Delivering free primary healthcare in Nigeria with microclinics

In April, 310 community members received free healthcare at Care Circle in Itire-Surulere, Lagos, the second month running above 300 and bringing the clinic's total since launch to 1,984 patients, almost 2,000 in roughly eight months.

What stood out was loyalty. Returning patients jumped to 64%, up from 45% the month before, while 112 people (36%) came for the first time. We treated patients from four communities (Itire, Ijesha, Kilo and Lawanson), 84 of them children under 18, ranging from two baby girls to an 82-year-old grandmother. 68% were women, who usually manage healthcare for the whole family, and the average patient lives on $5.44 (about £4) per person each month, well below the poverty line. Malaria was the most common condition (37%), followed by upper respiratory infections (17%) and hypertension (15%). Nurses Benedeth and Sylvia ran the clinic all month, and patients rated their care 99% five stars.

We spent $435 (about £345) on medications, supplies and operations, partly offset by about $53 from the clinic's plastic-waste recycling programme, which also cuts down nearby mosquito breeding sites. Medication costs are creeping up, so we've opened bidding for lower-cost local suppliers. Demolitions in parts of Itire-Surulere continue, though we're hearing fewer reports now, and the clinic stayed open throughout.

Mrs Adeyemo came back for her third visit after a friend first told her about Care Circle, and shared her experience on video.

With repeat visits climbing, we expect to pass 2,000 patients next month.

In March, 241 community members received free healthcare at Safe City in Oworoshoki, Lagos, bringing the clinic's total since launch to 7,497 patients. Numbers dipped from February's 303 because Safe City recently went through a staff change. We think some patients are still adjusting to the new team, while ongoing home demolitions in Oworoshoki continued to displace residents through the month. Healthcare is built on trust, and trust takes time, especially when a familiar face changes.

Despite the dip, 62% of March's patients were returning, the highest returning rate of either of our two clinics this month, which suggests families who've come once keep coming back. Children under 18 made up 34% of visits, 80 kids whose parents had nowhere else to take them, and 73% of patients overall were women, most supporting families on around $7.81 per person per month, well below the global poverty line. One patient travelled 12.1 km from Mushin to reach us, nearly two hours each way. Malaria was the most common condition we treated (30%), followed by muscle and body pain (17%), upper respiratory infections (7%), and high blood pressure (3%). We spent about £296 (US$375) on medications, supplies, and operations.

Mrs Emini, a Safe City patient, shared her experience on video, describing what free care has meant to her.

We expect numbers to bounce back next month as the new team settles in and the community grows comfortable with them.

In March, 304 community members received free healthcare at Care Circle in Itire-Surulere, Lagos, bringing the clinic's total since launch to 1,674 patients. Of those, 167 (55%) were visiting for the first time, up from 41% in February, which means word about the clinic is still reaching new families.

Demolitions in parts of Itire-Surulere are still ongoing and have displaced some community members, but the clinic stayed fully open all month and crossed our 300-patient target. 70% of patients were women, and the average patient lives on $5.37 per person per month, well below the global poverty line. Malaria was the most common condition we treated (38% of visits), followed by upper respiratory infections (18%) and hypertension (14%). We spent about £321 (US$407) on medications and nurses' salaries, and the plastic waste recycling programme attached to the clinic also turned 4 pounds of neighbourhood waste into cash to support operations, while reducing mosquito breeding sites in the process.

Mrs Sandra came to Care Circle for the first time after a friend told her about it, and shared her experience on video.

With first-time visits still climbing, we expect Care Circle to keep growing through April as word about the clinic continues to reach new families.

This month, we purchased and installed solar panels at Safe City, our clinic in Oworoshoki, Lagos. We contracted a local vendor and installer from the Oworoshoki community, which also provided a small economic benefit to the area.

