In Adamawa, rural PHCs rely on volunteers due to staffing shortages

At the Damare Primary Health Centre (PHC) in Girei Local Government Area, Adamawa State, Nigeria, volunteer health worker Godiya Deborah Umaru found herself working alongside only one permanent staff member when a surge of patients arrived, including a woman in labor and an accident victim. The waiting area was crowded with outpatients, while admitted patients also required attention.

This scenario is not unique to Damare PHC; it reflects a widespread challenge across rural PHCs in Adamawa State. A significant shortage of health workers has left these facilities struggling to meet the escalating demand for services. Health workers in Girei LGA routinely juggle multiple roles within a single shift, moving between antenatal care, deliveries, outpatient consultations, immunizations, and emergency responses.

Findings indicate that PHCs in this LGA depend on volunteers to fill critical gaps in the workforce. These volunteers assist with essential services such as immunizations, antenatal care, labor and delivery, and wound dressing. Interviews with facility managers, volunteers, health workers, and government officials, along with a review of state health sector documents, reveal a primary healthcare system under immense pressure.

The system is hampered by persistent staffing shortages, inadequate equipment, and an uneven distribution of healthcare professionals. While the Adamawa State Government claims to have recruited additional personnel and is working to improve service delivery, rural facilities remain heavily dependent on volunteers to maintain basic healthcare services for thousands of residents. This reliance underscores a system stretched beyond its capacity, with permanent staff often needing to abandon assigned duties to respond to emergencies elsewhere within the clinic, creating a fragile operational arrangement.

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