Primary Health Care (PHC) is perhaps the most essential health care services. It is based on practical, scientifically sound and socially acceptable methods made universally accessible to individuals and families in the community. PHC involves full participation of the community and it is being provided at a cost that the community can afford in the spirit of self-reliance and self-determination.
PHC was first introduced by the WHO in 1978 at the Alma-Ata International conference, which had representatives from 134 countries including Nigeria. The PHC is the first point of entry into country’s health system such that everyone, including those in the core rural and remote communities, will have access to quality health care. PHC is essential to the fulfillment of the ‘Health For All’ goal by year 2020.
Prior to the onset of PHC in Nigeria, an attempt was made to set-up Basic Health Service Scheme (BHSS) – which has major similarities to PHC. The BHSS, just like PHC was designed to sustain community and people oriented health system. However, while implementing this scheme, community participation was not involved and this is perhaps one of the reasons for its failure as the scheme ended with no clear basic health care service.
From 1986 to 1992, Nigeria made huge progress in local government focused PHC with massive restructuring of health departments and units at the federal, state and local government levels. During this period, there was extensive expansion of PHC infrastructure, establishment of School of Health Technology to train community health workers and creation of the National Primary Health Care Development Agency (NPHCDA) in 1992. Development committees were also set up at community, district, LGA, state and zonal levels. It was during this period that the Universal Child Immunization target of 80% was attained. However, the LGA-District/Village structure, which is based on the District Minimum Health Care Package, used for PHC operation then had no clear demarcation of what a district is made of. The whole process and operation was politicalized, and this resulted into uneven distribution of PHCs and marginalization of people with lesser political power and representation.
The WHO’s Review Committee in 1992 noted that community mobilization in health would be greatly achieved if boundaries of health districts are same as that used in electoral system for wards. In response this, the Federal Government through NPHCDA adopted the use of Ward health service System in 2001 in order to re-vitalize the PHC system in Nigeria and provide health for all.
Despite the above, PHC system in Nigeria is largely ineffective, and thus, the purpose for which it was adopted – which is fulfilling Health for All- remains unachieved. In other to address the ineffectiveness in PHC system, NPHCDA in 2013 promulgated “Primary Health Care Under One Roof” policy with the singular aim of improving performance of PHCs as a strong entry for the Nigeria’s Health Care System.
The Policy mandated all States to establish a State Primary Health care Development Agency; appoint an Executive Secretary to head the Agency and form a Governing Board with the sole responsibility of designing operational guideline for the Agency.
WATCH OUT FOR:
PART-2 ADVOCATING FOR IMPROVED PERFORMANCE OF PHCs – WHAT DOES PHCUOR POLICY REALLY ENTAIL?
PART-3 ADVOCATING FOR IMPROVED PERFORMANCE OF PHCs – PHCUOR POLICY: EDO STATE IN FOCUS.
PART-4 ADVOCATING FOR IMPROVED PERFORMANCE OF PHCs – WHY IS PRIMARY HEALTH CARE KEY TO IMPROVING MATERNAL AND CHILD HEALTH?
PART-5 ADVOCATING FOR IMPROVED PERFORMANCE OF PHCs -CHALLENGES IN IMPLEMENMTING PHCUOR POLICY.