Inside Osun’s Rural Primary Healthcare Centres, Where State Government Spending Meets a Different Reality

By VAM News Investigative Desk

For residents of Agbinpa, a rural community in Ede South Local Government Area of Osun State, accessing basic healthcare can begin with a difficult journey.

The road leading to the community is rough and uneven, making transportation expensive and, in some instances, discouraging commercial motorcyclists from making the trip.

At the end of that journey is the Agbinpa Primary Healthcare Centre, a facility that remains important to the community but whose physical condition tells a story of years of limited attention.

Overgrown grasses cover sections of the compound. Parts of the building show peeling paint and cracks, while some sections of the facility have become unusable.

A staff quarters commissioned in March 1999 stands beside the health centre, serving as a reminder of how long the facility has been providing healthcare to residents.

But while the structure has aged, the community’s need for healthcare has not diminished.

ONE HEALTH WORKER, AN ENTIRE COMMUNITY

During a visit by VAM News, the facility’s lone health worker, Rashidat Lamidi, was attending to patients.

For years, Lamidi has effectively combined the responsibilities of healthcare provider, administrator and emergency responder at the centre.

She attends to pregnant women, children and other patients. Even after leaving the facility for the day, she said she sometimes returns when residents call for emergency assistance.

“Even if I’m at home and somebody comes to call me because a child is sick or a woman wants to give birth, I will come,” she said.

Lamidi said her salary is paid regularly by the state government.

Her concern, however, is the condition of the facility itself.

According to her, government officials and politicians have visited the community over the years, particularly during election periods, but the visits have not translated into the level of improvement residents expect.

“They come here, but they don’t do anything,” she said.

The situation raises a larger question: what happens to rural healthcare when a facility depends almost entirely on the commitment of one health worker?

Lamidi is already thinking about what will happen after her retirement.

“I don’t know what will happen to this place,” she said.

WHEN BASIC TESTS REQUIRE A JOURNEY TO EDE

The challenges at Agbinpa go beyond the appearance of the building.

The health centre does not have a functional laboratory.

Patients requiring basic blood tests are therefore referred to Ede, approximately 26 kilometres away.

Women who come to deliver are also sometimes required to purchase gloves, methylated spirit and other basic consumables before receiving treatment.

For residents, these additional expenses come on top of transportation costs.

A mother of five(5), Mum Kudurat, who delivered all five of her children at the facility, said the nurse’s commitment is one of the reasons the centre remains useful.

“The nurse is good. It is only because of the condition of the hospital that people do not come here,” she said.

Patients requiring scans are referred to Ede, she added.

“If someone is sick, what can we do? We have to go.”

For Abdulrahaman Babatunde, transportation is another major burden.

He said commercial motorcycles often avoid the route because of its condition.

“If you hire a bike, it can cost N6,000,” he said. “If the rider waits for you, they charge as much as N10,000.”

The poor road also affects farmers who depend on transportation to move agricultural produce to markets.

NO ELECTRICITY, HIGHER COST OF LIVING

Electricity is another challenge confronting residents.

According to Babatunde, the community has been without regular electricity for a long period despite the presence of poles and wires.

“There has been no light here for a long time,” he said.

Residents who need to charge their phones and power banks depend on privately operated solar charging points, where they pay between N400 and N700.

For a community already struggling with transportation and healthcare costs, such expenses add another layer to the economic burden.

ABUDO: WHEN THE JOURNEY TO THE HOSPITAL STARTS WITH A BAD ROAD

Agbinpa is not an isolated case.

About an hour from Osogbo, Abudo Primary Healthcare Centre in Egbedore Local Government Area presents another dimension of the rural healthcare challenge.

Here, the first barrier is the road.

The poor condition of the road has made commercial motorcyclists reluctant to travel to the community.

When VAM News arrived at the facility at about 1 p.m., the health centre was locked.

Through dusty louvre windows, patient registers and other documents could be seen inside the rooms. Cobwebs were visible in parts of the building.

There was no health worker on the premises.

Telephone numbers had been written on a wall for patients who needed assistance.

VAM News called the numbers several times. The calls either failed to connect or the phones were switched off.

A COMMUNITY HEALTH CENTRE WITHOUT A PHARMACY

Chief Alao, a community leader, said Abudo PHC serves residents of the community as well as people from neighbouring settlements.

He attributed some of the healthcare access problems to the condition of the road.

“This road was not constructed by the government,” he said. “The community did it ourselves, although there are still many potholes.”

Kemi Olawole, a palm kernel processor, said patients whose conditions cannot be managed at the facility are referred to Ede, about 16 kilometres away.

The community also depends on a motorcycle vendor who brings orthodox medicines into Abudo.

Without the vendor, Olawole said, residents would have to travel outside the community to purchase essential medicines.

Kehinde Olumide, who works in the palm kernel oil trade, said transportation remains a major obstacle.

“We hardly see motorcycles here,” he said. “And when you get one, it is very expensive because of the road.”

For residents, the healthcare problem is therefore not limited to whether a PHC exists.

The real issue is whether residents can reach it, whether health workers are available when they arrive, and whether the facility has the equipment and medicines required to treat them.

