Public-Private Partnership and sustainable primary healthcare facilities in Nigeria

The Nigerian healthcare system is divided into the primary, secondary and tertiary levels of care, which are under the three tiers of government (local, state and federal) with some overlapping of responsibilities. The Federal Ministry of Health (FMOH) develops policies and physical structures, and supervises the operations of the healthcare system. The Primary Health Care (PHC) level has been identified as the appropriate setting to tackle 90 - 95% of major causes of morbidity and mortality because of its proximity to over 80% of the populace. At the PHC level, the services provided include integrated preventive, promotive and community development activities. However, the implementation of PHC in Nigeria has lacked impact and sustainability, thus leading to the research discussed in this paper which is aimed at proposing an innovative procurement system for sustaining PHC facilities in Nigeria. The proposed system is focused at developing and encouraging a new market for investment in primary care and community-based facilities and services. It is a form of Public­-Private Partnership (PPP) that enjoys national support but with local control. One of the central objectives is the idea of bringing together all the various local stakeholders, interests and users that comprise the local health economy. The arrangement is expected to offer considerable social and economic benefits while satisfying the fundamental philosophy of PHC.