Despite budgetary allocations and stated commitments, Nigeria continues to record some of the worst maternal and child mortality rates globally. One of the evident states is in Plateau State, where healthcare infrastructure is in decline, community health workers are in short supply, and communities are left in crisis. Uncompleted projects, like the Gindiri Public Health Care (PHC) facility, exemplify systemic governance failures and what the Plateau State Government can do to course-correct. 

Nigeria records approximately 2,300 children under the age of five die daily from preventable illnesses, and each day about 145 women of childbearing age die due to preventable pregnancy-related complications. As of 2024, Plateau State records a maternal mortality ratio of approximately 900 deaths per 100,000 live births and a neonatal mortality rate of about 80 deaths per 1,000 live births. These figures are among the highest in Nigeria with another 2023 study titled A Review of Basic Health Care Provision Fund (BHCF) and Primary Health Care Assessment in Plateau State revealing that many PHCs in the state lack proper infrastructure, and essential supplies, limiting quality healthcare across all 17 LGAs. These causes largely stem from poor access to quality healthcare services driven by inadequate healthcare personnel, long travel distances, and weak implementation of primary healthcare, which accounts for 80% of deaths in rural communities.These outcomes contradict Nigeria’s commitment to achieving Universal Health Coverage (UHC) and the goals set under the National Health Policy and  National Strategic Health Development Plan II (NSHDP II), which prioritize functional and accessible PHC across all communities. Nigeria’s Basic Health Care Provision Fund (BHCPF), established under the National Health Act mandates that funds be allocated to ensure PHCs like the one in Gindiri are adequately equipped and staffed to deliver essential services.

In the Plateau State 2025 budget, the social services sector, which encompasses healthcare, is allocated 24% of the total expenditure, which places Plateau State above average, allocating more to social services than most states. The Plateau State Government also invested N327 million in the Plateau State Contributory Healthcare Management Agency (PLASCHEMA) to improve healthcare delivery, and the agency confirmed receiving the full amount. These allocations and investments underscore the government’s commitment to improving healthcare services for its citizens.​ Reflecting on 2019, the Plateau State approved budget  also highlights the government’s commitment to improving healthcare infrastructure across the state. The government allocated funds for various health projects. including the construction and renovation of PHCs to ensure that even the most remote communities had access to quality healthcare services. This commitment was seen when the Plateau State Government awarded a contract for the construction of a PHC in Gindiri, Mangu North, to Brass Construction Company. The project, valued at N16,795,978, was intended to expand the PHC facility, as the existing structure is cramped and in a severe state of disrepair.

The abandonment of this PHC project weakens the legal obligations outlined in the National Health Act, which stipulates the right of all Nigerians to basic minimum healthcare services. By failing to complete and operationalize this health facility, the state is not only failing its people, it is also falling short of federal policy mandates and health financing expectations.. Imagine a loved one admitted for more than two days  and their relative, exhausted and vulnerable, spending nights exposed to harsh weather and insecurity. Speaking to one of the caregivers, he noted that he lost his two-year-old son to malaria because they couldn’t access medical treatment in time, as the facility was too crowded. “If the PHC had been well equipped and functional, my child would still be alive today,” he says, his voice filled with grief. Speaking with the nurses, their frustration was evident. They struggle daily to manage an overwhelming number of patients with limited resources. Some admitted they are actively seeking better opportunities and may soon leave if they find them.

What is the most heartbreaking reality? If these medical professionals eventually walk away in search of “greener pastures”, what will happen to this community? Who will care for the sick, the pregnant women in labour, the children battling malaria, or the elderly in need of urgent treatment? The healthcare facility in Gindiri remains abandoned, threatening the fate of an entire population.

This challenge and lack of accountability are seen in the broader culture of unfulfilled promises and abandoned public projects, particularly in critical sectors like healthcare. Across Nigeria, many PHCs meant to serve vulnerable communities remain incomplete, poorly equipped, or entirely abandoned. For instance, in Sokoto State, the Labsani Health Post, intended to serve approximately 10,000 community members, has been abandoned since 2018. In Cross River State’s Abi Local Government Area, several health centers are in deplorable conditions, posing significant threats to the lives of the community members. In Zamfara State, over 500 out of more than 700 PHCs were reported non-functional in 2023, contributing to the state’s high maternal mortality rate. These facilities, which were meant to provide essential medical services, now symbolizes failed governance and wasted public resources.

The completion of this PHC facility in Gindiri would significantly curb these challenges, offering a quality healthcare supply chain, maternal and child healthcare, and essential immunizations. However, the project has stalled since its award. The non-completion of the Gindiri PHC project means that the community continues to face healthcare access challenges. Expectant mothers, children, and the elderly are among the most vulnerable populations affected by this delay. The absence of a nearby healthcare facility puts their lives at risk and hampers the overall development of the community.

While this PHC remains abandoned, we are left with so many unanswered questions; why is it still incomplete? Why should the community members continue to suffer from this ongoing neglect? This unfinished project not only undermines trust in public institutions but also delays development outcomes that the government itself has prioritized. Instead of the Nigerian government’s proposed plan to construct 8,800 new PHCs, Accountability Lab Nigeria calls on the government to focus on improving existing PHCs by conducting an independent audit and publicly disclose the implementation status of all PHC projects initiated between 2019 and 2024. The government must also identify and prioritize the completion of stalled PHC facilities, particularly in underserved rural communities, by the end of 2026. Targeted funding and clear timelines must be backed by effective implementation and responsive citizen feedback mechanisms to fast-track the operationalization of these essential infrastructures. Community-led monitoring mechanisms should be institutionalized to enhance transparency in healthcare projects. Finally, it is important to ensure that healthcare funding directly translates into improved service delivery through continuous stakeholder engagement and oversight. The residents of Gindiri and Nigerians at large deserve better.