J VISooSulrN.n5 a82l,4 o22f02 1H-R89e4 a1let9h v, M iAevnd iiIcnniRnteerg naean tdviHo Nnaauelrm sPaineeglpr t- r ihe vn ic e g w a e d r P J e o r u r iDn ma l e al i r v y eD Or H I y: 1 e:0 . a7 C1 l7 6t o / hJ Hn c M t aN e r x e t - i www.iiste.org Abstract DeOpwarutmmei,n Bt o.Ef .S o c iToaloiwg yo,, UP.nAiv. e r s iKtyo olof ,I Vba.dI Bn. a Nseigde Irsisau es for neTrifaghftoieico riorneeusnl sa an tl ltiydiko eepnl uisNvrhesiigurpyee r bssieaytrt.saw tIteneemeg Anise .us hHg etuooas lwittm he1 vp9aer8nor7d,v , eh sP eutarhsiletmta hhia nearaaynbl dtlhh eeh asedtlaaethltvtuchesalc oraoeprf e m(a P denHnealtCti ivh)oe anwrv’ysae sics lio ataidnz ogmep nbatrejeyode r tn ha psrero sotuhtbagelbhe lc mifosu hrncneocedtnr.is fotrHence the need to Nthahnaievdg e veh raeniraaoi,olt t uhrsse ip gvsoniovlilifucitcyiao innnts lN y iigmeprirao. vAedb nooannletliy no gef fdhfeeecvatleitvlhoe p caiannrdge pNthrieog deaurviceatr iafvogece uc Nistiiinizgngeeg nro isanp, n rtP.ih t mhTeatHraCher ib y hsada y sp h agte b hpea e eenlt ;eoh nuac tnaa dtrdhe vrt haebnee erating ne c dcdeoecateidoml i a ntvoe d aes e lsr syowa la vofviftean eiahgrb,lthe ;ia stluthd i r presents a t l teb ouvatl e stes wree rritvnli h hub of health l miaactv aeei e lv.s e Ishn ha townso rtehvhdaeetu bf waethcecc ie at heal tolhl m oenf e cod oatw t spto hinen adrlenylind nn pghir aeoelacd lthcare in Nigeria it that militates against successful implementa of health pou rcncoaoebr melhe iemdcae ,rll etidhvaeyelfi rtyyyai nnitnodg sisrnetcrfcoaooptrememg myaa lenf nohdder aetphldote hl ia rcs eyutv hbao-pmsrreoopcucitngeogshrs oe sfsoi ptpfue raciPtmiiaHoalnlCry y a thihnneea a ltlNyrtshaiigd sce ht reipiooaonr le iactinycd.a Ilo td ueitxacgaomnmoiesnsie.s s T othfh eet h ppear postebat as rl e ecm oonsf c oalfuf fdPaeHidrsC tho, afi dth eceneatrlittfahyicnina dgree g fdiacepilstisv weinIriyt ht hTiinne Y KD OeyIw: 1o0rd.7s1: 7H6e/JaHltMh, Npr/i5m8-a1ry0, context-based he iaatirloten iaan al c Nphcreoiegauleluntrhdtiea ecd. a trofeo arp ratbhcoetti ttoipomrno-egurrpsa mapsom alie cv’ysia bainlpecp aarposEa awcciheta,l lt Riiaonsnc l.cu osIsitSto nehf owevhcare, policy, revamping foefc ttihv eeer T1tnho.h ere Introducti V optimr mpeaaahlllceilnytyio eidmsn u teehwn ao o I facto htto ninmc h oa fn thealth and illness in human history dates back toU time i Nmmemorial. They constitute some of ricneocsntldouirdrtisiin nogtgnh attdthh ieaas tfe bfaaeolsctedets b yr.hs a i l tHts ha henla icfesee ns;ht aiibrldeel n ttwheosu esfmea nicas en m a i pnade nher’svissoi anbet ixioiopnlneoc rAglfiuriecdonaimcnle g,Rc ooohfrmi slaip fnboe Yos.i indWttiyeo hrnari