Sydani Group, Abuja, Nigeria.
National Primary Healthcare Development Agency, Garki, Abuja, Nigeria.
Health Res Policy Syst. 2024 Sep 30;22(1):133. doi: 10.1186/s12961-024-01223-6.
Achieving universal health coverage (UHC) and the Sustainable Development Goals (SDG) by 2030 relies on the delivery of quality healthcare services through effective primary healthcare (PHC) systems. This necessitates robust infrastructure, adequately skilled health workers and the availability of essential medicines and commodities. Despite the critical role of minimum standards in benchmarking PHC quality, no global consensus on these standards exists. Nigeria has established minimum standards to enhance healthcare accessibility and quality, including the Revised Ward Health System Strategy (RWHSS) by the National Primary Health Care Development Agency (NPHCDA). This paper outlines the evolution of PHC minimum standards in Nigeria, evaluates compliance with RWHSS standards across all public PHC facilities, and examines the implications for ongoing PHC revitalization efforts. The study used a cross-sectional descriptive design to assess compliance across 25 736 public PHC facilities in Nigeria. Data collection involved a national survey using a standardized assessment tool focussing on infrastructure, staffing, essential medicines and service delivery. Compliance with RWHSS minimum standards was found to be below 50% across all facilities, with median compliance scores of 40.7%. Outreach posts had a median compliance of 32.6%, level 1 facilities 31.5% and level 2+ facilities 50.9%. Key findings revealed major gaps in health infrastructure, human resources and availability of essential medicines and equipment. Compliance varied regionally, with the North-west showing the highest number of facilities but varied performance across standards. The lessons learned underscore the urgent need for targeted interventions and resource allocation to address the identified deficiencies. This study highlights the critical need for regular, comprehensive compliance assessments to guide policy-makers in identifying gaps and strengthening PHC systems in Nigeria. Recommendations include enhancing monitoring mechanisms, improving resource distribution and focussing on infrastructure and human resource development to meet UHC and SDG targets. Addressing these gaps is essential for advancing Nigeria's healthcare system and ensuring equitable, quality care for all.
实现全民健康覆盖（UHC）和 2030 年可持续发展目标（SDG）依赖于通过有效的初级卫生保健（PHC）系统提供优质医疗服务。这需要强大的基础设施、足够数量的技能型卫生工作者，以及基本药物和商品的供应。尽管最低标准在基准 PHC 质量方面发挥着关键作用，但全球范围内尚未就这些标准达成共识。尼日利亚已经制定了最低标准，以提高医疗保健的可及性和质量，包括国家初级卫生保健发展署（NPHCDA）制定的修订病房卫生系统战略（RWHSS）。本文概述了尼日利亚 PHC 最低标准的演变，评估了所有公共 PHC 设施对 RWHSS 标准的遵守情况，并研究了这些标准对正在进行的 PHC 振兴努力的影响。该研究采用横断面描述性设计，评估了尼日利亚 25736 个公共 PHC 设施的合规情况。数据收集涉及一项全国性调查，使用标准化评估工具，重点评估基础设施、人员配备、基本药物和服务提供情况。所有设施的 RWHSS 最低标准遵守率均低于 50%，中位数遵守率为 40.7%。外展站的中位数遵守率为 32.6%，一级设施为 31.5%，二级及以上设施为 50.9%。主要发现显示，卫生基础设施、人力资源以及基本药物和设备的供应存在重大差距。合规情况在区域上存在差异，西北部拥有最多的设施，但各项标准的表现各不相同。经验教训强调了迫切需要采取有针对性的干预措施和资源分配，以解决已确定的缺陷。本研究突出表明，迫切需要定期进行全面的合规评估，以指导决策者确定差距，并加强尼日利亚的 PHC 系统。建议包括加强监测机制、改善资源分配，并注重基础设施和人力资源开发，以实现 UHC 和 SDG 目标。解决这些差距对于推进尼日利亚的医疗保健系统和确保所有人获得公平、优质的医疗保健至关重要。
