The World Bank has urged state governments to take ownership of investments made under the Immunisation Plus and Malaria Progress by Accelerating Coverage and Transforming Services project to prevent the reversal of gains recorded in child survival, malaria prevention and primary healthcare delivery.
The World Bank Country Representative, Matthew Verghis, gave the advice on Thursday at the IMPACT End-of-Project Dissemination and Transition Forum, held as part of the 2026 Joint Annual Review of the health sector.
Verghis said the project had demonstrated the benefits of sustained investment in primary healthcare but warned that its achievements could only endure if governments maintained the facilities, supported health workers and provided adequate financing.
“The challenge now is not simply to preserve these gains. It is to take what worked and move it to greater scale,” he said.
He disclosed that the project contributed to reducing under-five mortality from 132 to 110 deaths per 1,000 live births, surpassing its target of 112 deaths.
He added that malaria prevalence among children under five declined from 22 per cent to 15 per cent, while the proportion of fully vaccinated children aged 12 to 23 months increased from 31 per cent to 39.7 per cent.
According to him, the quality-of-care scores in supported health facilities also increased from 39.3 per cent to 50.2 per cent.
“The results are concrete. IMPACT contributed to reducing under-five mortality from 132 to 110 deaths per 1,000 live births, surpassing the Programme Development Objective target of 112,” Verghis said.
He said more than 2,600 primary healthcare facilities nationwide were upgraded to Level Two standards, with improvements including solar power, boreholes, staff quarters, perimeter fencing, additional service rooms and wards, as well as essential medical equipment.
The project, he added, procured and distributed more than 10 million long-lasting insecticidal nets, prioritising pregnant women and children under five.
Verghis disclosed that more than $20m was transferred directly to primary healthcare facilities to address operational needs and support the implementation of the Basic Health Care Provision Fund.
He also said approximately $170m was spent on routine vaccine procurement over four years, providing bridge financing for Nigeria’s domestic co-financing obligations and helping unlock Gavi-supported vaccine financing.
On human resources, the World Bank representative said more than 15,000 health workers were engaged to address staffing shortages and had subsequently been absorbed by state governments.
He added that more than 6,000 primary healthcare facilities were equipped with laptops, while medical records officers were trained to upload routine service-delivery data through the District Health Information Software 2 platform.
“As a result, all supported facilities now report routine service-delivery data digitally from their facilities,” he said.
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Verghis said the project also supported Nigeria’s drive towards vaccine security and self-reliance by strengthening the work of the Presidential Vaccine Advisory Committee and contributing to the institutional foundations for domestic vaccine manufacturing.
On the transition, he said the Nigeria Health Sector Renewal Investment Initiative, its Sector-Wide Approach and the HOPE-PHC programme would provide a framework for sustaining and expanding the achievements.
“HOPE-PHC does not simply start where IMPACT ends. It builds on foundations that IMPACT has helped establish,” he said.
He added that HOPE-GOV would complement the programme by strengthening financial and human resource management in primary healthcare and basic education.
Verghis said the success of the transition would depend on ownership by federal institutions, states and local governments.
“Investments must be maintained, health workers supported, facilities financed, data used for decisions, and accountability for results strengthened,” he said.
Also speaking, the Executive Director of the National Primary Health Care Development Agency, Dr Muyi Aina, said IMPACT had contributed significantly to the agency’s ongoing primary healthcare reforms, particularly in immunisation, malaria control and infrastructure development.
Aina disclosed that 16.6 million children had been fully immunised, according to the agency’s Primary Health Information System records.
He said the proportion of fully immunised children aged 12 to 23 months increased from 31 per cent to 39 per cent, based on the Nigeria Demographic and Health Survey.
On malaria control, Aina said prevalence declined from 22 per cent to 15 per cent between 2021 and 2025, while the proportion of pregnant women who received the recommended three doses of intermittent preventive treatment for malaria increased from 31 per cent to 33 per cent.
He also reported a four per cent increase in the proportion of children using insecticide-treated mosquito nets.
“Some of the gains we have recorded in immunisation would have been more challenging to achieve without the financing opportunities provided by the IMPACT Project,” he said.
Aina said the project funded more than 200 million doses of routine vaccines over three years and provided more than 3,000 solar-powered vaccine refrigerators to strengthen the cold-chain system.
He added that 2,500 primary healthcare centres across 30 states and the Federal Capital Territory were upgraded to Level Two functionality.
“The cold-chain infrastructure also benefited from the project, with the provision of over 3,000 solar-powered vaccine refrigerators,” he said.
The NPHCDA boss further disclosed that the project supported an ultra-modern vaccine storage hub in Lagos, which would serve more than 90 million Nigerians across the South-West and South-South regions.