EKUSA: A RENOVATED FACILITY, BUT HAVE THE PROBLEMS ENDED?

About 36 kilometres away, in Ekusa, Odo-Otin Local Government Area, the story takes another turn.

The community’s PHC was renovated in 2020.

An inscription on the building states that the project was carried out by the Odo-Otin Local Government and commissioned on March 15, 2020.

Six years later, however, residents say the renovation has not resolved many of the facility’s problems.

During the visit by VAM News, portions of the premises were overgrown with weeds and the borehole was not functioning.

Health workers declined to speak on the condition of the facility, with one worker requesting anonymity because of restrictions on speaking publicly about PHC matters.

“Many people have come here asking questions,” the worker said. “If it is something I cannot talk about, it is better I don’t say anything.”

The worker directed enquiries to the Osun State Primary Health Care Development Agency.

Residents said the facility normally closes around 4 p.m., meaning patients who arrive later may have to wait until the following day or travel elsewhere.

Mojisola, a resident, said people often seek treatment outside the community when the facility cannot meet their needs.

Abdulrahaman Wasiu, a spiritual and youth leader, said the problems had persisted despite the 2020 renovation.

“People only came to paint the building,” he said. “Apart from that, nothing much changed.”

Wasiu recalled visiting the facility after suffering a dislocation but leaving without receiving the treatment he needed.

According to him, the health centre has existed for as long as he can remember but remains understaffed.

When VAM News returned to the facility with Wasiu, they encountered another resident wearing an “Imole cap” who identified himself as a supporter of Governor Ademola Adeleke.

He confirmed that health workers had been directed to refer enquiries concerning PHCs to the relevant government agency.

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He also acknowledged that the facility required attention but said Governor Adeleke would intervene if he became aware of its condition.

FOLLOWING THE MONEY

The conditions encountered by VAM News raise questions about the connection between government expenditure and the actual quality of healthcare available to residents at the grassroots.

Osun State’s budgetary commitment to healthcare has increased significantly over the years.

An analysis of approved state budgets indicates that about N157.74 billion was budgeted for the health sector between 2020 and 2026.

The state approved N7.2 billion for health in 2020.

The allocation increased to N9.8 billion in 2021 and N12.4 billion in 2022.

In 2023, the allocation reached N17.92 billion, representing 12.96 per cent of the state’s N138.27 billion budget.

Although the proportion subsequently declined, the nominal allocation continued to rise.

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The state budgeted N18.6 billion for health in 2024, N32.58 billion in 2025 and N59.24 billion in the approved 2026 budget.

The figures demonstrate a substantial increase in the amount earmarked for healthcare.

But for residents of communities such as Agbinpa, Abudo and Ekusa, the more important question is not simply how much is budgeted.

It is what the money delivers at the point where ordinary residents seek treatment.

WHAT PROCUREMENT RECORDS SHOW

VAM News also examined available procurement records relating to healthcare projects in the state.

The records indicate that the government awarded contracts between 2020 and 2024 for the rehabilitation of health facilities, medical equipment, solar power systems, boreholes and other healthcare interventions.

Among the projects recorded was a N35.7 million contract awarded in 2020 to Olupopson Nigeria Limited for the rehabilitation and upgrading of General Hospital, Ifetedo.

The procurement records also contain contracts for medical equipment, including theatre lamps, diathermy machines, X-ray machines, instrument trolleys, suction machines, emergency stretchers, ultrasound scanners and ECG machines, among others.

Other procurements covered laboratory supplies, HIV/AIDS consumables, hepatitis B testing kits, computer systems and surgical equipment.

Some contracts were marked completed, while others were listed as active or had no completion status.

The largest group of investments examined by VAM News occurred in 2024.

Procurement records show multiple contracts valued between approximately N426 million and N592 million for the renovation of PHCs across the state’s three senatorial districts.

Separate contracts valued at more than N188 million each were awarded for the supply and installation of solar power and inverter systems across the three senatorial districts.

Additional contracts ranging from approximately N119 million to N556 million were approved for the sinking and repair of boreholes.

However, an important limitation emerged from the records.

The procurement documents did not clearly identify every individual PHC covered under the various phases of these projects.

Consequently, VAM News could not independently establish from the documents reviewed whether Agbinpa, Abudo or Ekusa PHCs were among the facilities specifically covered by the 2024 renovation, solar or borehole projects.

That gap is significant.

It means that the existence of large procurement figures alone cannot be used to conclude that every rural PHC has benefited from them.

STATE GOVERNMENT: PRIMARY HEALTHCARE REMAINS A PRIORITY

The Osun State Government has consistently maintained that primary healthcare is an important component of its development agenda.

During an inspection of renovated PHCs in Telemu, Ola-Oluwa LGA, and Ido-Osun, Egbedore LGA, in March 2025, Governor Ademola Adeleke said his administration was committed to improving healthcare access, particularly in rural communities.

The governor said the state had embarked on the rehabilitation and upgrading of PHCs to strengthen healthcare delivery at the grassroots.

He also said the government would continue with the upgrade of health facilities.

In his third anniversary broadcast in November 2025, Adeleke said his administration had rehabilitated more than 200 PHCs across the state.