nuled hmeainltdh aosn othnee osnyes tehman,d a dree sacbrilbe etso af ustnacteti oof he state of man’s heaRlth by disrupting n medicHinoew aesv ecra,n d buee ftooou encnndooc meram,m p almoeLlncxagyint i deafIistrf ofiBewmnrh e senpontr cepeivhaeeloi srplt iolhfereesi c ap fnaatidlrmlt sicc euusslil tcauh krta.eh dseT . rly i a h nh l ith issto e h aprdstt oiow enex ltilos ta issnu goc htbh aenlrao nramcneda, l t ehoxrrtodeuergnr.ha l psycho-cu I vt arreifoeurss ct soao ucasineaysl chdoeisanelsatehsqceua earenn tdd efdolirrviAmveeraynli zsbeaNyeti momn t oood hfe arsnvo ecm biaeelde nioc rasgwla nescpizitea antiscoiedn e,a bntryda dwtietecisohtnenaronll ommgeeydd.Iiinccecii 1 e nlm7 vi e twi sn nreea, sdhi- eadt edm unh1egi8c lttyhho , c eienann ttsuh reoie fse ,mm meariogndeteanricning used to be the mneia zjaootfir o h tn eraaso da lt uni h rtcdi oand t e tnhoaefl IBaswn otsorwhs Aoacridast eDdce nwtrealfliazraet isoenr,v iacse sn attoi ocniatilz egnosv.e r nTmheenrets wsatasr tte thheea eltmhcpahraes ibs eogna n‘g etorm a pthperoopryri’a oategies and funding, through which healthcare can te f pmootlodiiotseinecr anpol mrfai nmehddea iaerclycitn oheincn aowtremean sitcd i iencsltl irivtmooed erupyscr toeshdmya stobt eotyemb ,t thsare ie n–sc toioanlrno ed n iaiofzrfrree arrmnse,gna seti unmcctoae bhdnee intr temohcf eooa p andrle lseayt ih st ath ivnega grienl aaeobtefel dre“ arttoolol l etdohser egvi anepnl eoitozhppae tl mieop.e rnTaosnv,h siips si evogoinsap- vàoe-f v bihsire taphlo th and character which varies hu anstr Biersi toafi n(t hWien H wthOoe,r cld2a,0s e0h e7oa)f.l In m tloic itehse, byeya vrsa,r itoou sd efovremlosp o af ninda sd t Nhcigaereroi ads.et Dldivueeevr eytol oa dpllsiiefno fg eah rnaecdsno tuva nascorttriicooiieunosss-, hlHiefoeaw.l tehT v hceear r,ae ai –mll t ohofef thhthueibsse o pafa t a tut ecphese qrmtouapser a ciion stcs ic edhosiafu pfvneoetrris to pro sese eds .b Ly ipk untry’s vnhuitedf faepel otrchelridic oet iil tecih otstaei c her policl a a ysina l ,n d mesfso ceepocigr hr nftoaoogtrmers a yaimnthtse aonvs a mdmdeeeovneglo optihnegr cfaocutnotrrsi.e Ns, igheerailath h aiss astlrsuog cghleadra ocvteerri ztehde 2In. evHereya lctohucnatrrey Dofe ltihvee rwy In Nigeria: d ra orld, the healtShi tsueacttoiorn isa lv Aernya klyesyi st o ethrael vsils erefleo ovmrpi vmatahjeole nr o tdfai eslh sleeiuvafefelsotr hyrf t ocso arif rn tehc oadetr eherleei vrtvo eas rmpiyth psie nirvn eNagss itoog ffec rinptiiaarzi.t mei onanrryayl. bheoadlyth coaf res ynseteemd .o fT thhies pies odpulee wtoh ot huel tiimmaptoelryta cnot nrsotlietus tet9 hp4a rto dthuec tisv efecu tnaogcr teipnoltnasa