Enugu State has recorded notable improvements in primary healthcare delivery across key indicators, including routine immunisation, skilled birth attendance, and healthcare utilisation. However, health officials warn that persistent vaccination gaps could expose the state to a potential measles outbreak.
The warning is contained in a new performance report presented by the Enugu State Primary Health Care Development Agency (ENSPHCDA) during a Town Hall Engagement Meeting held on Monday in Enugu.
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The meeting, jointly organised by the ENSPHCDA and the National Primary Health Care Development Agency (NPHCDA), reviewed statewide primary healthcare performance data between October 2025 and March 2026.
According to the report, Enugu State’s population estimate is 5.88 million people across 17 local government areas, supported by 566 primary healthcare centres and 990 public and private health facilities.
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Of these, 260 facilities have been upgraded to Type 2 PHCs under the Basic Health Care Provision Fund (BHCPF) framework, while 736 health facilities provide routine immunisation services across the state.
The report also estimates a high-risk population of 294,152 pregnant women, 235,322 children under one year, and over 1.17 million children under five years requiring continuous healthcare interventions.
Health facility utilisation data showed fluctuating but improving service uptake, with attendance peaking at 176,009 visits in February before declining to 130,000 in March.
The report attributed the December-January drop in attendance to seasonal absenteeism, but noted overall recovery in service demand across the six months.
Rise in skilled birth and ANC
The report highlighted a significant improvement in skilled birth attendance (SBA), which rose from 40.9 per cent in October 2025 to 59.3 per cent in March 2026, representing an 18.4 percentage-point increase within six months.
The report attributed the growth to the Maternal and Neonatal Mortality Reduction Innovation Initiative (MAMII), improved staffing, and expanded access to maternal health services.
It added that the MAMII programme is currently active in three LGAs, with plans to scale across all 17 LGAs by the fourth quarter of the year, including the distribution of MAMA Kits to all 294,152 pregnant women in the state.
Routine immunisation performance also improved, with Penta 3 coverage rising from 78.5 per cent to 88.9 per cent, surpassing the national target of 85 per cent.
Antenatal care utilisation also improved, with first ANC visits rising from 16.8 per cent to 24.2 per cent within the review period. However, only 10.2 per cent of pregnant women completed ANC 4 visits by March, indicating a significant drop-off between first contact and full pregnancy care completion.
“Community follow-up systems must close this retention deficit,” the report stated, highlighting weak continuity of maternal care.
Immunisation gaps
Despite overall gains, the report raised alarm over critical immunisation gaps, particularly for measles vaccination. It stated that MCV2 coverage stands at just 36 per cent, describing it as a serious public health threat with outbreak potential.
Other weak indicators include IPV2 at 59 per cent and MCV1 at 61 per cent, which were also classified as below acceptable thresholds.
“MCV2 at 36 per cent is the single most dangerous coverage gap – measles outbreak risk is real,” the report warned.
The agency recommended emergency catch-up campaigns across all 17 LGAs, beginning with Aninri and Nkanu West.
On Local Government Area performances, data showed wide disparities across local government areas.
Enugu East and Ezeagu recorded the highest overall routine immunisation coverage at 95 per cent each, while Ezeagu (97 per cent) and Enugu North (95 per cent) led in Penta 3 coverage.
At the lower end, Aninri recorded 57 per cent overall immunisation coverage, making it the worst-performing LGA in the state. Nkanu West and Nsukka were also flagged for weak performance despite their relative proximity to urban centres.
Infrastructure shift
The report noted the state government’s ongoing construction and the upgrade of 260 Type 2 PHCs across all wards, valued at N46.8 billion.
Each facility is designed with 13 rooms, staff quarters, solar power systems, boreholes, and modern equipment aimed at ensuring 24-hour service delivery.
The report contrasted current progress with conditions inherited before 2023, when many facilities were described as dilapidated, under-equipped, and unable to provide basic maternal or emergency care.
Maternal mortality was previously estimated at 712 deaths per 100,000 live births, above the national average of 512.
The ENSPHCDA says maternal mortality has dropped to 178 per 100,000 live births by the end of 2024, describing it as a dramatic improvement linked to ongoing reforms.
Health facility utilisation also increased, with attendance peaking at 176,009 visits in February, signalling growing public confidence in primary healthcare services.
READ ALSO: Were spending N24 billion for 260 new PHCs in Enugu Official
Intervention and workforce expansion
The agency said federal support through constituency projects and the BHCPF has complemented state interventions across several LGAs, including Enugu East, Udi, Igbo Etiti, Oji River, and Nkanu West.
It stated that the state received N254 million under the BHCPF programme, with three Phase 1 PHCs completed and more than 20 additional facilities targeted for Phase 2 upgrades.
It added that more than 266 PHCs have now benefited from combined federal and state interventions under the ongoing health sector reforms.
The report revealed that 2,200 health workers have been approved for recruitment, with over 450 already deployed across PHCs in the state.
It also noted that Enugu has introduced a doctor-led PHC management model at the local government level, aimed at improving clinical oversight, accountability, and service quality.
To improve transparency, the state has deployed biometric attendance systems and facial recognition technology to curb absenteeism and eliminate ghost workers.
The digital health system currently tracks 566 PHCs, achieving a 97.5 per cent reporting rate across facilities.
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