THE PRIMARY HEALTH CARE (PHC) SYSTEM IN NIGERIA

Health is a resource to improve how an individual performs in wider society. It is not an end in itself. This underscores why a healthful lifestyle provides an opportunity for people to lead a fulfilled life—with meaning and purpose (Turner & Evashwick., 2014). Unfortunately, most Nigerians find this means to be elusive. According to the NDHS data, only 31% of children aged between 12 to 23 years old have access to basic vaccination while those with no access to basic vaccinations moved from 29% to 19%. In addition, about 29% of children below 6 months are exclusively breastfed whereas 37% under the age of 5 are stunted as a result of malnutrition. Although these figures show some improvements in the Nigerian PHC system, there’s need for an increased budget and, more importantly, application of some tested-and-proven innovative health management approaches (Morris., 2001; Laurenza et al., 2018; Russo Spena & Cristina., 2020).

The United States have a lower life expectancy than people in other developed countries (Younis., 2018). This is more so because of a variety of factors, which include: lifestyle choices and unhindered access to quality healthcare (Robine et al., 2009). In Nigeria, healthcare from the private sector is quite expensive and, although PHC centres are situated in almost every community, the health system is poorly managed and funded—a circumstance which derails the purpose for its establishment in 1988 and has led to loss of lives (Eme Ichoku et al., 2013; Adepoju & Akinluyi., 2017).

The Nigerian PHC architecture functions with the existing political structure of the wards (Worlu et al., 2016). The wards structure in Nigeria consists of a population of about 10000 to 30000 people residing in a particular geographic area or community. The national Ward Health guidelines ensure that PHC centres are available in each ward to deliver affordable, and in some cases, free health care services such as oral polio immunization and family planning. Community health care providers in Nigeria are commonly known as health posts, primary health clinics or primary healthcare centres. Ownership ranges from the government, private for profit or private for non-profit organisations like NGOs (Ozili., 2020).

However, the three tiers of government (federal, state and local governments) are topmost in the administrative cadre, initiating and implementing policies and framework for the operation of these healthcare facilities. FG plays these roles with assistance from the primary healthcare management agencies and boards at all levels of government. But lack of coordination between administrators in the three-tiered government, particularly partisan politics and corruption, has greatly undermined the performance of PHCs in Nigeria. Moreover, lack of continuity in governance is a major challenge to the actualization of PHC goals in the country (Aju & Adeosun., 2021).

Remarkably, PHC services are provided at the primary health centres or at the various homes of community members—with guidelines from the fundamental principles of the Alma Ata Declaration. Minimum standard from this operation is further outlined at the national Ward Minimum Health Care Package, which highlights the following health care functions:

• Controlling of communicable diseases like Malaria and Sexually Transmitted Diseases (STDs) such as HIV, syphilis, gonorrhoea etc
• Promoting child survival, maternal and newborn care
• Ensuring proper nutrition, prevention of non-communicable diseases and
• Facilitating health education and community mobilization.