Initiative, the Basic Healthcare Provision Fund and partnerships with state governments and development agencies, intensified efforts to revitalise thousands of primary healthcare centres across the country.
The Coordinating Minister of Health and Social Welfare, Prof Muhammad Pate, disclosed during the quarterly meeting of the Expanded Ministerial Oversight Committee, held in Abuja in June, that N235 billion had been released to PHCs across the country through BHCPF over the past three years of the current administration.
As such, many facilities have received new equipment, essential medicines, improved water and sanitation systems, solar power, staff accommodation and expanded maternal, newborn and child health services.
Findings from health workers show that more women are returning to primary healthcare centres not simply because buildings have been renovated, but because those facilities are beginning to offer something many communities had lost over the years: trust.
That trust is perhaps most evident in the growing number of women embracing antenatal care, skilled birth attendance and family planning after years of relying on hearsay, cultural misconceptions and dangerous alternatives.
Increase family planning uptake
For 34-year-old Grace Yakubu, motherhood had become a cycle of exhaustion.
After the birth of her fourth child, she hoped to regain her strength, care for her young children and gradually return to normal life. Instead, barely a year later, she discovered she was pregnant again.
The pregnancies came so close together that she barely had time to recover physically or emotionally.
Yakubu told PUNCH Healthwise, “There were days I woke up feeling completely drained. Sometimes I become dizzy while doing simple house chores. I loved my children with all my heart, but I kept asking myself how I was going to care for all of them when I was always tired.
“My youngest daughter stopped breastfeeding earlier than she should have because another pregnancy had started. I couldn’t give each child the attention they deserved because there was always another baby on the way.”
Grace said she had been told stories about how modern contraceptive methods “would make a woman barren or seriously ill. Others claimed it would destroy marriages because women would no longer have children. Those stories made me afraid.”
But a counselling session with the family planning officer during one of her postnatal visits to the renovated Sabon Tasha PHC changed her perception of contraceptives, and she opted for one.
“They didn’t rush me. They asked about my health, my family and whether I still wanted more children in the future.
“When I told them yes, they smiled and explained that family planning was not about stopping childbirth. It was about allowing my body enough time to recover before another pregnancy.”
“They explained every method, the advantages, the possible side effects and answered every question patiently. Nobody forced me to choose anything.
“That decision gave me back my health. I finally had enough time to recover after childbirth. I became stronger physically, and I could take proper care of my children,” Yakubu recalled.
Dispelling myths, restoring confidence
A few seats away from Yakubu in the family planning clinic sits Rebecca Daniel, a 38-year-old mother of five whose journey mirrors that of countless Nigerian women.
For years, she deliberately avoided modern contraceptives. Like Yakubu, she had heard and believed that family planning could cause permanent infertility, excessive bleeding or sickness and refused to listen whenever the subject was discussed during postnatal visits.
As a result, Daniel had several unspaced pregnancies which took a toll on her health and her children’s.
However, her visit to the renovated health centre, where she met a kind health worker who calmly explained the side effects, advantages and disadvantages of each method, gave her the nudge to adopt a family planning method.
“They explained what family planning does and what it does not do. They made me understand that every woman is different and that different methods depend on individual health needs,” Daniel said.
For the first time, the mother of five said she felt empowered to make an informed decision.
Today, the 38-year-old has become an advocate within her community.
Daniel believes the renovated health centre itself has encouraged more women to seek professional care.
“Before now, many people didn’t even want to enter this place because they thought government hospitals could not offer quality care.
“But when people see clean buildings, organised clinics and health workers who treat patients with respect, their confidence returns,” Daniel noted.
PUNCH Healthwise reports that prevalent myths, cultural, religious and personal beliefs and misconceptions are factors causing the low uptake of family planning, leading to unplanned pregnancies, abortion and closely spaced pregnancies.
It was also reported that there is a need for women to undergo screening before choosing a contraceptive method, noting that a medical evaluation ensures safety by screening for risks like high blood pressure and assessing personal health history and helps identify the most suitable, complication-free option.
A facility transformed
Officer-in-Charge of the Sabon Tasha Primary Health Care Centre, Mrs Alice Williams, has witnessed the transformation from both sides of the consulting table.
She remembers when leaking roofs, deteriorating buildings and the absence of staff accommodation made quality service delivery difficult.
“Before the renovation, the facility was in a deplorable state. Healthcare workers travelled from different parts of Kaduna every day because there were no staff quarters.
“At night or during emergencies, patients sometimes arrive before health workers,” Williams told PUNCH Healthwise.
Today, the story is markedly different as the newly constructed staff quarters have enabled healthcare workers, including a National Youth Service Corps doctor, to reside within the facility.
“That single intervention has made a tremendous difference. When a woman arrives in labour at midnight, someone is already here to receive her.
“In maternal healthcare, every minute matters. A delay of even thirty minutes can determine whether both mother and baby survive,” she said.
Williams said the renovation has also improved the morale of health workers.
She, however, stressed that sustaining the gains would require continued investment.
Among the outstanding challenges are inadequate consulting rooms, insufficient toilets for patients and visitors, unreliable electricity after the theft of some solar batteries and poor access roads leading to the facility.
“We have made significant progress. But healthcare is continuous. Maintaining these facilities is just as important as renovating them,” the health worker said.
Compassion beyond consultation room
For the Corps Medical Doctor attached to the facility, Dr Onovu Christopher, the transformation extends far beyond infrastructure.
He believes the greatest change has been the restoration of public confidence.
He noted that the centre now offers almost all the essential services expected of a standard PHC.
These include antenatal care, postnatal care, routine consultations, family planning, child welfare clinics, immunisation services, HIV counselling and treatment, nutrition services and general nursing care.
Christopher believes compassion is just as important as clinical expertise.
He said the facility has adopted a patient-centred approach that prioritises saving lives above every other consideration.
“There are occasions when patients cannot immediately pay for prescribed medicines or services. We don’t send them away. They receive treatment first and can return later to settle outstanding bills because preserving life comes before everything else,” he explained.
That arrangement, he said, is gradually rebuilding trust between communities and public health institutions.
“When communities trust their health centre, pregnant women register earlier for antenatal care, they deliver under skilled birth attendants, they bring their babies for immunisation, and they seek family planning counselling. That is how stronger health systems are built—not only through buildings, but through relationships,” Christopher said.
He believes the improvements witnessed at Sabon Tasha demonstrate what is possible when investments in infrastructure are matched by dedicated frontline health workers.
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