Addressing security threats affecting primary healthcare service delivery and uptake in Nigeria

Background: Security of health facilities in low- and middle-income countries (LMICs) is of vital importance in ensuring that health care can be provided in safe conditions. There is paucity of literature on the issue of threats to the personal safety of primary healthcare (PHC) providers and service users in Nigeria and what should be done. Thus, the current study seeks to fill this gap. Method: Key-informant interviews with 12 health workers and non-participant observations were utilised for data collection in Enugu, Nigeria. Their responses were analysed using a descriptive qualitative analysis approach in structuring narratives in themes. Result: There is lack of vital security infrastructure across the health facilities, and we recorded reports on armed robbery attacks, theft of drugs and other items, including a case of a stolen newborn. These findings are structured in three themes that reveal experienced threats in PHC facilities, their implications on health service delivery, and responses that can be taken to make PHC facilities safe. Conclusion: Security challenges constrain both access and provision of essential and affordable healthcare services at the primary healthcare level in Enugu, Nigeria.