Primary Health Care Approach to Achieving Universal Health Coverage in Nigeria: Are Extant Legal and Policy Regimes Adequate?

The Declaration of Alma-Ata was quite categorical in projecting primary health care (PHC) as the key to attaining health for all or universal health coverage (UHC). PHC is not only the first level of interface between a patient and the health system, it is also the foundation of health systems and a crucial determinant of whether a health system is on a path to attaining UHC or otherwise. More recently, the World Health Assembly went a step further in not only affirming the link between PHC and UHC but also identifying a vital component of actualizing this goal, namely, social health insurance (SHI) system of health financing. In essence, to succeed in attaining UHC, countries must integrate PHC approach and SHI system into their national health architecture. This is critical given that for long, the capacity of PHC to deliver on its key mission, namely, improving efficiency in health care delivery, has been hampered by cost. Yet, cost challenges can be mitigated by adopting a SHI method of paying for health care. Nonetheless, whether extant legal and policy frameworks in Nigeria sufficiently address (if at all) this very crucial component of UHC is not at all clear – hence the significance of this paper.