ywls ohipones repa ratiocomtniv ooittfiin etghs eca unnladmt ioimnnaa taiens t iaani ncnoianmtgipo lntehaxel JVI SooSulrN.n5al of Health, Medicine and Nursing www.iiste.org tcadhnoeedmv e 8l2o,4 2p202m1-89e4 n1t9. An International Peer-reviewed Journal DOI: 10.7176/JHMN cmhoeuiatnmltthreycn.a tU.r e TnA dhllieitkshlei ovh mueagrsay hnr etyNhs oueig ltmtheeerduira c ic’hnso rutiehsnq etnru iuoierntse f,ada Nn va oietgtuxeercnraeitbaipol teinis o shintnai g tttoehh leotyh f a ihrasee ftpfaea rroiiornfsgc peitphrnilaeoetor, iuctthshe governmdivides. Each of the peoples and cultures making up Nigeria had deviez,al aoprtapoicoeltander, ri ivzfzueaend d t eahintrioulneos g d heaalnsidv n evorayt r aioocucso rodtehde rh m‘imeeptoinrgta titohne’ir ofh ewaletshtcearnre mneedeidcisn ef,r oinmit iatilmlye toi mm f healthca meeetm tohrei anl.e eHd oowf etvheer ,c othloen iaadl voefnfitc ioalfs .n cigTon hlvdoiaisngr iiecaonuluiolssmum ssio nmcalietoeedt-d hc outiodl iertnsue ap r lth oiuanflt vseyysaetablish pesraoitrpoe lmu1es.8s 9w mi5ne.e snmWtet eroientfht i fntahtghe i tsfh,i eras tlh ieehnao l stwphicetaas n t thhee NSaiggeurai,a O,B 8gy5u cilities which rlthe e( arSnnsa ecsemprdeersded a ioHcdfi eart hospital, Lantoro) in Abeokuta, present day Ogun state in the 2002), the p%tnhegr euos odyf neewan-Ereh lsi2,cs 0hioe0 rna5g,r,a e Ent hipdzerea ikFtmiieo aadnrneaydrl a haOle nMakdlo tihmmn ieacs ttar ntNyeh irogogfeur Hragidaheunaoaslutl.htl yT t( hhFbeeMe gcsoaioHtnuu )nat ttoeiros ytne,i xm phiasraotts ev sdicid dhaiea nt-ngobg tyaev-ldas oridiwfoe i2u t3shth , 6hec4 eo0aiunl nthdhteil geasesletnshr ov nfuiaucscem ismlb itteeiorde ssi tc hoianefl ammmeeodrenic Agcio nltmneh soohuuralegtsi h nta hglwas ronoe soc7tmoe0nr%snt i(Jegede, 2002). (er2rei0 af1la 4ce)iq.l uiAtiipepsa,r t1 f4r%om s eucrobnadna-bryia sa nind t0h.e2 %si titnergt ioafr yt h(eO fyaicbiolictiheas, (IJreingoedyee,, cloocnatlr oglloevde brnym theen tf e m ldeevreal nls o,um fe e dicsidNinn iticsog itne er tyr eh is the officially rehi aroeinfav sleh t he(aA anliddtshe cfawoo lmhcaiojpcunhe,c t eu2s hr0fra1aerv comougernnaitbz leoydf wthsiyetsh ft eaimtcsi l iwotiefe ssth eheraanvl tech o ruecduced them to the status of Healthcare delivery which is organized along the three0ne )tsm. Nriaetijesgompero r lineaisnv’is eb ltihshl ieetoay fl N twchia igrtseheer: c imatponrirni micissoat rrndi neaostrme eor ipfci anihrl eet,adN lg tiiahgni e,na ritirn aetg,hg eupt rlosaatptdaeuitdteliI a oaarninh nT taddyl Y aihhsn oe dmawl toeUhvealthrc e e cphc roeo rl,sii cdt2lyd0y,eare del 1 n iat4 b vhn)eed.r y yRhu a ena atmhlteyhrr sitaehdca tnoo fp prerovbenletimvse