In February, 315 community members received free healthcare at Care Circle in Surulere, Lagos, a 50% increase on January that brings the total since the clinic opened five months ago to 1,370 patients. Of those, 41% were visiting for the first time and 59% returned for ongoing care, which suggests families are building a regular relationship with the clinic.

The average monthly household income among patients was about 11,400 naira (roughly £6) for a family of four, working out to about £1.50 per person per month. This is lower than January, which suggests Care Circle is increasingly reaching families with the fewest financial resources. We spent about £310 (US$391) on medications and nurses' salaries.

Earlier months saw a slower ramp-up than expected, partly due to government home demolitions in the area causing displacement and instability. With conditions calming, patient numbers have now picked up, and the slower early months also meant we could stretch the clinic's operating funds and extend its runway through to the end of April.

In February, 303 community members received free healthcare at Safe City in Oworoshoki, Lagos, bringing the clinic's total since launch to over 7,250 patients and 681 treated in the first two months of 2026 alone.

Patient visits dipped slightly from January due to government-led home demolitions in Oworoshoki, which displaced residents and created instability in the area. Despite this, Safe City stayed fully operational and slightly exceeded its monthly target. Of the 303 patients, 35% were visiting for the first time and 65% were returning, a continued increase in repeat visits that shows how central the clinic has become for ongoing care.

The average monthly household income among patients was about 24,400 naira (roughly £13) for a family of four, which works out to about £3.30 per person per month. We spent about £303 (US$384) on medications and staff salaries.

Mrs Victoria, one of Safe City's oldest patients and a grandmother in Oworoshoki, shared her experience on video, describing how the clinic has changed her life.

With solar panels now installed and power issues resolved, the team is well placed to maintain this pace heading into Q2.

In January, 378 patients received free healthcare at Safe City, our clinic in Oworoshoki, Lagos, bringing the total since launch to 6,953. Patient visits picked up as residents returned to Lagos after the holiday season, following a quieter December.

Of the 378 patients, 40% were visiting for the first time and 60% were returning. New patients continue to hear about the clinic through word of mouth from their neighbours. The average monthly household income among patients was about 21,700 naira (roughly £12) for a family of four, which works out to about £3 per person per month. We spent about £375 (US$474) on salaries and medications.

On the infrastructure side, we have finalised plans with local engineers to install a small solar generator at the clinic. The community helped raise funds alongside Kwanda's contribution, and the vendor will install the system within the next few weeks, which will help keep the clinic running smoothly as patient numbers continue to grow.

In January, 212 community members received free healthcare at Care Circle, our clinic in Surulere, Lagos. This brings the total to over 1,050 patients since the clinic opened four months ago, with 51% of January's patients visiting for the first time and 49% returning for ongoing care.

The average monthly household income among patients was about 13,700 naira (roughly £7) for a family of four, which works out to about £1.75 per person per month. We spent about £310 (US$390) on medications and nurses' salaries.

Care Circle is ramping up as expected, and as more families in Surulere discover the clinic, we anticipate patient numbers continuing to grow through Q1.

During this two-month period, we provided free healthcare services to 412 patients, bringing the total number of patients served since launch to 843. Most patients had very low household incomes, averaging N10,819 (around $8) per month for a family of four, and nearly all were uninsured.

Malaria remained the most common condition treated, followed by hypertension and other common illnesses such as respiratory infections, diarrhoea, skin rashes, and body pain. Over half of patients seen during this period were first-time visitors, while 42% were returning patients.

Patient feedback suggests that Care Circle is becoming a trusted source of care within the community. In post-visit surveys, 98% of patients rated the care they received as excellent, with the remaining patients rating it as good. Patients also travelled from surrounding neighbourhoods, sometimes for up to two hours, to access affordable healthcare.

In the last 2 months, we spent $866 ($407 in November, and $459 in December) to provide care to 421 people at Care Circle, including on medications, staff salaries (2 months) and Christmas bonuses!

As Care Circle continues to grow, the team will focus on maintaining quality care while reaching more underserved households in Surulere and nearby communities.

