The National Primary Health Care Development Agency (NPHCDA) has been intentional in listening to the voices that matter in shaping the Primary Health Care (PHC) landscape in Nigeria.
CCSI partnered with the Agency as they led the convening of a series of Community Engagement Townhall Meetings across 20 states spanning Nigeria’s six geopolitical zones in May 2026 to strengthen trust, accountability, and citizen participation in the country’s Primary Healthcare (PHC) system.
Held under the initiative, Community First: Enhancing Primary Healthcare Delivery through Inclusive Conversations, the meetings brought together diverse stakeholders, including community and religious leaders, women, youth, health workers, policymakers, and vulnerable groups such as persons with disabilities. The engagements provided a platform for participants to learn about ongoing PHC reforms, share community experiences, and contribute to accountability commitments aimed at improving service delivery and utilization.
Designed to increase awareness of health sector reforms, gather community insights on PHC service delivery, and promote local ownership of health interventions, the initiative reached more than 2,000 participants across the country.
The town hall meetings addressed key barriers to PHC utilization, including mistrust, misinformation, weak feedback mechanisms, and low health-seeking behaviour, particularly in underserved communities. Through inclusive dialogue, participants gained a better understanding of ongoing reforms while sharing firsthand experiences, concerns, and recommendations for improving healthcare services.
“This meeting helped me understand that communities also have a responsibility to support PHCs.”— Bayelsa participant
Participants emphasized the need for structured community feedback mechanisms to strengthen accountability and responsiveness within the health system. Community and religious leaders also reaffirmed their commitment to promoting positive health behaviours and mobilizing communities to access antenatal care (ANC), immunization, and other essential PHC services, while supporting the monitoring and improvement of PHC centres.
““Our committee regularly monitors the PHCs in our domain. We don’t wait until a report is brought to our attention, we go to see things for ourselves because there is a lot we can do to improve our PHC.” — Chairman, Committee on Health, Ikere LGA
Through a structured platform for dialogue between communities and health stakeholders, the initiative helped bridge the gap between policymakers and citizens, ensuring that health reforms are informed by the realities and needs of the people they are intended to serve.
The town hall meetings yielded significant progress, signaling a shared commitment across government, religious institutions, and communities to strengthening PHC. Government pledged to close human resource gaps, investigate misconduct to strengthen accountability, and recruit additional staff, with Ondo State already onboarding new frontline health workers within weeks. Religious leaders also committed to weave health messages into weekly sermons, while State Primary Health Care Development Agencies (SPHCDAs) were tasked with institutionalizing quarterly LGA town halls and annual state-level engagements as a standing governance mechanism. Following this, the National Primary Health Care Development Agency (NPHCDA) is expected to scale its “Know, Trust, Go” campaign nationwide to extend these conversations further.
Inclusivity was a recurring priority during the conversations. Following concerns from persons with disabilities, government committed to disability-inclusive PHC standards, alongside efforts to improve access through toll-free NPHCDA hotlines and expanded SPHCDA call centers. Furthermore, at the grassroots level, community leaders across the twenty states pledged to mobilize residents for antenatal care, immunization, and broader use of PHC, while also committing to monitor facilities directly to ensure better service delivery.
Participants’ reflections across the states speak to both the value of these engagements and the work that still lies ahead: Speaking during the engagement, one of the participants, a Head of Traditional Birth Centre shared “Inadequate staff needs to be addressed. When we escort our clients for delivery or immunization, the facility staff are usually overwhelmed with work.”
During the engagement in Ebonyi State, a pregnant woman reflected on the service at the PHC in her community, “I delivered my first baby at the PHC, and I have started ANC for this pregnancy. The health workers attend to us very well, but they need to replace the old beds.” — Pregnant woman, Ebonyi.
Overall, the Community Engagement Town Hall Meetings highlight the significant role that citizen participation plays in strengthening primary healthcare systems and how collaborative accountability among government, communities, and partners can translate into meaningful, lasting improvements.