wmheidcihc iinnec awphaiccihta tfeodrm thse t hsyes tthermu stto o af sPtaritme aorfy yv s ,thi irsettueuactlaionEtolh nc cdo aal(rlrEaReypr –iasn ento hd(seE hStoemr, eti,1a U9ry9c,8 hi)es. ins uNstiagienraiba country’s dh(oJeefe alhgilveteheadr leftyha,, c 2wbi0luio0ttri2 ekh;ss a,A, shib nifdgfuruhral tsrchtaoerhurse tc eetoumnfrs ,ahh lreie naa, clngtldhuiv cdheaeenr aei ntl htsaheedcr efvarqriaceuge aideliverl deficit, and low ,tlc eeso hsmeoucmrpotpan yo imn iNc igeria Olapipo and Amodu, 20ug1lnye2i t)ooy.f f Ti pn bdasehhyYvreuosgslevi so c ,eh i hna mpaano wsso h,dr i pecrroailed veUen tn ion heom, Nrau nit ondn g ldiye estrtroraiwiaItbi aoruerVntds curative medicine which healthcare in Nigeria is lar atwraanrse si notos. The major problatenfes dhos efot aohfl ethlhoae lwawthl to qhpru kepaerrlsrioostgy,n r l ana e otem m ftli tcm sau and oerde f es pmaafmthooefvo oreerndrg the bourgeois clas co tt uyhhn aewtnar lyh7t’ih0csc% hah r eaeoaf ffla ettnhchd teis n i ctmdsoi oucaar sge ( eAtlhyrua iddnnue eht,de a Orlimfnj ueionqaf,eu NdaIs libihgtyoye tihn acceRss to health services among Nigerians. Hence, access to R rates and deaths from nontsis ttforoiyarcLs’bi sal( etple iofddIep i csueBoelxaaspttssieeo sc(n Ut,ah nntahicvte rre yie d aaA iam e’n sdap pblAioiclbitayr it,o 2p0a1y3, )a. Isnit uthaeti ofna cteh aotf heacso rneosmulitce dc riins ims eadnidc apl etrovuarsiisvme (OyibOokcohma, eI,r iOnAo.Ly.e, ,2 S0Na1g4u)a. ,T Ohgisu ndgevideelo –p mEsesniet nis, Edg tNeo kbnaiietio largel yra t pahnut,is loa mnDti aoeitsvne re tnheloaaspplt emmmceaioanjrlottl aryPil tirpytoy ego orrfpaa Ntlmeei, g [iinUen rNfiraauDnnrtasP lal ]aan, crd2ek 0a n0tseh7 oew)- .w nhLaihcitteahtrll eecmw ownoitosrhttnaaidtllui etttroye, B I3thn. a cAt liCism oaccorded pr nfdrduo em t ob aladc kto o fw porrisoer,i tpizaarttiiocnu laasrl yw eilnl aths en elagslit gtnD e wnot adtteecnatdioens I pacsaasnrot iccmiuaelteaesrt c lesytpu hctie anded ounth c ohatemhsa iormbeltaearviyna hnienca edl toehvf cepalroreipm,i nwagrh yicc ohhue inast lrttihheecs ahorufeb w ohfi chhe aNlthig cearirae idse loinvee,r yth ienr eN iigs enreiae d(A tob idoedvuenl,o 2p0 s1y0s)t.e ms that p‘asneprireppvvr ieoicnnae tcsith vh teeh( Orrboaulutidher etehl tsahf,an ctc ahcerau etro pafntr eiicvmeoedam mroymef h duetinhcaiec large and vulnerable populations. It was in the bid to achieve this, of health probslgee ha,m p2psp0 rri0oon7xa )tichm.h eP’a HtfteiorC saa tdc specdlreravescesse ss, t ao l hinase tahehbc.el aeIart l etdah wii smceaasas r saieent s tf prootrhrod avumtic daeriajdnov.g raB iged the country at that point in time and their problems arise. This