Implementation of Primary Health Care in Lagos Nigeria: An Assessment of Governance and Service Availability

Abstract

Background: There is limited understanding of the role and effectiveness of community involvement and governance in enhancing  primary healthcare (PHC) services. This study aims to assess governance structures and the availability of PHC services in Lagos State,  Nigeria.

Methods: A cross-sectional study was conducted from November 2022 to January 2023, using a multi-stage sampling technique  to select five Local Government Areas (LGAs) in Lagos State, Nigeria—Alimosho, Kosofe, Ojo, Epe, and Surulere—and four Primary  Healthcare Centres (PHCs) per LGA. Data collection included health facility assessments and key informant interviews. Data analysis was  conducted using SPSS and NVivo software. Ethical approval was obtained for the study.

Results: Most (84.2%) of the Primary Health  Centres (PHCs) had active development committees that were involved in various activities, such as fixing service prices (100%),  discussing administrative issues (42.1%), and managing facility repairs (31.6%). All PHCs offered family planning services, facility-based  vaccination, and outreach-based vaccination programs. However, only 52.6% of the facilities offered essential obstetric care and labour  and delivery services. Key informants emphasized their role in advocating for primary healthcare utilization and promoting community health initiatives. Challenges included low community participation due to the need for more financial incentives and unmet government  promises.

Conclusion: PHC governance in Lagos State shows promising community engagement through active development  committees, yet challenges persist. Improvements are needed in service availability, particularly in maternal and child health services and infrastructure. Strengthening governance structures is crucial for sustainable healthcare delivery and equitable health outcomes.