By Chidimma Oparaochaekwe
Lagos State is moving to future-proof its primary healthcare system against a looming population surge, with the government projecting that the state could accommodate between 40 million and 50 million residents within the next two decades.
To prepare for the anticipated pressure, the Lagos State Primary Health Care Board, LSPHCB, has commenced work on a three-year strategy and costed implementation plan aimed at tackling critical weaknesses in grassroots healthcare delivery.
The plan will focus on more than infrastructure, targeting shortages of healthcare workers and equipment, inadequate financing, quality assurance, facility location and clearer responsibilities among the state, Local Government Areas, LGAs, and Local Council Development Areas, LCDAs.
The three-day strategy workshop, which began in Alausa, Ikeja, is supported by Immunization Plus and Malaria Progress by Accelerating Coverage and Transforming Services, IMPACT, and other partners.
The initiative is coming at a time Lagos is facing rapid urbanisation and an increasingly complex disease burden, ranging from infectious diseases to hypertension, diabetes, obesity, antimicrobial resistance and mental health challenges.
Speaking during a keynote session on the Lagos State Development Plan 2052, Commissioner for Health, Prof. Akin Abayomi, said the state could no longer afford to plan its health services around its present population.
“Lagos needs to get ahead of the curve, because our city will just not stop growing,” he said.
Abayomi stressed that primary healthcare must remain the foundation of the state’s health system, noting that about 70 per cent of healthcare delivery takes place at that level.
He said the state must strengthen PHCs to prevent and detect diseases early and manage them before they progress to more complex and expensive stages.
According to him, this requires simultaneous investment in infrastructure, equipment, human resources and financing rather than focusing on physical renovation alone.
Malnutrition adds to pressure
The commissioner also raised concern over the burden of malnutrition among children in Lagos.
He said about three in every 10 children in the state were struggling with some form of malnutrition, including both undernutrition and overnutrition.
“How does Lagos want to be globally competitive if three out of 10 of your children are struggling with some form of malnutrition?” he asked.
Abayomi said the PHC system must be equipped to identify nutritional problems early and provide appropriate interventions at community level.
He listed population growth, climate change, infectious disease outbreaks, antimicrobial resistance, hypertension, diabetes, obesity, drug abuse, brain drain and healthcare worker shortages among the challenges Lagos must prepare for.
He called for stronger collaboration among state and local governments, federal agencies, private-sector organisations, development partners and insurance providers to mobilise resources for PHC development.
State targets functioning facilities
The Executive Secretary of the Health Facility Monitoring and Accreditation Agency, HEFAMAA, Dr Victoria Egunjobi, said the state must also ensure that investments in PHC infrastructure result in facilities that can actually deliver care.
“A renovated PHC is not a functional PHC,” she said.
Egunjobi explained that functional healthcare centres require trained personnel, equipment, electricity, water, appropriate clinical guidelines, proper records, infection prevention and control systems, waste management and other essential services.
She urged LGAs and LCDAs to work with HEFAMAA to ensure that all public PHCs are registered and comply with prescribed standards.
She said PHCs would also be expected to display the HEFAMAA-approved facility logo from January 1 to indicate compliance with required standards.
Beyond infrastructure, she identified patient communication, payment transparency and adherence to clinical guidelines as important measures for restoring public confidence in primary healthcare.
Three-year roadmap
Permanent Secretary of the LSPHCB, Dr Ibrahim Mustapha, said the strategy was intended to convert identified PHC problems into practical interventions with defined responsibilities and funding requirements.
“We are here to move beyond identifying the challenges to developing practical solutions that can be implemented at the LGA and LCDA levels,” he said.
“Our goal is to have a clear direction, with defined priorities and responsibilities, that will translate into better primary healthcare services for the people of Lagos.”
The Director, Planning, Research and Statistics, LSPHCB, Dr Temitope Balogun Alo, said the exercise would establish a baseline for planning and investment across the state’s PHC system.
She said stakeholders would assess existing facilities and services, identify gaps, determine appropriate locations for PHCs and develop a costed implementation plan for the next three years.
The process will also define the roles of the different stakeholders and minimise duplication of interventions.
With the strategy, Lagos is seeking to move from fragmented PHC interventions to a coordinated system in which infrastructure, personnel, equipment, financing and quality assurance are planned together.
The ultimate test, however, will be whether the three-year roadmap can translate into functional PHCs capable of meeting the health needs of a rapidly expanding population.
