In a bold and strategic move to transform the delivery of primary healthcare services in Nigeria, the Federal Government has launched an unprecedented reform initiative that will see the deployment of 774 Performance and Financial Management Officers (PFMOs)—one in every local government area across the country. The ground-breaking initiative, unveiled on Tuesday in Abuja, represents a major milestone in the journey to improve accountability, efficiency, and equitable service delivery within Nigeria’s primary healthcare (PHC) system.
The launch, presided over by Dr. Muyi Aina, Executive Director of the National Primary Health Care Development Agency (NPHCDA), signals a strong push by the administration of President Bola Ahmed Tinubu to recalibrate the nation’s health sector. Dr. Aina emphasized that the PFMO initiative is not merely an administrative policy but a structural overhaul with the potential to redefine how healthcare reaches ordinary Nigerians. “This is not just a policy; it is a transformational effort aimed at securing the future of healthcare in Nigeria, where young people not only participate but lead,” he stated.
PFMOs, he explained, are trained professionals tasked with tracking performance metrics, supporting local health outreach efforts, and ensuring transparency in the use of the Basic Healthcare Provision Fund (BHCPF). With more than 60,700 health workers retrained under ongoing reforms, Nigeria’s PHC facilities are undergoing a facelift—solar-powered energy systems, modern medical equipment, and upgraded infrastructure are becoming the new standard. Although the formal launch occurred in the North Central region, Dr. Aina clarified that implementation is nationwide, covering all 36 states and the Federal Capital Territory (FCT). He further noted the strategic inclusion of traditional institutions to strengthen community collaboration and drive grassroots ownership of healthcare reform.
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This reform has not gone unnoticed by global health experts. Dr. Francis Ukwuije, a Health Economist with the World Health Organisation (WHO), lauded the initiative as a significant leap toward achieving value-based healthcare in Nigeria. “The appointment of PFMOs is a commendable step. We must also emphasize the importance of ethics and dignity in care delivery, principles central to WHO’s values,” he said. Dr. Ukwuije identified five key pillars that should underpin Nigeria’s value-driven healthcare agenda: equity, efficiency, effectiveness, ethics, and dignity. He further urged stakeholders to establish a robust learning agenda to extract and document lessons from the PFMO implementation process. These lessons, he argued, could be institutionalized in Nigeria and shared globally as a model for health system strengthening.
Adding perspective from another key development partner, Dr. Onoriode Ezire, a Senior Health Specialist at the World Bank, recalled how the earlier Nigeria State Health Investment Project (NSHIP) laid the foundation for direct facility financing. “PHCs are often underfunded and poorly managed—not because health workers lack commitment, but because they’re not trained as managers,” Ezire explained. To sustain the gains of the PFMO reform, Dr. Ezire emphasized the need for continuous technical assistance. He called for systematic capacity building in financial planning, leadership, and data management to enable health workers to function not just as caregivers but as competent health system managers.
The human impact of this initiative is already being felt at the grassroots. Mallam Mohammed Baba Gana, a facility manager from Niger State, shared how the deployment of a PFMO has begun to restore trust and structure in his local PHC. “For the first time, we have dedicated eyes and ears on the ground to ensure funds are spent where they matter most. With PFMO support, we now feel more confident managing our facility’s finances and can focus more on care delivery,” he said. Similarly, Ms. Farida Mohammed from Kogi State described visible improvements in her health centre since the initiative began. “We now have more drugs, the workers are more responsive, and there’s always someone ensuring things are working properly. Before now, many of us struggled with budgeting and reporting. The PFMO training and support are bridging that gap and helping us better use the BHCPF funds,” she said.
