Primary Health Care in Nigeria: 24 Years after Olikoye Ransome-Kuti’s Leadership

Policy makers need to strengthen and revitalize primary health care (PHC) in Nigeria. This opinion aims to inform policy decisions and actions by examining the evolution of PHC in Nigeria, the role of Professor Olikoye Ransome-Kuti in the implementation of Alma Ata Declaration, the present state of PHC, the challenges and opportunities in implementing PHC in Nigeria, as well as ways to maximize the opportunities. In 1960, there was no strong focus on health systems development. Policy makers and political actors made efforts to establish and expand health-care infrastructures with more emphasis placed on curative medicine rather than preventive medicine (1). From 1975 to 1980, health system development was initiated with PHC as the cornerstone (1). The National Basic Health Services Scheme (NBHSS) was developed based on a PHC approach (1). Unfortunately, the NBHSS program could not achieve its goals due to implementation challenges; hence, PHC services were not delivered across Nigeria (2). In 1985, Professor Olikoye Ransome-Kuti was appointed the Minister of Health. Professor Ransome-Kuti adopted PHC in 52 local government areas as models based on Alma Ata Declaration of 1978 (3). Furthermore, Nigeria's first comprehensive national health policy based on PHC was launched in 1988 (3). From 1986 to 1990, Professor Olikoye Ransome-Kuti expanded PHC to all local governments, achieved universal child immunization of over 80%, and devolved responsibility for PHC to local government areas (3). Professor Olikoye Ransome-Kuti worked assiduously between 1985 and 1992 to implement PHC policy based on the Alma Ata Declaration for the benefit of the Nigerian population. Professor Olikoye Ransome-Kuti introduced a comprehensive national health policy with a focus on PHC, placed emphasis on preventive medicine and health-care services at the grass root, ensured exclusive breast feeding practice, introduced free immunization to children, encouraged the use of oral rehydration therapy by nursing mothers, made compulsory the recording of maternal deaths, and encouraged continuous nationwide vaccination and pioneered effective HIV/AIDS campaign. In 1992, the National Primary Health Care Development Agency (NPHCDA) was established to ensure that the PHC agenda is continued and sustained (1, 3). The military takeover of government that occurred in 1993 brought to an end the giant strides recorded under the leadership of Professor Olikoye Ransome-Kuti from 1985 to 1992. Twenty-four years after the leadership of Professor Olikoye Ransome-Kuti, the need to strengthen the PHC in Nigeria is relevant as ever before. The current state of PHC system in Nigeria is …