Frequently Asked Questions

The Adopt a Primary Healthcare Facility (ADHFP) programme aims to establish one PHC in each of Nigeria’s 774 Local Government Areas to ensure equitable and accessible healthcare for all. 

By becoming an adopter of ADHFP, you gain access to an incredible opportunity to make a tangible impact on Nigerian healthcare. 

You also gain access to a wealth of adopter benefits, which are detailed in our ADHFP Prospectus Document. 

ADHFP adopters also become part of an influential network of like-minded innovative thinkers who are committed to collective and sustainable progress. 

Every little bit helps, and individual donations are also possible. We accept donations of any amount. We also accept donations of services such as supplies and IT support. 

Monitoring and evaluation/accountability mechanisms are in place. 

The estimated time to complete construction is approximately 16 weeks. However, multiple PHCs can be constructed simultaneously according to the PSHAN implementation plan. 

The selection criteria for each LGA include: 

• The health indices of the area. 
• Availability of a secondary health centre. 
• The number of viable PHCs for the population. 
• Unmet health needs. 

Regardless of these criteria, you may suggest an LGA/PHC that you would like to adopt.

Please take a look at the adopters subscription section for payment structures. 

Yes, package upgrades or downgrades are possible. The adopter will be assigned to the appropriate PHC once PHCs are identified and eligible for adoption. 

Yes. Please speak to an ADHFP project team member about this.  

PSHAN is looking for board members with similar interests, experience, and Public-Private Partnership knowledge, although adopters will not become board members automatically. Criteria for board membership include: 

• Highly qualified and credible individuals with a proven track record of success. – Personal and professional connections. 
• Ability to drive advocacy strategy and planning. 

Please contact us for more information about applying to become a board member at PSHAN.

Yes, we are open to flexible payment solutions that allow for pre-payment. 

We welcome physical and service donations of the following items: 

• Infrastructure – fencing, landfill, generator house, borehole with pumping machine and storage tank, medical equipment. 
• Alternative power source – generator, solar panels. 
• Clean water – borehole, water tank. 

No. For uniformity and consistency, the inclusion of vendors, suppliers, and contractors will be in accordance with the implementation model and selected by PSHAN. 

PSHAN has already completed the pre-pilot phase of the program and completed the establishment of two PHCs (one each in Delta and Bauchi states). Following completion of these pilots, the ADHFP has been officially launched, and is now in the first phase where an additional 18 PHCs will be established across Nigeria.

PSHAN takes full responsibility for every aspect of project management and operations. We would work with various stakeholders, including operating partners and other service providers, to accomplish this mission. However, adopters/funders interested in taking a more active role in the operation of their PHCs can be easily accommodated in our current model. Below is a list of the specific roles of PSHAN: 

• Governance. 
• Programme design (for all programme components, including key partners, key activities, value propositions, relationships, customer segments, channels, cost structure, and funding sources). 
• Oversight of PHC operations. 
• Engaging stakeholders and partnerships (including adopters, state and local governments, PHC operators and health care professionals, the federal government, suppliers, patients, and the general public). 
• Establish operational levers, technology requirements, and reporting structures. – Financial management. 
• Implementation plans for market rollout. 
• Monitoring and evaluation. 

The adopter/donor could take an active or inactive role in the implementation of the project. However, the PHC design and selection of staff would be done centrally by PSHAN to ensure that quality control and minimum standards are met. 

PSHAN handles all required communication with local government entities. 

From an operational perspective, PSHAN ensures that services are delivered as required. The government remains legally liable for all care defined in the direct agreement between PSHAN and the local government.

PSHAN has a number of potential funders for the ADHFP project spread across multiple states

The ADHFP has already been launched with 2 pre-pilots completed and delivered in 2022. The program is now in the next phase with an additional 18 PHCs in progress. 

The following risks were identified in the development of delivery options for the ADHFP:  

1. Fiduciary risk: the risk that implementation partners do not act in the best interests of PSHAN and beneficiaries.
2. Operational risk: the risk that there are operational inefficiencies or failures that may lead to losses along the value chain.
3. Technological risk: the risk that there will be failures or inefficiencies because of adopted technologies and technology platforms.
4. Funding risk: the risk that there will be challenges in accessing funds required to adopt or maintain PHCs
5. Compliance risk: the risk that the implementation of the program will be in breach of any applicable laws or regulations.
6. Procurement risk: the risk that PHCs will be unable to adequately source medicines due to supply chain challenges.
7. Environmental & Security risk: the risk that day-to-day operations at the PHCs are disrupted by security or environmental concerns.

PSHAN is funded primarily by its members through the payment of annual fees. In addition, PSHAN receives funding from donors (mostly international) for specific projects. 

Primary health centres established under the ADHFP are expected to be income-generating during the adoption period; however, a major focus is on achieving significant social and environmental returns. Running as impact investments, the financial and social profit orientation is due to the need to ensure sustainability in the quality of service delivered to end-users while contributing to health system strengthening.

Treatment guidelines are based on local policies (e.g., standard treatment guidelines developed by the Federal Ministry of Health, minimum standards for PHC care developed by the National Primary Health Care Development Agency) that describe the scope of services to be rendered and provide an overview of treatment and care services. To improve the quality of care at points of care (i.e., PHCs under ADHFP jurisdiction), clinical operating guidelines are being developed based on global best practices such as the Safe Care Healthcare Standards. 

Currently, primary health care centres use the Sustainable Drug Revolving Fund (SDRF) to finance the procurement of commodities. These commodities (medications, etc.) are managed by the State Primary Health Care Board, responsible for stocking and distributing them to PHCs based on need and availability. Purchases from distributors/pharmaceutical manufacturers are based on standard operating procedures that vary from state to state. Given regional differences in health care quality and supply chain systems, some PHCs use the direct market approach. However, this method is unpopular due to a lack of resources. 

While there are regional differences in needs, our comprehensive assessment of health indices, the strength of human resources for health, and the quality of PHC infrastructure conducted in 256 PHCs across Nigeria’s six geopolitical zones reveal important commonalities . These findings informed the development of a financial framework that reflects our estimates of minimum costs per centre, which may be revisited in some areas (e.g., urban areas). 

Facilities were divided into two categories: Greenfield (facilities that require the construction of a PHC and institutionalisation of service delivery mechanisms) and Brownfield (PHCs that need renovation and strengthening of their systems). These are further categorised based on population dynamics to determine the cost per PHC centre. 

PHCs that will be adopted under the ADHFP are staffed. However, they are severely understaffed. Some PHCs – especially those in rural areas – do not have staff because personnel want to live in urban areas. 

For this reason, ADHFP is striving to do the following: 

• Build health worker capacity (where available) to adapt to current realities, leveraging the resources and expertise of organisations. 
• Provide HRH to PHCs where the need is greatest. In addition, where feasible, we seek to address this issue by implementing technology solutions, such as using an ERP system or digitising processes, such as record keeping, that require staff and increase wait times.