Assessment of resources for primary health care: Implications for the revitalization of primary health care in Akwa Ibom, Nigeria.

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Date: March-April 2020
From: Nigerian Medical Journal(Vol. 61, Issue 2)
Publisher: Medknow Publications and Media Pvt. Ltd.
Document Type: Article
Length: 3,458 words
Lexile Measure: 1460L

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Byline: Christie. Akwaowo, Olugbemi. Motilewa, Anyiekere. Ekanem

Context: Primary health care (PHC) is the cornerstone of the Nigerian National Health Policy. The national policy on PHC under one roof is undergoing implementation nationwide as a means of strengthening the PHC system. Akwa Ibom State (AKS) is set to commence full implementation of the policy. Aims: The aim of the study was to assess the existing human resource and infrastructure in PHC facilities in AKS. Settings and Design: A descriptive cross-sectional study was carried out in 18 facilities selected from the three senatorial zones of AKS, Nigeria. Subjects and Methods: A rapid assessment of selected PHC facilities based on a checklist adapted from the minimum standards for PHC as provided by the National PHC Development Agency. The results were analyzed using Excel and presented in tables. Results: A total of 18 health facilities were included in the study. Human resources available were 276 full time core health workers, of which 48 (17.4%) were volunteer workers. There was inequitable distribution in district and facility type as 122(44.2%) work in Ikot Ekpene Senatorial district and 242 (87.7%) of them work in the Operational Base. Basic lifesaving equipment such as resuscitation sets was unavailable in more than 50% of the health facilities. Conclusions: There are absolute deficit and inequitable distribution of available human resources in AKS PHCs. Basic-lifesaving equipment is grossly inadequate. There is an urgent need for more health workers to be employed and provision of basic equipment for the PHCs.


Globally, there has been renewed interest and commitment to primary health care (PHC) in light of the 2018 Astana Declaration.[1] Subsequently, the World Health Assembly in 2019 adopted a resolution recognizing the role of PHC in providing the full range of health services needed throughout the life course, including prevention, treatment, rehabilitation, and palliative care.[2] It has been acknowledged that achieving the health-related sustainable development goals, including universal health coverage (UHC), will not be possible without stronger PHC.[2],[3]

The National Strategic Health Development Plan outlines the revitalization of PHC as central to achieving UHC in Nigeria.[4] Such revitalization can only be possible with adequate numbers of competent, highly skilled, motivated, and productive frontline health-care workers that are equitably distributed. Human resource for health, however, remains a global crisis. The World Health Organization estimates a global shortage of 18 million health workers by 2030, with the worst-hit countries being in the low- and middle-income countries (LMICs).[5]

For many Nigerians, especially those who live in rural areas, PHC is the first point of contact with the health-care delivery system.[4] It is the level at which short-term, uncomplicated health issues should be resolved. At this level, health promotion and education efforts are undertaken, and patients in need of more specialized services are connected with secondary care.[6] As the bedrock of the National Health Policy, PHC has been described as the 'main focus for delivering effective, efficient, quality, accessible, and affordable health services to a wider proportion of the population.'

Although PHC is reported as...

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Gale Document Number: GALE|A623903200