Investing in Primary Health Care: A Path to Healthier Communities and a Stronger Nation

Imagine a Nigeria where every citizen regardless of their background or socioeconomic status has access to quality healthcare. A Nigeria where mothers can give birth safely, children receive essential vaccinations, and chronic diseases are effectively managed. This is not a distant dream, but a vision within our reach.

The pursuit of a healthier Nigeria begins with strong Primary Health Care (PHC). It is a journey that requires unwavering commitment and strategic action at all levels.

Robust PHC is the foundation of a healthy society. It’s where healthcare begins, providing essential services close to communities and empowering individuals to take control of their health. When people have access to quality healthcare, they are healthier, more productive, and contribute meaningfully to society. This translates to stronger families, more resilient communities, and a more prosperous nation.

However, while significant progress has been made toward strengthening PHC, challenges remain. Many countries, particularly low- and middle-income countries such as Nigeria, face obstacles including inadequate healthcare infrastructure, a shortage of skilled healthcare workers, limited and inefficiently allocated financial resources, and inequitable access to PHC services, particularly in underserved communities.

Strengthening PHC is not only a health imperative; it’s a strategic pathway to achieving the broader Sustainable Development Goals (SDGs), impacting poverty reduction, education, gender equality, and more. It is an investment in our nation’s future.

Foundation of a Healthy Nation: Investing in PHC

Revitalising PHC service delivery is not simply about building more clinics; it’s about building a comprehensive system that delivers quality care, empowers communities, and addresses the root causes of health disparities. It starts with a strong commitment by leadership – to understand the issues.

A critical element of strengthening PHC lies in ensuring adequate and efficient funding. This involves not only increasing the overall allocation to PHC but also ensuring that existing resources are used effectively and transparently, reaching the facilities and communities that need them most.

Investing in PHC infrastructure is also essential. This means not just constructing new buildings but also equipping existing facilities with the necessary equipment, supplies, and technology to deliver quality care. Furthermore, a well-functioning PHC system relies on a well-trained and motivated workforce. Investing in the training and development of healthcare professionals at the primary level, including doctors, nurses, and community health workers, is crucial. This includes providing them with the skills and knowledge they need to address the specific health challenges facing their communities.

Beyond infrastructure and workforce, strengthening PHC requires a focus on service delivery. This means ensuring that essential services, such as maternal and child health care, immunization, and treatment for common illnesses, are available and accessible to all, particularly in underserved communities.

Finally, community engagement is paramount. Building trust and partnerships with communities is essential to understanding their health needs, empowering them to take ownership of their health, and ensuring that PHC services are appropriate and responsive to their needs.

Partnerships for a Healthier Nigeria

Strengthening Nigeria’s Primary Health Care system requires more than just government action; it demands a concerted effort from all stakeholders. Philanthropic organisations, private sector companies, international NGOs, and community-based organisations have been invaluable allies, providing critical financial, technical, and capacity-building support.

At the Gates Foundation, we are deeply committed to improving the health and well-being of Nigerians, and we recognise that strong PHC is the cornerstone of achieving this goal. We have invested significantly in supporting critical PHC services, including strengthening immunisation programs to protect children against preventable diseases like polio, measles, and diphtheria. This has involved procuring life-saving vaccines, training healthcare workers in immunisation techniques, and supporting robust vaccination campaigns across the country. Additionally, the foundation supports efforts to combat infectious diseases such as malaria, HIV/AIDS, and tuberculosis.

Investing in strong PHC systems is critical to achieving universal health coverage (UHC), and we believe that partnerships are essential to ensure its success. PHC is the cornerstone of UHC, with 91% of essential UHC interventions classified as PHC. Scaling up access to strong PHCs in low and middle-income countries could save 60 million lives and increase average life expectancy by 3.7 years by 2030. Yet, spending on PHC in low-income countries is significantly less than in high-income countries, leading to higher out-of-pocket costs and poorer health outcomes.

24% of the global population lives in fragile contexts, including many regions within Nigeria, where delivering quality essential health services is extremely challenging. These communities often face significant security threats, displacement, and limited access to basic infrastructure, making it more challenging to deliver essential health services. A large proportion of preventable maternal, childhood, and neonatal deaths occur in these fragile contexts. Strengthening PHC in these challenging environments is crucial to ensuring that all Nigerians, regardless of their location, have access to the care they need to survive and thrive.

To further demonstrate this commitment, the Gates Foundation is proud to support initiatives like the Primary Health Care Leadership Challenge Fund (PHC-LCF). This strategic initiative recognises that strong political leadership is crucial for accelerating progress towards effective PHC and addresses critical leadership gaps.

This initiative, a collaborative effort between the Federal Ministry of Health and Social Welfare, the Nigeria Governors’ Forum, and the National Primary Health Care Development Agency (NPHCDA), with technical assistance from UNICEF and financial support from the Gates Foundation and the Aliko Dangote Foundation, empowers states to take ownership of their PHC systems.

The PHC-LCF encourages states to fully implement the “Primary Health Care Under One Roof” initiative, as well as the Abuja Declaration and Seattle Declaration, thereby solidifying their commitment to PHC strengthening. Their leadership, resource allocation, and effective implementation are essential for revitalising PHC systems and ensuring quality care reaches all communities within their jurisdictions.

By fostering strong partnerships and prioritising data-driven decision-making, we can ensure that all Nigerians have access to quality, affordable healthcare and build a healthier, more equitable future for our nation.

The Road Ahead: Overcoming Challenges and Seizing Opportunities

Despite significant progress, several challenges persist in strengthening PHC in Nigeria. One of the primary challenges is the lack of adequate PHC infrastructure, particularly in rural areas. Many facilities lack the basic equipment, supplies, and resources necessary to provide quality care. This disparity in access creates a significant barrier for many Nigerians and hinders the overall development of our communities.

Another challenge is the shortage of skilled healthcare workers at the primary care level, which can lead to suboptimal care and delays in treatment. This shortage is exacerbated by factors such as inadequate training opportunities, challenging working conditions, and the ongoing emigration of healthcare professionals seeking better opportunities elsewhere.

Financial constraints are another significant challenge. While increased investment in health is crucial, it is equally important to ensure that resources are allocated efficiently and effectively to reach PHC facilities and programs. Marginalised populations, such as women, children, people living with disabilities, and those living in poverty or remote areas, often face significant barriers to accessing quality healthcare.

However, despite these challenges, Nigeria has a unique opportunity to leverage its growing economy and increase investment in healthcare. By prioritising PHC, strengthening partnerships, mobilising domestic resources, and implementing innovative strategies, we can overcome these obstacles and build a truly robust and equitable PHC system. The Gates Foundation remains committed to supporting these efforts.

The journey towards a strong PHC is a marathon, not a sprint. It requires sustained commitment, collaboration, and a shared vision. By working together, we can create a healthier, more equitable Nigeria where everyone has access to the quality primary healthcare they need to thrive.

Uche Amaonwu serves as the Nigeria Country Director for the Gates Foundation, leading efforts to deliver life-saving interventions and economic opportunities to Nigeria’s most vulnerable populations.