“Despite visiting hospitals, we often find no doctors available. During labour, when medical attention is crucial, we cry for help only to discover no one to assist us,” says Hajiya Lami Gwarzo, a mother and concerned community member. This story echoes the healthcare inequities faced by rural women in Gwarzo, Kano State.
Gwarzo’s healthcare system struggles with significant inequities, from staffing shortages to mismanagement of resources. The Yar Kasuwa Health Facility Gwarzo, a Level 2 Primary Health Care (PHC) and a focal facility under the Basic Health Care Provision Fund (BHCPF), provides critical services to thousands. Despite its importance, the facility grapples with inadequate infrastructure—only two rooms to accommodate antenatal care, immunisation, nutrition, and family planning services. It also lacks inadequate facilities for deliveries and staff for 24-hour services.
Distance and access are additional barriers. Women often travel miles on poor roads to reach care, only to face long wait times or unavailable staff. This challenge is worsened by political interference in the once-functional Ward Development Committee (WDC), limiting community-led solutions.

“We cry for help during labour, but no one is there,” Hajiya Lami Gwarzo shared. Her experience reflects the reality for many women in Gwarzo, where timely medical attention remains elusive. The community leaders, Sanusi Hamza Garba Gwarzo of Tsohon Garu and Sani Hamza of Kawo Kofar Kudu highlighted that: “Free medications provided by the government are being diverted by staff for private gain, leaving patients without essential drugs.”
Aaron Bawala, Community Engagement Coordinator at Nigeria Health Watch, drew the participant’s attention to the Federal Government’s Health Sector Renewal Plan, and its focus on upgrading health facilities to serve community needs better. “While women access healthcare facilities more than men, systemic gaps hinder their health outcomes,” Bawala said.
Deputy Officer-in-Charge Kabir Aliyu Gwarzo noted, “Despite being upgraded to a Level 2 PHC, we lack the infrastructure and personnel to meet community needs, especially for 24-hour care.”

Image credit: Nigeria Health Watch
Healthcare inequities in Gwarzo strain limited resources, with infrastructure, staffing, and resource mismanagement worsening outcomes. Political interference in WDC operations further undermines local advocacy efforts. Although the BHCPF has helped reduce costs, its effectiveness is limited by the diversion of resources and inadequate infrastructure.
The Federal Government’s Health Sector Renewal Plan (2023-2026) as part of its four-point agenda, specifically the second pillar aims to strengthen healthcare systems, particularly PHCs. Addressing Gwarzo’s challenges—staff shortages, resource mismanagement, and infrastructure gaps—is crucial to achieving equitable health outcomes.

Policymakers must prioritise increased staffing and community-led accountability mechanisms to restore trust in Gwarzo’s healthcare system. Infrastructure investments, including structural upgrades for the Yar Kasuwa PHC and the construction of more health centers to meet the health needs of the growing population, are essential to ensure safe deliveries and accessible healthcare services.
Healthy mothers mean healthy communities. With systemic reforms and community-led advocacy, we can transform Gwarzo’s healthcare system, ensuring every woman receives the care she deserves.