Revamp PHCs to Deliver Basic Healthcare, Akhimien Uges FG

A former President of the Pharmaceutical Society of Nigeria (PSN), Pharm. (Sir) Anthony Akhimien, has called on the Federal Government to urgently revamp and resuscitate Primary Health Centres (PHCs) across the country to deliver accessible, community-owned basic healthcare services, describing strong primary care as the foundation of an effective health system.

He said PHCs must be repositioned to address the basic health needs of communities before referring patients to secondary health facilities, stressing that the continued neglect of primary healthcare has overburdened higher-level hospitals and worsened health outcomes, particularly in rural areas.

According to Akhimien, who spoke with Pharmanews in an exclusive interview, “Government must revamp and resuscitate our Primary Health Centres across the country. They must be accessible, owned by the community and adequately equipped to address basic healthcare needs before referral.”

Available data from the National Primary Health Care Development Agency (NPHCDA) indicate that there are between 30,000 and 34,000 primary healthcare centres nationwide. However, health sector analyses suggest that only about 10 to 20 per cent of these facilities are truly functional.

The World Health Organisation (WHO) defines primary healthcare not merely as a network of facilities, but as a comprehensive, people-centred approach to health. It focuses on meeting individuals’ health needs as early as possible and as close as possible to where they live and work, encompassing health promotion and disease prevention, treatment, rehabilitation and palliative care. The approach also emphasises equity, community participation and the broader social and economic determinants of health, supported by integrated health services, multisectoral action and empowered communities.

Akhimien also advocated a credible job evaluation framework for all health workers, noting that fair and transparent assessment of roles and responsibilities should form the basis for negotiating wages and fringe benefits in the sector.

He explained that addressing long-standing disparities in remuneration would help rebuild trust within the health workforce. “A credible job evaluation will restore harmony and confidence among healthcare workers and ultimately improve service delivery,” he said.

On immunisation, Akhimien urged government to scale up coverage by permitting community pharmacists to administer vaccines, particularly in rural and underserved areas where access to health facilities remains limited.

He further emphasised the importance of task shifting, noting that it must be implemented credibly and within clear regulatory frameworks to enable Nigeria to meet its universal health coverage (UHC) goals. “Task shifting, when properly regulated, is critical to closing human resource gaps and expanding access to care,” he stated.

Speaking on health sector reforms, the healthcare advocate said reform efforts should focus on systems that are clearly underperforming, while lamenting the poor implementation of reform outcomes in Nigeria. He said his priority would be to engage with a recent bill aimed at establishing a comprehensive framework for delivering quality primary healthcare to over 200 million Nigerians.

“This must be followed by increased budgetary allocation to the health sector across all tiers of government,” he added, while also calling for sustained investment in digital health transformation to integrate digital systems nationwide and build capacity across the health workforce.

Akhimien also expressed concern over the migration of skilled health workers, describing it as an unfortunate trend that has left large segments of the population underserved due to manpower shortages.

To reverse the situation, he said government must address discriminatory wage structures and provide incentives for health workers across the board. He added that long-term solutions include legislating policies that protect the health workforce through measures such as research scholarships, bonding beneficiaries to serve locally, and equipping hospitals with modern facilities to discourage medical tourism.

On medicine safety, Akhimien referenced the national drug policy, which stipulates that any facility dispensing medicines must be supervised by a licensed pharmacist, warning that failure to integrate pharmacists’ expertise has contributed to avoidable medication errors. “Diagnosis without the right medication endangers a credible healthcare system,” he said, stressing that pharmacists play a pivotal role in medicine procurement, storage, dosing, pharmacovigilance and medication error analysis.

He also called for a transparent and accountable drug revolving system to address frequent drug shortages in health facilities, while urging government to support local pharmaceutical manufacturing to reduce Nigeria’s heavy reliance on imported medicines.

According to him, strengthening local production, ensuring clear audit trails in the drug supply chain and supporting regulatory agencies would help sanitise drug distribution and guarantee consistent access to safe and affordable medicines nationwide.