Partners Support in the Primary Healthcare System: Sustainability Challenges and Way Forward

Collaborations and partnerships between different stakeholders play a significant role in improving health outcomes, healthcare delivery, and create sustainable improvements in public health. These partnerships leverage diverse resources, programs, and initiatives to address healthcare challenges and promote better health for all, particularly within the primary healthcare system. While there are still challenges to overcome, various partners and stakeholders, in the past and recent times have contributed greatly to positive changes in the healthcare system.

One of the earliest global efforts is The Mother Care (March 1992 to September 1993), a project that tackled maternal mortality. This initiative was developed by the United States Agency for International Development (USAID) with the goal of improving pregnancy outcomes for mothers and their newborns1.

In 2012, the Federal Government of Nigeria launched the Saving One Million Lives (SOML) initiative to address the poor state of Maternal, New-born and Child Health (MNCH) indices in the country, and to improve access to healthcare and health outcomes. The initiative partnered with the World Bank through a “cash-on-delivery” (COD) approach which achieved specific programmes results2. Also, in collaboration with international partners, the Nigerian government has implemented Conditional Cash Transfer (CCT) programs, such as the National Cash Transfer Program (NCTP). These programs aim to provide cash incentives to mothers and caregivers who meet certain requirements, encouraging them to seek Maternal, Child Health (MCH) services. CCT programmes have been an established program for social protection for over 20 years which is increasingly used in Africa and other regions and has a beneficial impact on health outcomes.3.

Other major programmes developed to address inequity in basic health services for MNCH include: The Midwives Service Scheme (MSS) launched in 2009, to improve the MNCH indices by engaging newly graduated, unemployed, and retired midwives to work temporarily in rural areas4. Gavi the Vaccine Alliance, developed to support immunization programs (2020). Gavi partnered with UNICEF, to strengthen vaccine delivery systems, reduce vaccine-preventable diseases, and increase access to vaccines for children and pregnant women. There are several other partnership programs that have contributed significantly to the programme for availability and accessibility to basic primary healthcare services in Nigeria.

Despite all these supports and positive changes partners have brought to the Nigerian PHC system, there are still some persisting challenges. The major challenge has been the sustainability of the programme progress and achievements, to achieve a more resilient, healthcare system. To address this challenge, many global health organizations and governments are advocating for more integrated approaches that strengthen health systems while addressing specific health issues. Further collaborations and commitment among partners, effective monitoring and accountability, and a commitment to long-term solutions are crucial for sustaining improvements in the primary healthcare system in Nigeria.


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