A primary healthcare centre that was rebuilt and restocked to serve thousands of residents in Shahuci Ward, Kano Municipal Area Council, is being undermined by thugs — local enforcers whose harassment of staff and patients is quietly reversing one of the federal government's most visible healthcare interventions in northern Nigeria.
Fuskar Gabas Primary Healthcare Centre was among more than 217 PHCs across Kano State that were revitalised under a programme driven by the Federal Ministry of Health and the National Primary Health Care Development Agency. Kano, Nigeria's most populous state with an estimated 15 million residents, has some of the worst maternal and child health indicators in the country — making functional primary care not a convenience, but a lifeline for the women, infants, and low-income families who cannot afford private clinics.
The revitalisation programme, which the federal government scaled up significantly from 2023, aimed to repair dilapidated structures, equip facilities with essential medicines and diagnostic tools, and post midwives and community health workers to underserved wards. For communities like Shahuci — dense, urban-poor, and historically neglected by specialist hospitals concentrated in Kano's commercial districts — the renovated PHC represented the first credible point of care within walking distance.
But the promise of that investment is colliding with a familiar Nigerian problem: the infiltration of public institutions by political thugs who intimidate staff, extort patients, and, in some documented cases, take effective control of facility grounds. This pattern is not unique to Kano. Across the North-West and North-Central zones, community health workers have raised alarms about harassment that discourages women from attending antenatal visits and drives skilled workers away from postings in volatile wards.
Health officials and civil society actors familiar with the Kano situation have warned that without direct intervention from the Kano State Primary Health Care Management Board and the Kano Municipal Area Council, the physical infrastructure restored at enormous cost will decay in utility even if it stands intact. The NPHCDA's model depends on consistent community trust and foot traffic — both of which collapse when a facility becomes associated with fear rather than care.
Observers are now watching whether the Kano State Government will direct security forces and local government authorities to assert control over affected PHC premises before the problem spreads to other revitalised facilities in the state's 44 local government areas. The federal government's Renewed Hope Agenda has placed primary healthcare at the centre of its social investment narrative, and a visible failure in Kano — the North-West's flagship state — would carry political and public health consequences well beyond Shahuci Ward.
For the pregnant woman in Shahuci who finally had a functioning clinic at the end of her street, the question is no longer whether the building exists — it is whether she can walk through the gate without being turned away by the wrong kind of gatekeeper.