According to the governor, the interventions included structural rehabilitation, clean water systems, perimeter fencing, roofing repairs, furniture, sanitation facilities and solar power.

He also announced that another phase covering nearly 200 additional facilities was underway.

The administration has further highlighted the revitalisation of the Osun Health Insurance Scheme, increased insurance coverage, free surgical interventions and other health-related programmes.

These interventions indicate that government spending and policy attention to the sector are real.

The challenge emerging from the communities visited by VAM News is whether those investments are reaching every facility with the urgency and consistency required.

PHC AGENCY: FUNDING AND LOCAL GOVERNMENT ISSUES AFFECT IMPLEMENTATION

VAM News contacted the Osun State Primary Health Care Development Agency over the findings.

The agency’s Executive Secretary, Adesina Igbalaye, said the state had invested significantly in primary healthcare.

He explained that the agency conducts routine monthly and quarterly assessments of health facilities to monitor infrastructure, staffing, equipment and service delivery.

According to him, the assessments help government identify facilities requiring intervention.

He said the state had adopted a strategy of upgrading one focal PHC in each ward.

Such facilities, he explained, receive interventions including renovation, solar power systems, boreholes, medical equipment and other improvements.

Igbalaye also said the government had introduced stipends for volunteer health workers who previously worked without pay and provided counterpart funding for health programmes implemented with development partners.

On why all PHCs had not received similar interventions, he cited funding limitations.

He also said disputes concerning local government administration affected access to local government funds from February of the previous year, slowing parts of the programme.

According to him, however, other interventions—including drug supplies and routine support—have continued.

He maintained that the agency remains committed to expanding access to primary healthcare across Osun.

THE GOVERNMENT’S OWN ASSESSMENT REVEALS GAPS

The agency also provided VAM News with a copy of its “5-Day Routine Quarterly Quantitative Integrated Supportive Supervision at PHCs in 15 Selected LGAs” report for the second quarter of 2026.

According to the report, supervision teams visited at least 150 PHC facilities between June 1 and June 5, 2026.

The assessment covered infrastructure, staffing, service delivery, availability of medicines, immunisation, maternal and child health indicators and data quality.

However, the report did not identify the 15 LGAs or provide a facility-by-facility breakdown that would allow VAM News to determine whether Agbinpa, Abudo and Ekusa were among the facilities assessed.

More importantly, the report itself acknowledged several problems similar to those identified during VAM News’ field visits.

These included:

* Shortages of health workers;
* Stock-outs of essential medicines and consumables;
* Absenteeism among some health workers;
* Poor record-keeping;
* Difficult rural roads affecting access to healthcare.

The report stated that 50 facilities experienced stock-outs of malaria medicines, while 20 facilities lacked oral rehydration salts (ORS).

It also noted that rainy-season road conditions affected access to some rural PHCs.

Among the recommendations were increased procurement of essential medicines and consumables, conversion of ad hoc and volunteer health workers to permanent staff, stronger monitoring of staff attendance and increased funding for supervision.

MORE THAN BUILDINGS: WHAT MAKES A PHC FUNCTIONAL?

For health advocates, the issues uncovered in Osun reflect a broader problem in Nigeria’s primary healthcare system.

Sheriff Gbadamosi, Advocacy and Community Engagement Manager at Nigeria Health Watch, told VAM News that the presence of a health centre building does not necessarily mean residents have access to functional healthcare.

He said PHCs are designed to be the first point of contact between communities and the formal health system.

“Access should not be measured by the presence of a building alone,” he said. “It should be measured by whether facilities are adequately staffed, stocked with essential medicines and equipped to provide basic services.”

According to him, infrastructure rehabilitation is important, but buildings alone cannot produce better health outcomes.

He identified workforce shortages, weak supply chains, financing gaps and governance issues as some of the challenges affecting PHCs across Nigeria.

The case of Agbinpa, he said, also illustrates the danger of depending heavily on the extraordinary commitment of one health worker.

“No PHC should depend entirely on the extraordinary commitment of one individual. Strong health systems are designed so that quality care does not rely on heroism,” he said.

He also pointed to the Basic Health Care Provision Fund (BHCPF), under which participating facilities are expected to receive funding to support healthcare delivery.

According to him, such mechanisms should translate into improved infrastructure, medicine availability and additional human resources.

THE REAL COST IS PAID BY RURAL RESIDENTS

The findings from Agbinpa, Abudo and Ekusa point to a common thread.

The problem is not necessarily the absence of government spending.

It is the gap that can emerge between budget allocation, project implementation and the experience of the person standing at the door of a rural health centre.

A PHC may have a renovated building but no functioning borehole.

It may have a health worker but lack laboratory services.

It may have equipment but insufficient personnel to use it.

It may exist on paper but remain inaccessible because the road leading to it is practically impassable.

And when patients are referred elsewhere, the financial burden does not disappear.

It moves to the patient.

Transport fares, diagnostic costs, medicines, consumables and lost working hours all become part of the price of seeking healthcare.

For poor and rural households, these costs can determine whether treatment is sought early, delayed or abandoned altogether.