Primary Health Care took the world center stage in 1978 at the International conference on Primary Health Care where countries signed on to the Alma-Ata Declaration as a major milestone and key for the attainment of the goal of Health for All. Following the strong call by World Health Organization for countries to return back to the Alma-Ata declaration 40 years after, how well has Nigeria fared in achieving a functional Primary Health Care System.
Recently, The ‘Primary Health Care Under One Roof’ (PHCUOR) initiative became a national policy in 2011, when the National Council for Health approved the initiative along with its implementation guidelines. Each State in Nigeria was to create a State Primary Health Care Development Agency/Board that is responsible for implementing primary health care and ensuring its functionality. Furthermore, the National Health Act 2014 made the establishment of state PHCDA/B a condition for states to participate in the Basic Health care Fund established by the Act. However, since 2013, each State has achieved varying degrees of success in the nine domains that formation and advancement is measured against.
A PHCUOR scorecard was initiated to assist States identify, in a systematic manner, areas within the PHCUOR framework in which they need support. The scorecard is a peer review mechanism as well as an advocacy tool to Government and stakeholders for the purpose of facilitating symmetrical and synergistic implementation of the policy nationwide. In 2015, the PHCUOR scorecard assessment emotional support animal highlighted various gaps and challenges that each State Agency was experiencing. However, the scorecard proved to have its own limitations in accurately assessing the progress each State had made. Furthermore, many States face strong opposition as the concept of PHCUOR (which involves one plan, one management and one M&E) is still very alien to key stakeholders.
The health system of the nation cannot function unless Primary Health Care, which is the foundation and base of the health pyramid, is rightly positioned. Key stakeholders do not understand the concept of PHCUOR, there is duplication of functions, wastage, poor coordination, inefficient and poorly funded Primary Health Care system presently in the country. It is against this background that the Cross River State government is eager to host a collaborative summit with all stakeholders involved in the Primary Health Care system in Nigeria.