explains why primn aadtrlh tyewh hhfpeierrarosletbt hlcsecuomacnrhstea. cpiPstr roloiabmfrl geapemraylt tpiyaers neiotvcsfea nwlly, primary healthcare hinges on the idea of the fact that health in Nigeria is a concurrent item, constitutionys a h odlelcoyacml.t uh atc iiatvchreoe ,tu hipnsert roahymiem’sao elttpdihvo eaps,ty u cpsluatreetrimavoten inva tenui dnsa ignnt hdgteh rreaee hfoogacrrbcaeius lruistr saeertnoisvc oeeat pfrwaerhchoeiadlrbiuetiyc lii ttnhiasget iyaoa n ls cimovofeam tlhlpa enru edhnh eietwa nlwotshirhv koie,cf h ohc enipta irzloitnehvnd idsicv eawisrd eiuta ha sil, household or irc, ilperdo vaitd teh eim lomceadl ig fynas mttheiemly a, vwbaaiitlshae bdtl heoe rn e cspoormuormmceuosnt.i IioIttny ni ,sa b to bring health health service pnasr usooittsste.hh ceeFtlrilor otnahm ,ap npric rmeo acovn tae evcrneee crp anctrimleoo neswary thio n ena,l t,ehr hrt t ehltreev ealn, dd es e wsphiet those which c at oiors ert ah acteiie mopnneeopcan ontl eydar nboa lneet provided in a hospital. der 95 JVI SooSulrN.n5 a82l,4 o22f02 1H-89e4 a1lt9h , M Aend iIcninteer naantdio Nnaulr sPineegr - r e v i e w e d J o u r n a l D O I : 1 0 . 7 1 7 6 / J H M N www.iiste.org NPdfmuer aelitio Onafflici vlmt ehplaooardprystm i cahHeine adealall tytlhet hc i hcnPantrroooelld oiciugsycy e eodmsf s aebNdnyet ii gtauhelnre ii hvaWe earfrslHtoahOlm ly c 1aAa9rceu7c g8ebu sassAsti eblma Ata decpnat tiionn t haen ds paitr iat ocfo sste ltfh-arte ltihaen cceo manmd usn 1987 when eiltfydl-e d a eotnotned ri npmcdroiainuvcantiitdtc liaatlr ,aw tsiaocsin e primary healthcare was intended, not just to focus on priorityiruo yaan rlc.se a Faansrn oad ,i nptrr mnf fft oiafm ioimcdialualirlecyyes dish.no e Autahnlcttrhdi st od emfianiintitoead hc of health needs, coardrein gb etcoa mWe HthOe i ( o n cn,ao naimtdt m socially accebut acelavusnoen ribyttoye s tbtihanergf oeecur urgoleh 1pv 9ttea7hrb8eali)lerl, sensitive, cIimnnooctmelnunmiddtoueerdndii n tgy par f their implementtaao cot icfoae nhfl tfeeiecracai ofl pttt ehatd thdo ry, sustainable and self reliant. an eaE htaxee;pan elattinnhrsde national population, its (PHC’s) main stated objectives tdu rathllayt cdthhoeiraanorlgruthrhgee hspaoslr uocdtgoi srtuhaenemat src;ey o aisunntnu ditd nriwyfea;si nd;p terCsso IpamArneo uetrcdieao drnPead p ar ovpgareilaramsboimnlinetye l o onfd Ieemsvsemelnoutpniamilz eadntrituo;g ns i (miEnpP arIol)lv; aeirmde apscr ooovlfl eetdhc etin ocunot ruintaitnordyn ; bagarcikcguRrleotuaurlniezd,i ,n ligisv enthsetieosd cektdh, e irffei ntfhoaern ecp erro,e gqirnuafi ) mored Pw dH ocCrhl idrolo dffm rahecoentta .ib lo(tonNho ikaogw)fe) r aoirarea npl