Some healthcare practitioners have attributed the persistent overcrowding in secondary and tertiary health facilities to the ineffectiveness of Primary Healthcare Centres (PHCs) across Nigeria.
The experts made the assertion in an interview with reporters on Sunday in Lagos, noting that poor performance at the PHC level has contributed significantly to the lack of bed spaces in higher-level hospitals.
Dr. Livinus Abonyi, Dean of the Faculty of Healthcare Services at the Federal University of Allied Health Sciences, Enugu, stressed the urgent need to strengthen PHCs for optimal performance. He lamented that PHCs are poorly funded, especially in manpower, facilities, and equipment, and called for them to operate 24 hours to handle health emergencies.
“Currently, a patient may visit two or three tertiary hospitals without finding a bed,” Abonyi said. “Many citizens are even carried home dead because of inadequate bed space. If PHCs were functioning properly, most cases would be managed at that level, reducing pressure on tertiary hospitals.”
Abonyi emphasized that effective primary healthcare could ensure early intervention, preventing conditions from escalating to the point where tertiary care is required.
Supporting the call, Mr. Donatus George, a teacher, shared his personal tragedy: his wife died while being transferred between public hospitals due to a lack of beds and insufficient medical staff. He urged strengthened emergency response systems to prevent similar avoidable deaths.
Dr. Gerald Chinasa, a general physician, also highlighted a widespread belief in Nigeria that quality care is only available at tertiary institutions. He argued that equipping PHCs with adequate manpower and resources, alongside public awareness campaigns, could shift public perception and reduce overcrowding at higher-level hospitals.
Dr. Wasiu Adeyemo, Chief Medical Director of Lagos University Teaching Hospital (LUTH), described the overwhelming patient load at tertiary hospitals and called for the establishment of more public hospitals nationwide. He noted that most secondary healthcare facilities and PHCs often refer cases that should be treated locally to tertiary hospitals, exacerbating pressure on limited beds and resources.
“In many instances, patients arrive without prior notification, making it difficult to manage admissions effectively,” Adeyemo said. “There is a limit to what tertiary institutions can handle given existing personnel and facilities. Strengthening PHCs is crucial to decongesting tertiary hospitals and improving healthcare delivery across the country.”
