A prominent human capital development expert and health management consultant, Dr. Ben Nkechika has fingered the neglect of primary healthcare systems across Africa as the beginning of the continent’s health crisis and not from the absence of advanced hospitals.
Speaking in an interview with journalists on Monday in Abuja, Nkechika said that while global conversations often focus on state-of-the-art facilities and cutting-edge medical equipment, the real battle for health is being lost in rural communities where PHC centres are either non-existent or barely functional.
“Strong primary healthcare is not controversial; it’s essential,” he said. “The real tragedy is that most people in Africa never even make it to a hospital.”
He described widespread scenarios where mothers still deliver babies on bare floors due to the absence of skilled health workers, or children die from preventable diseases like malaria because there is no nearby health post to offer timely treatment.
Nkechika estimated that up to 60 per cent of medical conditions in Africa could be managed effectively at the primary level. Yet, underinvestment and skewed priorities have left frontline facilities broken, under-resourced and short-staffed.
“We are building pyramids from the top down,” he said. “Real transformation starts at the base; in the dusty, forgotten clinics that still manage to save lives.”
Despite these challenges, he cited Rwanda, Kenya and Ghana as success stories. These countries, he said, have implemented decentralised PHC systems that are delivering vaccines, offering maternal care, screening for non-communicable diseases and creating thousands of jobs – all while maintaining cost-effectiveness.
He pointed to startling statistics: only four in 10 Nigerians have access to functional PHC facilities, while as much as 70 per cent of the health budget still goes to secondary and tertiary care. Meanwhile, preventable deaths continue to rise.
Nkechika called for a fundamental mindset shift.
“If Africa invested even half as much in PHC as it does in urban hospitals, we would save lives, reduce costs, and build resilient economies,” he said. “PHC is not just healthcare – it’s survival, dignity and a foundation for education and equity.”
With momentum growing globally for Universal Health Coverage (UHC), he posed a critical question: “Will Africa finally invest in its true frontline?”