Activities:

• Provided free primary healthcare services to 412 patients in November and December

• Diagnosed and treated malaria, hypertension, and other common illnesses

• Served predominantly uninsured patients from low-income households

• Collected post-visit patient feedback to assess quality of care

• Delivered care to patients travelling up to 20 km from surrounding communities

In December, as is common during the Christmas season, many Oworoshoki residents travelled from Lagos to their hometowns, leaving the area quieter than usual. Even in the calm, Safe City remained open for those who needed care, and over 300 sick community members came in for support. This brings Safe City’s total impact to 6,575 people since launch.

This month, 31% of patients were new and 69% were returning, showing how deeply Safe City is loved and how firmly it has become part of daily life in Oworoshoki. The average monthly income of patients in December was just N11,067 ($8), highlighting the continued importance of accessible, life-saving care for our community.

Activities:

• Provided primary health care services to over 300 community members throughout December

• Treated conditions including malaria, respiratory infections, and minor injuries

• Recorded patient data showing 31% new and 69% returning patients, with average monthly income of ₦11,067

• Recruited and onboarded Nurse Jennifer through a competitive selection process with over 40 candidates

• Completed AHA approach training and induction at other clinics for the new nurse

In the coming months, we will continue delivering consistent, affordable care while supporting Nurse Jennifer to fully settle into her role and further strengthen service delivery at the clinic.

In just one year, Safe City has helped 6,268 people, around 2,000 more than our original target.

On 30 November 2024, Safe City opened its doors to the Oworoshoki community, offering free healthcare to people who were suffering and earning so little, they couldn’t afford care. Since then, we’ve welcomed patients of all ages, from one-year-olds to 89-year-olds. We’ve supported mothers and fathers with multiple children earning just $20/month or less, and thousands of children who made up over 30% of patients each month.

In November alone, we treated 595 people. Of these, 30% were new patients, 95% had no insurance, and visitors came from eight different communities. One patient travelled over 23km, almost an hour in Lagos traffic, to reach us. Even after a full year, Safe City continues to reach new neighbours, near and far, showing just how urgent the need for care remains.

After opening in the last week of September, Care Circle had its first full month of operations in October and helped 226 patients, with patients earning just an average of $9/month. This means that in the month of October alone, Kwanda helped to deliver free health care to almost 700 people (692 total) across Care Circle in Itire Surulere and Safe City in Oworoshoki, Nigeria.

Patients of all ages flocked in - with 4 one year olds being our youngest and an 88-year old Grandma the oldest. Out of the 226 patients helped in Care Circle, 14 patients were repeat patients from September!! It is so exciting as patients are now beginning to recognise that Care Circle is here to stay as their new health home in their community and coming back as repeat patients for follow-ups and spreading word to their neighbours.

Patients like Mrs Oge are also enjoying the new care! In Care Circle’s post-visit survey, 96% of patients rated the services received as “excellent”, and the remaining 4% as good!

Patients are spreading so rapidly to other communities near and far! Of particular note, a mom came in with her 3 kids to Care Circle (ages 4-6) from Ikotun, a community 20km away (this is about a 2 hr commute!!) to receive care from Care Circle. She stated “we hope this comes to our community soon.” Mrs Oge travelled 2 hours to visit Care Circles because no other means for affordable care was close to her and her kids in their home area.

Patients like Mrs Oge are also enjoying the new care! In Care Circle’s post-visit survey, 96% of patients rated the services received as “excellent”, and the remaining 4% as good!

As Safe City approaches its one-year anniversary, the free healthcare clinic in Oworoshoki, Nigeria has now reached a total of 5,673 people since inception. With 466 people helped in October alone, Safe City continues to exceed the initial monthly impact target of 300-400 patients.

40% of patients seen in October (187 people) were new patients who had never visited the clinic before. This demonstrates that even as Safe City matures in the community, new families continue to discover and access its services.

