Why demand for primary health care services is low in Nigeria

The demand for Primary Health Care (PHC) services in Nigeria remains below the desired level largely due to social, cultural, and geographical barriers, said the Executive Director of the National Primary Health Care Development Agency (NPHCDA), Faisal Shuaib.

Mr Shuaib made this known during the “Close-out and Dissemination of the Strengthening Demand for PHC Services in Nigeria Project Findings” in Abuja on Wednesday.

Mr Shuaib, who was represented by the Incident Manager of the National Polio Emergency Operations Centre (NEOC), Usman Adamu, said the poor quality of care and low levels of trust in the health system arising from misinformation and disinformation are other reasons for the sub-optimal demand of PHC services.

He also pointed out that the COVID-19 pandemic worsened the situation by bringing about social restrictions and heightening public distrust in the health systems.

“This impacted negatively on health-seeking behaviours, and further weighed down on demand for services, especially at primary health care and community levels in the country,” he said.


Mr Shuaib said to improve demand for health services using existing structures and strategies, the agency partnered with the Bill and Melinda Gates Foundation (BMGF) to explore behavioural science approaches and human-centred designs.

He said the aim is to reach more evidence-based interventions that would lead to long-term desired changes in health-seeking behaviours.

He said the partnership with BMGF ramped up demand for PHC services in Niger and Gombe states.

He noted that the success stories in these states would motivate other states to scale up PHC health services.

“We initiated this project in 2020 in partnership with BMGF to build on our agency’s PHC demand generation strategies, strengthen the capacity of SPHCDBs (including LGAs/HFs), and community influencers to apply modern behavioural science approaches, advocacy, and communications to PHC demand generation in a COVID-impacted world,” he said.

In his remark, the Country Director, BMGF, Nigeria, Jeremie Zoungrana, said the foundation has one overarching goal, and that it is to create a world where every person has the opportunity to live a healthy and productive life.

Mr Zoungrana said this goal drives all of its engagements around the world “where they support and partner with governments, civil society, researchers, and innovators.”

‘‘Today’s event is a great example of the type of partnerships that we embarked on to deliver on our mission,” he said.

He said the impact of the COVID-19 pandemic reiterated the importance of the PHC system and the role that agencies like NPHCDA play in ensuring widespread access to quality health care.

“However, we also learned about the behaviours and beliefs that influence some of the barriers and issues preventing people from accessing health care services and the COVID-19 vaccines during this time, such as cultural religious, and social norms, misinformation, disinformation, and just widespread hesitancy’,” he said.

He said the understanding of these factors helped the agency and its partners to design tailored interventions aimed to address vaccine hesitancy and ensure essential services were still being delivered to communities.

Project impact

In his welcome address, the Director of Community Health Services, NPHCDA, Chris Elemuwa, said the project was designed to strengthen the demand for PHC services and that it has achieved that goal in more ways than one.

Mr Elemuwa said through the project, the agency has been able to raise awareness about the importance of accessing PHC services and educate communities on the benefits of preventive healthcare.

“We have also been able to provide training and capacity-building programmes for healthcare providers and traditional leaders to improve the quality of services they offer,” he said.

“This has resulted in a significant increase in the number of people accessing primary healthcare services, particularly in Niger and Gombe States.”

He reiterated NPHCDA’s commitment to providing accessible, affordable, and quality primary healthcare services to all Nigerians.


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