When the Lights Go Out at the Health Centre: Nigeria's Fight to Power Its Primary Healthcare Facilities

 

Up to 50% of Nigeria's primary health centres face unreliable electricity. A new solar power pilot in Rivers State is showing what is possible — and what needs to scale.

Picture a delivery room in darkness. A midwife presses a torchlight against her shoulder to illuminate the face of a woman in labour while she works. The generator has stopped and nobody knows if there is fuel to restart it. This was the reality at the Primary Health Centre in Rumuigbo, Rivers State, until recently and according to health workers and public health researchers, it remains the reality at an estimated 40 to 50 per cent of Nigeria's primary health care facilities today. In a country of over 230 million people, the basic infrastructure failure of unreliable electricity at health centres is not a minor inconvenience. It is a cause of preventable deaths, failed vaccinations, and a slow erosion of the trust that communities place in the health system closest to them.

The Scope of the Problem

Primary health centres are the first and often only point of formal healthcare contact for millions of Nigerians, particularly in rural and peri-urban areas. They are supposed to provide maternal and child health services, immunisation, basic diagnostics, family planning, and treatment for common illnesses. All of these services have power dependencies that are easily overlooked until the power fails. Vaccines must be kept at precise temperatures in cold chain equipment equipment that is useless without electricity. Diagnostic equipment cannot function. Sterilisation of instruments is compromised. Lighting for procedures, particularly those that occur at night such as emergency deliveries, becomes impossible without reliable backup.

The dependency on diesel generators as backup power creates its own problems. Fuel must be purchased, transported, and stored — each step adding cost and logistical complexity to the operation of facilities that are already understaffed and under-resourced. When fuel budgets run out, which happens regularly across Nigeria's health system, the generators stop and the facilities go dark. The connection between electricity supply and health outcomes is direct, measurable, and in Nigeria's case, deeply troubling.

A Solar Pilot That Is Showing What Is Possible

Against this backdrop, a pilot programme supported by the World Health Organisation, the Federal Ministry of Health, and a coalition of partners has been demonstrating that reliable clean energy for primary health centres is achievable at scale. At facilities in Rivers State and at least one facility in a northern state, five-kilowatt solar photovoltaic systems paired with ten-kilowatt-hour lithium-ion battery storage have been installed, providing uninterrupted power supply to critical services.

The results at the Rumuigbo facility have been striking. Cold chain equipment now maintains stable temperatures consistently. Lighting is reliable around the clock. Procedures that were previously impossible after dark  or that required improvised solutions that compromised safety can now be performed under proper conditions. Community Health Extension Worker Alaba Douglas, who worked through the years of unreliable power, described the change simply: "You cannot tell a mother in pain to wait because the light is gone. That was our reality for years. It is different now."

The WHO Representative in Nigeria, Dr Pavel Ursu, noted that the pilot demonstrates a replicable model: "Reliable power is essential for safe delivery, vaccination and emergency care. This pilot shows how clean energy strengthens primary health care." The Director of Climate Change and Environmental Health at the Federal Ministry of Health, Dr Zakari Mohammed, added that the programme provides a template that can be adapted and scaled across the country's network of primary facilities.

The Path From Pilot to Scale

The harder question is what it would take to replicate this model across Nigeria's thousands of primary health care facilities — a question that requires honest engagement with the financial and logistical realities involved. Nigeria operates approximately 35,000 primary health care facilities, though the number that are actively functional varies considerably by state. Even a conservative estimate of the cost of equipping a significant fraction of them with solar systems suggests a financing requirement that is well beyond what development partner support alone can provide.

The Federal Government's Nigeria Health Sector Renewal Investment Initiative, which frames the policy context for health infrastructure investment, includes commitments to improving facility infrastructure. But the translation of policy commitments into funded, implemented infrastructure projects has historically been uneven. States with stronger fiscal capacity and more proactive health ministries have tended to move faster; those with weaker revenue bases and less administrative capacity have fallen further behind.

There is also a tariff dimension that intersects awkwardly with the government's broader 2026 trade policy. The solar panels, batteries, and inverters required for health facility electrification are predominantly imported. If import costs for these components remain high, the cost of scaling the pilot will be commensurately higher. A targeted tariff exemption or reduction for solar equipment destined for health facilities would reduce the cost of the scale-up  a relatively simple policy alignment that has been recommended but not yet implemented.

Why This Matters Beyond Health

The electricity problem at Nigeria's primary health centres is a microcosm of a larger challenge facing the country's development ambitions. Infrastructure deficits  in power, in roads, in water  consistently undercut the effectiveness of sectoral reforms that are designed without sufficient attention to the physical environment in which they must operate. A health policy that assumes functional health centres cannot deliver its intended outcomes when the centres themselves lack basic utility infrastructure.

For communities across Nigeria  particularly the rural and semi-urban communities where primary health centres are the only realistic health option  the electricity issue is not abstract. It determines whether the facility in their ward can function when they need it most. Getting power to those facilities is not a luxury component of health system strengthening. It is a foundational requirement, and addressing it with the urgency it deserves would be one of the highest-return investments Nigeria could make in the health of its population.