A new research presented at the Task Shifting Symposium 2025 has revealed deep structural weaknesses in primary healthcare (PHC) delivery in the Federal Capital Territory (FCT), prompting the FCT Administration to restate its commitment to evidence-driven reforms aimed at reducing maternal deaths.
Mandate Secretary of the Health Services and Environment Secretariat, Dr Adedolapo Fasawe, said the findings offered "a rare opportunity to examine our system through the eyes of our frontline workers," insisting that maternal health policies in the FCT must now be guided strictly by data.
Speaking on Tuesday in Abuja, Fasawe warned that Nigeria still carries one of the world's worst maternal mortality burdens. "Reports from the World Health Organisation show that our country alone accounts for more than one quarter of global maternal deaths," she said.
"These deaths are preventable, yet they occur in settings where pregnant women face shortages of skilled providers, inadequate equipment, and long wait times."
She said PHCs, the first point of contact for most pregnant women, remain overstretched and under-resourced. "Our PHCs continue to suffer from chronic shortages of skilled personnel, maldistribution of staff, and the strain of a health workforce under pressure," she noted.
Fasawe described task shifting as a proven approach to expanding access to maternal healthcare. "When implemented well, it reduces delays in emergency care, expands access to life-saving interventions, and improves continuity of antenatal and postnatal care," she said.
She cautioned that implementation remains uneven. "Role definitions are sometimes unclear. Professional boundaries remain contested. Training and retraining are inconsistent. Supervision is not always structured. Resources are inadequate."
Fasawe argued that primary health research is "the bridge between vision and impact," stressing that evidence must shape reforms.
According to her, the FCTA is strengthening PHCs by expanding training and supportive supervision, deploying digital tools such as telehealth, improving work environments, clarifying task allocations, and enhancing integration of community health workers.
"Effective task shifting is not simply about giving more work to lower cadres," she added. "It is about equipping them, protecting them, supervising them, and supporting them to deliver safe, high-quality care. If Nigeria wants to reduce maternal mortality, research must guide our decisions, and policy must reflect the realities of frontline workers."
Presenting his research findings, Dr Francis Ayomoh, Honorary Postdoctoral Researcher at the University of Oxford, said the evidence highlights a dangerously fragile PHC workforce in the FCT.
"We have consistently led the global chart on maternal deaths," he said. "It is time we look into the issues within primary healthcare and address them because PHCs provide services to the majority of Nigerians."
He revealed that at least 50 per cent of PHC workers in the FCT serve as volunteers, surviving on facility stipends instead of government salaries. "This needs urgent attention," he warned.
Ayomoh described task shifting as a "policy dilemma", necessary but heavily constrained by resource gaps. "Ideally, we shouldn't be having task shifting, but we cannot do without it because of the human resource gap. While we implement task shifting, we must address the issues making it ineffective so we do not sacrifice quality for access."
He urged the government to demonstrate stronger political will by funding human resources, employing available lower-cadre workers, and ensuring proper training and supervision.
On the impact of ongoing strikes in the health sector, he issued a stark warning: "Some people resort to private facilities if they can afford it, others go to quacks, and others stay home and hope for divine intervention. Lives may already have been lost."
He called for honest and sustained dialogue between the government and health workers, describing a "trust deficit" that continues to fuel industrial disputes.