Towards Health for All in Nigeria: A Sustainable Primary Health Care Pilot Model in Ondo State, Nigeria

Abstract

Background: The Nigerian experience of primary health care (PHC) implementation falls short of key principles related to the Alma-Ata Declaration, with consequent poor performance. The desire for an improved PHC system stimulated the conceptualization and piloting of a community-driven and sustainable PHC and health for all (SPHC-HFA) model. This paper describes the SPHC-HFA model in Ward 7 of Ile-Oluji/Okeigbo LGAs, Ondo State, Nigeria, detailing its features, establishment, and comparison with the traditional PHC (TPHC) model.

Methodology: This is a review paper detailing the implementation process of the Okeigbo SPHC-HFA model project, from its conceptualization and community selection to the establishment of a functional, sustainable PHC model structure. Five primary care service delivery measures were adopted to compare the SPHC-HFA and T-PHC.

Implementation Processes: The community leadership of Okeigbo Kingdom took prominent roles in the establishment of the Ward 7 SPHC-HFA model, which entailed the selection of Ward 7; community nurse/midwife engagement and placement; enumeration area demarcation, de-jure census, and health survey; official launch of the program and take-off; development of at-risk-register; and routine home visits and commencement of clinic consultation. The SPHC-HFA model was rated higher than the T-PHC model regarding inclusiveness of care, active community engagement, and availability of population-based data for evidence-based PHC operations.

Conclusion/Implications: The Okeigbo Ward 7 SPHC-HFA model provides a practical demonstration of a community-driven PHC model with the potential for sustainability and presents the government and other stakeholders with a framework for possible adoption or adaptation of its best practices and lessons learnt