The Gates Foundation has invested $27m in Nigeria’s Primary Health Care Challenge Fund over the past four years, with the bulk of the funding deployed as performance-based awards to drive reforms and improve service delivery at the state level.
According to the foundation, about 70 per cent of the $27m investment was dedicated to performance awards under the Challenge Fund, which was designed as a proof of concept to incentivise state governments to prioritise, reform and sustainably finance primary health care.
Speaking on behalf of the foundation during the Nigeria PHC Challenge Fund event in Abuja on Friday evening, the Deputy Director for Health Systems Strengthening, Dr Nkata Chuku, said the initiative followed commitments made by governors in 2019 under the Seattle Declaration, which set out a framework for revitalising PHC across the country through stronger political leadership, improved financing and accountability.
“At the Gates Foundation, we remain fully aligned with the Government of Nigeria’s determination to revitalise primary health care.
“The Gates Foundation has invested $27 million, with 70% dedicated to performance awards over the past four years to fund this initiative as proof of concept. The current award structure of one national winner and additional awards for the best and second runners-up states across all six geopolitical zones is intentional. It reflects your stated preference for peer accountability and healthy competition, recognising that states within the same zone often face similar health-system realities,” He said.
Chuku noted that recent national surveys, high-frequency monitoring and administrative data point to progress in several health indicators since the introduction of the fund.
He said routine immunisation coverage has continued to rise, with national Penta3 coverage now in the high 60 per cent range and several states exceeding 75 per cent, compared to the low 60s recorded in 2022.
He added that between July 2024 and October 2025, more than 500,000 previously zero-dose children were reached through targeted house-to-house vaccination and integrated immunisation campaigns, representing about 24 per cent of the estimated 2.1 million zero-dose children nationwide.
Chuku said, “The 2025 performance landscape emerging from national surveys, high-frequency monitoring, and administrative data shows both progress and gaps: Routine Immunisation continues its upward trajectory, with national Penta3 coverage now in the high-60s, and several states crossing 75%, compared to the low-60s in 2022. Zero-dose children: Between July 2024 and October 2025, more than 500,000 previously zero-dose children were reached with vaccines through house-to-house outreach and targeted immunisation activities.
“This represents about 24% of the estimated 2.1 million zero-dose children nationwide, reflectingsignificant progress through integrated campaigns including the October 2025 polio–routine immunisation drive. NEWSVERGE Skilled Birth Attendance & ANC4: Skilled Birth Attendance continues to show progress, and ANC4 coverage is now above 50%, supported by expanded midwifery programmes and strengthened maternal health services.”
Despite the gains, Chuku warned that challenges remain, particularly insecurity in parts of the North-East and North-West, persistent zero-dose clusters, seasonal nutrition and malaria pressures, and gaps in data completeness and timeliness.
