Introduction: Although there has been recent success in managing the COVID-19 pandemic, Nigeria has struggled to achieve high levels of routine immunisation coverage. Primary Health Care (PHC) due to its close connection with local communities and households is ideally positioned to improve immunisation coverage rates. Nevertheless, strengthening PHC systems for routine immunisation necessitates a restructuring of PHC service delivery, built upon a thorough understanding of the current structures and systems as well as the potential creation of new ones. We assessed the current performance of PHC service by using an assessment tool to identify the possible challenges and propose steps towards improvement.

Methods: We conducted a cross-sectional observation study across 18 State Primary Health Care Development Agencies/Boards (SPHCDA/B) in six geopolitical regions of Nigeria during the period of May to June 2023. Primary data collection utilised a standardized organizational performance assessment tool (PAT) that evaluated six key areas: service delivery, adequacy of infrastructure, planning and coordination, partners and community engagement and information and data management. The tool was administered to stakeholders and the findings were subsequently validated with the respondents.

Result: Data from 397 RI providers across 18 SPHCDA/B were analysed. On average, the study indicates that the assessed states predominantly exhibit an expanding level of capacity, with mean scores falling within the 2.5 to 3.5 range out of a maximum score of 4. The lowest mean score of 2.2 was obtained in the area of information and data management. Of the six capacity areas assessed, planning and coordination (2.7), resourcing and financial management (2.8), infrastructure (2.8) and engagements (3.4) had the highest performance scores, whilst information and data management (2.2) and service delivery (2.5) lagged behind. Conclusion: Performance across the capacity areas showed a considerable variation between states, with information and data management and service delivery performing lower than other components. The findings of this study provided a measure of internal strengths that should be sustained and identified areas needing quality improvement.