Lilian Ugwu
A Westbridge Reporters investigation has uncovered that patients are being asked to pay for immunisation services officially designated as free at a primary healthcare centre in Abuja, raising concerns over informal charges and funding gaps in Nigeria’s healthcare system.
During a visit to the facility, this reporter was asked to make a payment before a child could receive routine immunisation.
When questioned, the officer in charge did not deny the practice. Instead, she offered a direct explanation.
“That is the only way we can survive here,” she said.
According to her, the funds collected from patients are used to support volunteer staff, purchase essential medical supplies, and maintain the facility.
“We have people working here who are not on salary,” she explained. “We use the money to support them, buy drugs, and keep this place running.”
Free on Paper, Not in Practice
Routine immunisation is officially provided at no cost in public primary healthcare centres across Nigeria, as part of efforts to prevent childhood diseases. However, findings by Westbridge Reporters indicate that patients may still face unofficial charges at the point of care.
At the Abuja facility, a mother who brought her infant for immunisation said she was surprised when asked to pay.
“They told me it is free, but when I came, they said I should bring money,” she said. “I didn’t argue because I needed my baby to be treated.”
A System Under Pressure
Health workers say such practices are often driven by operational challenges rather than policy.
The officer in charge cited irregular drug supply, lack of funding, and reliance on unpaid or underpaid support staff as key reasons for introducing the charges.
“We cannot send patients away,” she said. “But we also cannot run the centre without resources.”
Across many primary healthcare centres, volunteers play essential roles, yet there is often no structured funding to support them.
Public Health at Risk
Health experts warn that unofficial fees for essential services can reduce access, particularly for low-income families.
Findings by Westbridge Reporters suggest that even small payments can discourage caregivers from returning for follow-up immunisation visits.
This could weaken efforts to control preventable diseases and affect overall public health outcomes.
Policy vs Reality
While government policy guarantees free immunisation, implementation at the facility level appears uneven.
The situation observed by Westbridge Reporters highlights a disconnect between policy intentions and the realities faced by frontline healthcare providers.
Without adequate funding and oversight, some facilities are left to develop informal systems to stay operational.
Patients Left with Few Choices
For many patients, the decision is simple but difficult pay or risk missing essential care.
“I just paid because I didn’t want any issue,” one caregiver said. “My child’s health is more important.”
A Wider Pattern?
Although this report focuses on one facility, the issues raised point to broader systemic challenges within Nigeria’s primary healthcare system.
Further investigation may be needed to determine how widespread such practices are across other centres.