Historical Development and Roles of PHC in Nigeria Situating it in Alma Ara Declarations

PHC Programmes in Nigeria
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PHC Programmes in Nigeria
The Basic Health Services Scheme (BHSS) (1975-1980)
Efforts to establish and increase healthcare infrastructures with a particular focus on curative medicine instead of preventive medicine started as early as 1960 in Nigeria. During this post-colonial period, health sector reforms were framed within the perspective of national development plans. The first National Development Plan (1962-1968) contained the underpinning for expanding hospitals in major cities, healthcare centers, and maternity homes in rural villages and towns. On the other hand, the second National Development Plan (1970-1974) concentrated on correcting some of the challenges in the health delivery service system founded in the first plan. The health sector was required to pursue the objective of expanding, protecting, restoring, and enhancing the health of all Nigerian citizens (Anaemene, 2016). There were efforts to come up with a comprehensive national health policy that addressed such issues as health workforce development, disease control, improving medical research, provision of comprehensive health care as stipulated by the primary health service scheme, health planning, and management, as well as efficient implementation of healthcare resources.
This second National Development Plan performed relatively well compared to the first one concerning the expansion of healthcare facilities. For instance, substantial funds were allocated at the federal level to run the University Teaching Hospitals at Enugu, Ibadan, and Lagos. For instance, the Lagos University Teaching Hospital managed to expand its dentistry and radiotherapy specialties and complete the mobile theatre and physical medicine units. Adequate sums were also set aside to expand specialist hospitals in Ilorin, Benin, and Enugu (Odutolu et al., 2016). Moreover, there was marked improvement at the state level, where significant progress was made in restoring healthcare centres in the three Eastern States. Hospitals in the Mid-West and Kwara states also saw a marked increase in bed capacities. On the whole, more than 300 health centers, maternity wards, and dispensary units were created during the second National Development Plan period. However, the plan failed to structure a system of sharing responsibilities between the three levels of government.
However, it was not until 1975 that the third National Development Plan started a health system development initiative that applied primary health care (PHC) as the foundation stone. The Basic Health Services Scheme (BHSS) was founded in 1975 as Nigeria’s first concrete attempt at putting PHC into practice (Aregbeshola & Khan, 2017). This PHC programme focused on increasing accessibility of healthcare services for the entire population from 25% to 60%, training health workers, correcting healthcare disparities between rural and urban regions for all preventative and curative care, and utilizing community social workers to increase health services. Other objectives included integrating basic health units and combining prevention and health promotion services with curative services. Th...