An appraisal of primary health care policy implementation in Nigerian rural and semi-urban sector after four decades

Abstract

PHC remains the foundation and functional background for public health services accessibility. However, implementing the policy in Nigeria has raised unanswered questions over four decades, which the study seeks to answer. The study's objectives are to investigate the implementation of the policy and analyze the conditions of Primary Health Care Centers (PHCCs) in Nigeria. The research adopted a literature review methodology to portray and discuss the dilapidated status of PHCCs in selected rural and semi-urban communities across geopolitical zones. Relevant literature and data were used to analyze how the policy implementation was manipulated to the advantage of the elite class. The pictorials in the appendixes revealed the state of PHC infrastructures in Nigeria. The results revealed that there is no provision of efficient health care services, poverty and poor maintenance of infrastructure and facilities, poor political will in policy implementation, monitoring, and evaluation, low human resources, poor funding and management, and community apathy. Based on the results, it is concluded that decisive implementation of PHC policy remains the only avenue for the inhabitants of the rural sector to obtain standard and affordable health care services. The framework engendered social equity and availability. The study demonstrated the 'Urban Bias Theory’, which no known study on PHC has adopted to appraise and analyze the sad situation of PHC policy and PHCC structures in Nigeria. Therefore, the study recommends the revival and resuscitation of the decayed infrastructures and facilities; regular maintenance of all the available PHCCs across Nigeria; deliberate initiation of workable Public-Private-Partnership plan for the enhancement of Community Development Associations/Based Organisations [CDAs, CBOs, and NGOs] in the provision and management of funds for strategy and sustainability of PHCCs to put an end to apathy and non-ownership posture.