Olayinka Akanke Abosede and Olugbenga Fola Sholeye
Since 1978’s Alma-Ata Declaration on Primary Health Care (PHC) with the popular slogan “Health for All by the Year 2000” and subsequently the Millennium Development Goals (MDGs) of the Year 2000, Nigeria has made 3 major attempts to establish a sustainable PHC system and some of the reasons for failure of the first two have been identified. Even though there is some degree of general improvement, compared to other countries in the world, Nigeria’s indices in spite of international aids have remained poor {Neonatal Mortality Rate (40/000), Under-five Mortality Rate (157/000) and Maternal Mortality Ratio (545/100000). The aim of this descriptive, interventional study is to highlight positive steps taken by governments to re-establish and revitalise PHC, especially by empowering communities, the challenges, and lessons learned as potentials for improvement of a universal, qualitative PHC system in Nigeria. The Health Reform Laws and Strategic Development Plans emphasize commitment to the promotion and protection of the health of the people as an essential service for sustained socio-economic development and better quality of life. Community structures (Local Government Health Authorities–LGHAs, Ward Health Committees– WHCs and Health Facility Management Teams) backed by the law were either newly established or reconstituted and empowered. The study describes measures taken to strengthen the weak foundation of the PHC system in Lagos State (the study’s index state), the outputs, outcomes and potential impacts. The challenges and lessons learned from dealing with them can be projected for improved national coverage