Hear from Mrs Emako, a returning patient that shares her experience at Safe City:

Distribution by illness

In October, Safe City's nurses treated:

• 32% Malaria cases — slightly higher than previous months

• 22% Upper respiratory tract infections — predominantly in children and one of the leading causes of death in the country

• 16% Hypertension management — most common in older patients

• 30% Other conditions including diabetes, anorexia, wound dressings, and ear infections

The average monthly household income of patients in October was N14,801 ($10/month) for a 4-person household. With an average of 2 children per household, the adjusted monthly income per person is approximately $3/month. Around 90% of patients seen this month were uninsured.

These numbers continue to highlight Safe City's impact in reaching people with severely limited financial and physical access to healthcare.

Patient demographics

• 44% Children under 18 (higher than previous months)

• 27% Children under 10

• Oldest patient: 88-year-old grandmother treated for diarrhea and weakness

• Youngest patients: Five 1-year-olds with respiratory infections and malaria

• 64% Female

• 36% Male (a slight increase from ~30% in previous months)

While 95% of patients live in the Oworoshoki community, Safe City welcomed patients from three other nearby communities lacking affordable healthcare: Bariga, Sawmill (5km away — the farthest distance traveled), and Gbagada.

Financial overview

$448 was spent from the Kwanda budget on staff salaries, medications and supplies.

This month, Safe City recycled 4lbs of plastic and generated N46,000 in income from 4 months of recycled plastic through its partnership with Wecyclers. This income was reinvested into clinic operations, allowing the clinic to spend approximately $30 less from the Kwanda budget this month.

Looking ahead

Safe City is on track to celebrate its one-year anniversary at the end of November. In just 11 months, the clinic has become a vital healthcare resource for thousands of Nigerians in Oworoshoki — providing care to moms rushing in before closing time, grandmothers seeking treatment, and countless children who would otherwise miss school due to treatable illnesses.

Through early intervention and preventive care, Safe City is reducing deaths from malaria and other treatable diseases, while properly managing chronic conditions like diabetes and hypertension that would otherwise go undiagnosed.

In the final week of September, Care Circle opened its doors in the Itire, Surulere community and within just one week, 209 patients received free care. This strong start brought our total reach in September to 648 patients across its two free clinics in Nigeria.

Developments

• Patient numbers grew from 104 on launch day to 209 by the end of the week.

• A recycling station is being finalized in partnership with WeCyclers, allowing patients and community members to exchange plastics for cash to support clinic operations. This initiative is set to begin in November.

Activities

• Care Circle officially launched in the final week of September

• 209 patients received free healthcare during the first week of operations

• 100% of patients were new, with no prior treatment history at the clinic

Beneficiaries

One of the first patients was Mr. Olayinka, a father in his 60s who said:

It’s been more than 6 months since I was last able to visit a hospital. I’ve been stooling so much in the past week and felt very weak. I saw the new clinic opened near my house and received free treatment here. Without this clinic, I don’t know what I would have done.

His story reflects the clinic’s core mission: to serve Nigerians who live on very low incomes and lack access to healthcare.

In total, Care Circle treated 209 patients in its first week. Common conditions included:

• Malaria (22%)

• Respiratory infections (20%)

• Hypertension (21%)

• Peptic ulcers (2%)

• Skin rashes (6%)

All treatments were provided at 100% no cost.

Patient demographics

• By income: Average household income was N15,633/month (~$11), typically supporting four people—equivalent to $3/person/month

• By insurance status: 98% were uninsured

• By age: 30% were aged 36–50; children and teens made up 17%, with the youngest patients aged 1 and the oldest aged 81

• By gender: 70% female, 30% male

• By location: 98% were from Itire, while others traveled up to 7km from areas like Ojuelegba, Aguda, and Ilasa

Financials

In September, approximately $280 was spent on staff salaries and medications. Since staff began mid-month (including a week of training and onboarding), only half of the monthly salary budget was used.