Primary Health Care – The Key to Universal Health Coverage : But Not the Nigerian Approach

That Nigeria recognizes primary health care (PHC) as holding the key that could crystallize into universal coverage for its population is not in dispute. The language of the National Health Policy, the most important document on health in the country, is quite explicit, that the nation’s health system will be built on PHC. To realize this goal, the Policy document assigns specific roles and responsibilities to various administrative structures in the country, ranging from the federal government to local governments, ward and village health committees. An important component of these responsibilities is the construction and operation of all PHC centers in the country by the government. This paper argues that while on the surface this arrangement seems capable of achieving the goal of universal coverage, it is, upon proper scrutiny, the wrong kind of prescription. Rather than direct involvement in ownership and operation of these health facilities, the government should concentrate its effort on creating an enabling environment for private health care providers to assume responsibility for PHC services. By unearthing the factors sustaining the perilous state of PHC in the country, the paper demonstrates that public private partnership represents a better model of success