A recent assessment by Connected Development (CODE) has revealed that delayed fund releases, weak accountability mechanisms and limited access to information are undermining the implementation of primary healthcare funding in Nigeria’s Adamawa State.
The assessment, conducted under CODE’s Follow The Money initiative between April 7 and 11, 2026, examined the implementation of the Basic Health Care Provision Fund (BHCPF) 2.0 across the state.
According to CODE, although Adamawa has established the structures needed to implement the programme, significant governance and accountability challenges continue to affect its effectiveness.
Speaking on the findings, CODE Programmes Officer, Abdulazeez Abdulmalik, said the assessment identified weak relationships among stakeholders responsible for managing healthcare resources.
“The most important findings from this assessment showed that there have been some breakages as well as weak relationships between stakeholders in the management of resources from these gateways,” he said.
One of the major concerns raised during the assessment was the exclusion of Ward Development Committees (WDCs) from key financial decisions in some healthcare facilities.
Several WDC members in Yola North Local Government Area reported that despite being expected to serve as signatories to facility accounts, they are often left out of decisions regarding the management of healthcare funds. Some also alleged that reports are submitted without their knowledge or approval.
The report further noted that delays in inaugurating some WDCs have weakened their ability to carry out oversight responsibilities effectively.
The assessment also highlighted delayed fund disbursements as a major challenge affecting healthcare delivery.
Asmau Isman Kona, Executive Secretary of the Yola North Local Government Health Authority, said delays in releasing funds often result in shortages of essential medicines and difficulties in paying ad hoc healthcare workers.
“Sometimes the funds don’t come on time. When that happens, we may have stockouts of drugs and challenges paying some of the ad hoc staff engaged in the facilities,” she said.
Kona warned that delayed payments can lead to staff absenteeism, which ultimately affects service delivery in healthcare facilities.
Beyond funding challenges, the report identified limited public access to information as another obstacle to accountability.
Journalist Abdulbasid Dantsoho said it remains difficult to obtain information about how much healthcare funding is released and how it is spent.
“There is a difference between allocation and release of funds. Accessing information about those releases and how the money is spent is often difficult,” he said.
According to him, the lack of reliable data makes it difficult for journalists and citizens to independently verify government spending and hold public institutions accountable.
The assessment also pointed to broader structural challenges facing the healthcare sector in Adamawa. Officials disclosed that although the state has more than 1,100 primary healthcare facilities, only about 226 are active, while just 73 provide 24-hour services.
A shortage of healthcare workers, particularly in rural communities, was also identified as a persistent challenge.
Despite the concerns, CODE acknowledged signs of progress, including Adamawa’s continued access to BHCPF funding since 2019 and efforts by the state government to strengthen collaboration between Ward Development Committees and healthcare facility managers.
To improve transparency and accountability, CODE called for the establishment of community health monitoring teams to strengthen oversight and ensure that healthcare resources are effectively managed.
The organisation concluded that while the foundations for effective implementation of BHCPF 2.0 exist in Adamawa State, greater efforts are needed to improve transparency, community participation and accountability in the management of healthcare funds.