Community-led monitoring of primary healthcare facilities in Oyo State has recorded notable improvements, including solar installations, facility repairs and increased community participation, but stakeholders say urgent gaps in infrastructure, healthcare workers’ conduct, funding and essential supplies still require government attention. The concerns were raised on Monday at the Biannual Integrated Community-Led Monitoring (CLM) Media Roundtable Meeting, convened under the NEPWHAN/IHVN N-THRIP Project. The project, implemented by the Network of People Living with HIV/AIDS in Nigeria (NEPWHAN) through three community-based organisations – Family Counselling Centre, PriHEMAC and RAPAC ,focuses on monitoring healthcare services and strengthening community involvement in HIV, tuberculosis and malaria responses. Over 2,500 Patients Engaged According to the project team, 30 health facilities were mapped and monitored during the quarter, while more than 2,500 clients participated in quantitative data collection through Client Exit Interviews. The project also conducted advocacy visits to state and community stakeholders, focus group discussions with key populations, health-literacy activities and supportive supervisory visits to facilities. Mrs Titilade Ogunkunle, Project Coordinator, Family Counselling Centre, said the three community-based organisations had interviewed about 2,994 clients on healthcare services in Oyo State. She said community members were also being educated about their health rights, including the Patient Bill of Rights, while Case Managers continued to mobilise residents to access HIV, tuberculosis and malaria services. Community Support Improving Facilities Ogunkunle highlighted several improvements achieved through community intervention, including solar installations, repairs to doors, windows and ceilings, roof repairs and renovation of makeshift spaces for antenatal services. She cited Taras and Irawo Ile among facilities that benefited from solar installations, while communities also supported well construction and other infrastructure improvements. However, she said some facilities still faced serious challenges. At Ologuneru PHC, for instance, she said the facility lacks a fence and toilet, while its roof is leaking, limiting its ability to provide adequate services, including maternity care. She also raised concerns about the attitude of some healthcare workers, particularly alleged overcharging of patients. Stakeholders Demand Stronger Government Monitoring Mr Olawale Faith Abiola, Oyo State Coordinator of NEPWAN, called on the state government and the Primary Health Care Board to strengthen monitoring of healthcare facilities. He raised concerns about facilities where healthcare workers allegedly charge patients beyond approved rates despite the availability of the Drug Revolving Fund (DRF). He urged authorities to ensure that health workers do not exploit patients and called for greater transparency in the use of DRF funds. Abiola also stressed the need for communities to take ownership of the CLM initiative so that monitoring can continue after the project ends. Infrastructure, Staffing Still Major Challenges Dr Adio Oluwasegun, Oyo State Coordinator for ACOMIN, commended Governor Seyi Makinde’s administration for renovating about 400 primary healthcare facilities and employing thousands of health workers, alongside the recent recruitment of nutrition officers. He, however, said more needed to be done to upgrade health centres and strengthen continuous training and monitoring of healthcare workers. Mr Olatokunbo Famiesin, Oyo State Programme Officer for the Global Fund-supported Entry Project, also called for urgent mapping and rehabilitation of severely dilapidated facilities. He cited Ajibade Primary Healthcare Centre as an example, alleging that parts of the facility are occupied by touts at night and are unsuitable for proper healthcare delivery. Gaps Still Awaiting Action The monitoring project identified several issues that remain unresolved, including: Expansion of inadequate service spaces Basic health funding at Irefin PHC Electricity supply Water and sanitation TB reagents and other consumables Clear signage and DRF price transparency Stakeholders therefore called for stronger government oversight, continuous training of healthcare workers, improved infrastructure and greater community investment in primary healthcare facilities. They also urged communities to complement government efforts by supporting facilities within their areas, saying sustained community ownership would be critical to maintaining the gains recorded through the CLM project.