Stakeholders in the health sector have called for urgent and coordinated action to strengthen Primary Healthcare Centres (PHCs) as a critical pathway to achieving universal health coverage in Lagos State and nationwide.
The call was made at a leadership dialogue convened by the Lagos State Primary Health Care Board (LSPHCB) in collaboration with Nigeria Health Watch, EngenderHealth, the IMPACT Project and other development partners.
The one-day meeting, themed “Strengthening PHC Systems: A Joint Leadership Dialogue,” brought together key policymakers, local government chairpersons, development partners and health sector leaders to review challenges facing primary healthcare delivery and to chart strategies for reform, particularly at the local government level.
Speaking at the event, Lagos State Commissioner for Health, Prof. Akin Abayomi, stated that the dialogue aimed to achieve two major objectives: implementing mandatory health insurance coverage in Lagos and positioning the state as a leading medical tourism destination within Nigeria. He noted that several health system indicators directly under local government control, including hospital bed availability, insurance coverage, maternal and infant mortality, and healthcare financing, required urgent attention.
According to him, Lagos currently has about 50 hospital beds per 100,000 population, far below desired targets, while health insurance coverage nationwide remains among the lowest globally. He stressed that governments at all levels must collectively work towards allocating at least 15 per cent of their budgets to health, and added that although Lagos State has increased health spending, significant gaps remain, especially at the primary care level.
Abayomi said achieving universal health coverage would require focused investments in human resources, infrastructure, technology, healthcare financing reforms, service delivery and governance. He noted that Lagos was currently lagging most in service delivery and governance.
He explained that Lagos, with an estimated population of about 30 million, operates a complex healthcare ecosystem dominated by informal providers such as patent medicine vendors, community pharmacies and traditional medicine practitioners. He said about 60 per cent of residents seek care in the private sector, including the informal segment, largely due to weaknesses in the primary healthcare system.
Citing World Health Organisation (WHO) standards, Abayomi said Lagos should have one PHC per 10,000 residents, but currently faces the largest PHC-to-population deficit in the country. To bridge this gap, he said the state would need to build at least 2,000 additional PHCs. He added that audits showed at least half of existing PHCs required significant infrastructure upgrades, and warned that weak primary care had led to residents bypassing PHCs for private hospitals or informal providers, often with dangerous consequences.
He further highlighted the human resources crisis in the health sector, linking it partly to poor working conditions and the emigration of health workers. Using doctors as a benchmark, he said Nigeria has about 40,000 doctors but requires at least 300,000, while Lagos alone needs about 33,000 doctors but currently has only about 7,000. To address this, he disclosed that the state had passed a law to establish a standalone University of Medicine and Health Sciences to significantly increase the training of medical professionals.
Earlier, the Director of Medical Services and Disease Control at the LSPHCB, Dr Veronica Iwayemi, said the dialogue was convened because the success of statewide health interventions depended largely on the strength of the PHC system. She stressed that for many Lagosians, PHCs were often the only point of contact with the health system, particularly for maternal and child health, immunisation and preventive services.
Iwayemi said the engagement was meant to align technical health strategies with local government administrative capacity and to ensure that no community was left behind. She urged local government leaders to embrace shared responsibility and work collaboratively to equip PHCs and deliver life-saving services to the last mile.
Also speaking, the Permanent Secretary of the LSPHCB, Dr Ibrahim Mustafa, commended some local government chairpersons for constructing and renovating PHC facilities but noted that infrastructure alone was insufficient. He said effective PHCs required good governance, continuous service delivery, adequate staffing, financing, security, water, power supply and supportive working environments.
Mustafa called on local government leaders to provide stronger institutional support to PHC services by empowering local government health authorities, prioritising PHC budgets, monitoring facilities and engaging communities to improve accountability and health outcomes.
The Commissioner for Local Government, Chieftaincy Affairs and Rural Development, Bolaji Robert, described PHC as the foundation of the health system and said local governments played a central role in planning, funding, staffing and supervising PHC services. He emphasised the importance of community participation and collaboration with traditional institutions, civil society and development partners to ensure no community was left behind.
In her remarks, the Special Adviser on Health to the Governor, Dr Kemi Ogunyemi, said strengthening PHC was central to achieving universal health coverage under the THEMES Plus Agenda of the current administration.
She charged local government chairmen to demonstrate strong political ownership of PHC services, ensure effective use of the Basic Health Care Provision Fund, and deepen collaboration with the primary health care board and partners.
She expressed confidence that the dialogue would translate into concrete actions to improve health outcomes and build a more resilient, people-centred primary healthcare system across Lagos State.
