IMPLEMENTATION GUIDELINES FOR PRIMARY HEALTH CARE UNDER ONE ROOF (PHCOUR)

Abstract

Primary Health Care (PHC) is based on clearly defined principles which need to be translated into practice through the existence of structures and managerial processes. Consequently, organizational structure of primary health care determines how roles, power and responsibilities are assigned, controlled and coordinated and how information flows between different levels. While remarkable progress has been made in primary health care development in Nigeria, the system has remained weak and the health outcomes suboptimal due to multiple challenges in various aspects of the health system framework. The unsatisfactory governance system which largely results from fragmentation has continued to undermine the delivery of primary health care in Nigeria. The existence of multiple administrative frameworks (State Ministry of Health, State Ministry of Local Government & Chieftaincy Affairs, State Ministry of Women Affairs, Local Government Service Commission and sometimes the Office of the Executive Governor) at the state level with concurrent and overlapping responsibilities for primary health care has constituted significant challenges to the delivery of high quality, efficient and equitable health services. It is in response to the foregoing development that the National Primary Health Care Development Board in collaboration with key stakeholders introduced the “Primary Health Care Under One Roof” (PHCUOR) initiative as part of a new governance reform designed to improve primary health care implementation at state and sub-state levels. Primary Health Care Under One Roof is a policy for the integration of all PHC services under one authority (State PHC Board) to reduce fragmentation in PHC management and service delivery. This is in line with the National Health Act and Sustainable Development Goal 3 (SDG3) to achieve Universal Health Coverage (UHC).