errisemsh;a ydrdyer vaheteilooalnpt mhtcheaenrrtea opPfyo alfi ocnirae tstir.o en(alaitbml rfeaanrmyt ioolyff wdasuhpe to be inter-sectoral, while appropriating inputs from education, thoeis cet chTot s f hmu eon uff hromgsa otv e aboalthcadeleusv repaolbrfoo l r pePv e i iH sddoCeecdl ii aavislerng couf nscp yttare a rup t th ioectpsutl.ur eer e c I ednm romammbeao mtmvioueu nnsw.it t ayoTs plh eebuvrosae,rtl ne. ae e focfuoictm ieobnfi tnltyaht eiao nrnde ceooffgf enwctoivrkelfyo,r cine bforothm p rdeivfefenrteivnet adnidsc cipulriaIntaiTvrye Y tdahriefef aepsr oewpnuti tlihan t iptohrneis d iromina ust function to optimum capacityan se glaarrgden. tAalyns d sl oupwcoh v,i enprcroimm (aNsocial ty leerv iyepg lohe repiisaua i ll ntafhetociqroauality) heavery nr ienh (sicAgtaahbnn d csbueien l rcws laathhhieed ce ther te a emo rem owra e s tuhnaditan iobc 7cnee0 cso%sofi n bhosleifed a petlotrehe om dpa alspen r ayoa drfEpeuuRe cnlotodpicvalaemet,.e SeeHdns topianwel cerriuivagrlelharylt, iu amdneipvqleeurmastaeelnl ytaa ctdicoeesnsi sgo nft eotdh eh aepnardlot hgpcraraomrepm ewrel yial ls i mwbepe lllew maesle lin tstfe ecdlot, nbtshyee q tuhreoenl etc uiatnYinzsdue nstr g,eb s.a l OeepI v l Utw apipo an abeineslct lw etsh ueNeoeit fne i d d npt ahrf A deioIm r m er a Vaioqucr cyh do uacau , 20 yhnn edtiarn lyt 11), thh dlceieka spre the case is not 4 a inability that has led to its incai e goNp anoi i c,rn g eri t isasact c iowahp iiweed vhion. e ai. e nnrIdgef phhB(Aee .e Proaafgllottrhhree r s cc i sN mae a rnwiegt r ieed y trrhesi a Hli’se ailntdhecare: C R betwwoeseink a,1 927050,t 5h va)ael e.ln r cy.dAor efn Tapenden1owt h 9tihho is 8ein led 0cr . h op fArc hc oetaollenges An ovn i esntorh Il1e1i 9d0eB6a,s t0t0ea,d0 ba 0l bi dR1sy fha0 P rospcm-thyileeeinta Aitmre eodicts In Ns dfei n vv1cea9llruo8idop0iums is gep ehnrtaial plan (1946–1956) was introduced to enhance cthoem rmuriatml aerneta so,n At hthee s cpNhaertm oef pthroLeolv tgfhiredoadeumedgrm ng havl ei a,mt bhtielhne ei fs BobtrHuaynsS iodScfa thhieeoevanaelsltnt hhot u,n sap elworlvyoh iric rgeoeeasdnl utsehccr eahsdlec mhhtrooeeos mpl(sBie tanaHlndsSdo Sa uin)sn d swd tsieatevusv eteidloonpsm, esneveral clinics and lau ffauinled ts in health care Ebo din gd uaen dt or reavle olothpeerd haenadlt ho pceernatteerds BpLaGrAntAircceshui emlaadserD l,fiy nu2 la0c1lr19ou48nm;8g Lotvahfim eso- bàptoh-evr,r eias2et i0 ott1hin5ee,r) s.mN Toaartfhik eogi nnofaguvl le tlrh hnieemma blpetehlnge tmi pn(oenfleniindctageytr iaooolfnf, dsNoetfaic g cePehnHr tiPte araC H na dl (i C izAna lo l cteacNion m aionlg g ee goh et eofvarious reasons, irianu basce,ao lomA of