BY EHON, Idialu Anthony Ph.D. (Health Economics expert and Monitoring, Evaluation and Learning Expert)
In the journey towards achieving Universal Health Coverage (UHC), a robust and efficient primary healthcare system remains the cornerstone of progress in Nigeria. Primary healthcare (PHC) is the first point of contact for individuals within the health system and is vital for early diagnosis, preventive care, and community health education. Yet, in Nigeria, the PHC system continues to face enormous challenges including underfunding, workforce shortages, poor infrastructure, and lack of essential medical supplies. As a result, patients often bypass PHC facilities, opting for more expensive secondary and tertiary care, thereby overburdening higher-level hospitals and exacerbating healthcare inequities.
A well-functioning PHC system is not only cost-effective but also plays a crucial role in addressing the majority of health needs of the population. Countries that have achieved significant progress towards UHC have done so by investing strategically in PHC services. In Nigeria, strengthening the PHC system will require a shift in focus from curative to preventive and promotive health services. This includes integrating services such as immunizations, maternal and child healthcare, nutrition programs, family planning, and treatment of common diseases into a comprehensive and accessible framework that reaches even the most remote communities.
Human resources are at the heart of effective PHC delivery, yet Nigeria faces a critical shortage of trained health workers, particularly in rural areas. Many PHC centers operate with minimal or no medical staff, leading to poor service quality and low community trust. Strengthening the PHC system demands investments in training, recruitment, and retention of healthcare workers through incentives, capacity building, and creating a conducive working environment. Equally important is task-shifting, which allows community health workers and other lower-level personnel to provide basic care, thereby extending the reach of health services.
Additionally, infrastructure and supply chains must be significantly improved to ensure that PHC centers are equipped with the necessary tools, medications, and technology. The revitalization of PHC facilities should include digital health innovations that allow for better data collection, real-time monitoring, and integration of services across different levels of care. Telemedicine, mobile health services, and electronic health records can bridge gaps in service delivery, particularly in hard-to-reach areas. Ensuring regular electricity, clean water supply, and transportation logistics are also critical components of infrastructure development in PHC.
Financing remains a central issue in strengthening Nigeria’s PHC system. While there have been commendable steps such as the Basic Health Care Provision Fund (BHCPF), much more needs to be done to ensure consistent and adequate funding for PHC services. Budgetary allocations should prioritize PHC, with mechanisms for accountability and community participation in health planning and budgeting. Public-private partnerships and international collaborations can also be harnessed to improve funding, service delivery, and innovation in the PHC sector.
Ultimately, achieving UHC in Nigeria hinges on the country’s ability to transform its primary care system into a people-centered, equitable, and efficient model. This transformation requires strong political will, multisectoral collaboration, and a commitment to long-term investments in health system strengthening. With an empowered and resilient PHC system, Nigeria can make significant strides in ensuring that all citizens have access to essential health services without suffering financial hardship, thereby fulfilling the vision of health for all.
