Under the scalding afternoon sun in Afowa-Uzaire, a community on the outskirts of Auchi, Etsako West Local Government Area of Edo State, Aishetu Ibrahim, 65 year-old woman clutches her faded wrapper tightly as she sits under a tree close to the only primary health centre in the community.
The centre, a block building with broken windows, has a resident community extension health worker, but lacks other necessary facilities to attend well to patients.
“We came here, but we could not be well attended to. There is no nurse and the health personnel here could not attend us satisfactorily. No drugs in the facility.
“Sometimes, when my grandchildren are sick, we trek to reach Auchi before we find a doctor. If you no strong, you fit die on the way,” she said
Ibrahim’s experience captures a grim reality playing out across rural Edo North, where residents grapple daily with a crumbling primary healthcare system.
In spite of visible improvements in urban centres like Auchi and Okpella, rural communities such as Iviukwe, Ekwotsor, Eware, and Ijagbe remain underserved.
Health centres in these areas often operate without qualified personnel, critical medical supplies, or basic security, a situation that exposes residents to preventable deaths.
In Nigerian rural areas, studies show Primary Healthcare Centres (PHCs) face significant challenges, including poor infrastructure, inadequate staffing, and limited access to essential drugs and equipment.
While PHCs are the first point of contact for many, many are understaffed and poorly equipped, hindering their ability to deliver quality care.
This, obviously, leads to a higher reliance on secondary and tertiary healthcare facilities, increasing healthcare costs and travel distances for rural populations.
Furthermore, records indicate that while urban centres averaged one healthcare worker to every 800 residents, some rural centres had ratios as high as one healthcare worker to 4,000 people.
In Eware, for instance, the only health worker is a male community health extension worker, attending to patients from four to five coverage villages.
When a young farmer, Sunday Odion, suffered a snakebite last November, the centre had no antivenom or even a trained nurse to administer first aid.
“I cried until my eyes dried. If we had a real clinic here, the problem would have been minimal,” said Mrs Rebecca Odion, the mother of the victim.
Part of the crisis stems from a shortage of healthcare workers willing to serve in remote areas plagued by insecurity.
In recent times, there has been a surge in the reported cases of kidnapping and attacks along the rural corridors of Edo North.
Health workers posted to these areas often abandon their posts after a few months, citing threats to their safety.
An official at the Edo Primary Healthcare Development Agency (EDOPHCDA/, who asked not to be named because she was not authorised to speak, admitted that insecurity is a major deterrent.
“We have recruited recently and deployed staff to several rural centres, but the truth is, many of them don’t stay.
“You can’t blame them. Who will risk their life every day just to go to work?”
Government efforts, such as the introduction of the Edo Social Health Insurance Scheme in 2023, have made some impact in improving access to healthcare in towns and semi-urban centres.
However, community leaders in rural Edo North argue that these initiatives have yet to reach them meaningfully.
For instance, Chief Moses Eregie, a resident of Ivianokpodi, Etsako East Local Government Area of the state, lamented the state of healthcare services in the area.
“We hear on the radio that the government is giving us better healthcare. But what we see here is different.
“Our health centre has no doctor, no drugs, and even the roof is leaking. How are we supposed to survive?”
A visit to several primary health centres in the rural parts of Etsako East, Etsako West and Etsako Central confirmed Chief Eregie’s claims.
In Iviukwe, Etsako East LGA, the health centre had no electricity, no running water, and only one rusted examination table.
Essential medicines like antibiotics, antimalarials, and blood pressure drugs were conspicuously absent.
It is a similar situation in Ughiole-Aviele, Etsako West LGA, where the building is relatively in good shape, but lacks good beds, electricity and constant water supply.
Dr Samson Igbinedion, a public health expert based in Benin City, stressed that the disparity between urban and rural healthcare access was not merely an infrastructural issue but a question of political will and resource allocation.
“Rural communities are being left behind. If the state government does not deliberately prioritise staffing, security, and supply chains for rural centres, the cycle of preventable deaths will continue,” he said.
Some attempts at community-driven solutions are emerging. In Iviukwe, residents have pooled resources to get a retired nurse, who is attending to their needs.
While the arrangement is far from ideal, it represents the community’s desperation and resilience in the face of neglect.
Mrs Stella Okoro, a resident in the community, explained, “We cannot just wait for the government.
“We contributed small-small money, and the nurse is helping us. But she also needs equipment, medicines, and security. We can only do this, the government needs to double up.”
With the new government in the state being led by Gov. Monday Okpebholo, she believes the situation of healthcare services in the rural areas would improve in earnest.
The consequences of the rural healthcare gap are profound. Children under five years old are three times more likely to die from preventable diseases like malaria and diarrhoea than their urban counterparts, according to a UNICEF-supported survey on health outcomes.
Maternal mortality rates are also significantly higher, with many women delivering at home without skilled birth attendants.
While the crisis continues, voices like Aishetu Ibrahim and Rebecca Odion’s call for urgent action.
“We are not asking for too much. Just give us small care, small security. Let us have life, even in the village,” Ibrahim said quietly, staring at the cracked wall of the health centre.
However, the state government pledged to improve primary healthcare services to ensure all local governments have access to affordable and quality medical care.
The Deputy Governor of the state, Dennis Idahosa during the meeting of officials of the Taskforce on Primary Health Centres (PHCs), said the steps aligned with Gov. Monday Okpebholo’s Security, Health, Infrastructure, Natural Resources and Agriculture, and Education (SHINE) agenda.
“This represents a pivotal step in our collective mission to strengthen the PHC system and improve healthcare outcomes,” Idahosa said.
The deputy governor reiterated that PHC was the foundation of a functional and sustainable health system.
He, however, urged local government chairmen and stakeholders to take active roles in enhancing PHC infrastructure, staff deployment, and resource allocation.
According to him, an efficient PHC system reduces referrals to secondary facilities and ensures timely care.
Similarly. Dr Cyril Oshiomhole, state Commissioner for Health, said that the ministry had trained 146 facility managers in digital health data management and distributed 210 laptops and tablets across PHCs to improve monitoring, evaluation, and service delivery.
The government’s immediate focus, according to him, included strengthening immunisation, maternal and child health services, and ensuring the availability of essential medical supplies in all LGAs.
As policymakers draw up future healthcare plans, the voices of Edo North’s forgotten rural communities must be brought to the table.
Without deliberate, targeted investments in staffing, infrastructure, security, and community engagement, the crisis of neglect will only deepen, further entrenching inequality in a region where every life should matter equally.
The story was produced for the Frontline Investigative Program and supported by the Africa Data Hub and Orodata Science