health work necrlsu dtoin wg orpko oinr I nmaotiboinliazli npgr simupaproy rth, ebaoltthh cloarcea l daenvde ilnotpemrneantito naagle, nfcoyr thwea os pecrraetaitoend anasd stuhset acinoaoofb vritdelhiiretnny am h peimegarlbetanihtrce es emwydso htileenenmn 1,i t9( was officially Alenog toienf ngPt )H.s CtIrn u cthe sa AC9mbejegture ch2uae,e r tugoyse,e i a dan2 h rg0,w 0 att5nhh)dee, healt4h.ca ith 1. rpCre oonueolrtse mpshtioemue eemrnadanr cttt auset ,en dAhel a yimtn i tc ig oiynotbe brNmimriegosm eborioilfalmilimzautnioii ez:h nae,ta iAbe guaranteen, col otsnht c:m a jertheg iassh e rianvnvicdoe lEsv bevodisr e-saiem-nvesi is(t i2tzh0ien1 g4n )e teihddee nt tified five key strategies by which primary 4.2. Service integration inimization and appropriate utiplatform, for the purtspy: os mutshesoi tsaob ifinli inmazvbaaoitxlilioivtmyne sioez fnit nhghgeee nahidlentehacr lospth rrcp oroogemrrsaaomtmuiourmncne ietsosy fw phda olpri etziuoacttpiiiplloieazn te iooo snfnu hcaPehnHa dlo Ctcph op samoenrrmdtvu iunctnihetiseite,y s Mo.o pwIapngno aearwtrdusdahn iiit(pti2io,e0 nsa1 n2tido)t 4.3. HeAimpneip daaelectxmhta iamonrlpdeols gecey oa ivrsienc rh taha:gne e yt.ih ngitsiev geisrna tapio onspt uroalaft etigcohyni .l dtWh ahitte hae lpnthrao bpwleeisrt h r tehmseea atiredcr iff eninalteli e irhmeentficapatrl tohsv eirvices ion pnorgof gehfrfaeimac toimegneecstyh earn du nedffeerc taiv esinnegslse. 96 h, resources can be l tahp ppr/rsooepbrrvlieiacmteeslsy fadonerd p wlothiydeeeidrr JI VSooSulrN.n5 a82l,4 o22f02 1H-a89 e n4 a d1 lt9h , M Aend iIcnine newer mter naantdethi Nurs oodnal P ineegr - r e v i e w e d J o u r n a l D O I : 1 0 . 7 1 7 6 / J H M N www.iiste.org 4.4. PHC, health reseawCwthoiaitsrph k rasecrhaeioltqiypzu saib stauiiotniendl d sstihnekami rgcts: h Pat hpHlseroC oi dm cauapdcnooe rpsbt taeaen nddc eeecvv aoiepdfl eomnpcaeend-p bfooawsr eesdro ialnvping health problems so identified. As a strategy of 4.5. Nimopnl-egmoevnetrinngm ae nlatarlglli sen, aparursnos dtignh ragat mi naamrt eece roo narnagst tiaPnino a Huin czoiCaeu tdy lsc b afto u ncrrano i ilhlndleingotai anbblgeoth para a r wnasn o ydaao rp cshrto rtgao botrinoenkr sebe:r-y st trr eprogramme implementat oaagmniny mri nefeogg ru c laaeapnqrp nubroiapots pabicisenh. g.o vwTehoreirskm ep iohn the responsibility rs aa.s n izd government alone, g ivoefn i stdh eeds ohign e edm .t ahIntr aoigsu egorhns bogUofaN svteIehdCren EmovFree,gn naUttun.S rizeATa. IhtADieoss,n e a instcrlauteg ning and ssptreecnigfitch etneirnmgs ,t hteh eeyDsx ,i FhsaaItiDnvnde g S d das erooev y eb, fotPohthHret h CCl.o htcThialhedl reresaefenno d,r c eDo ionlaltccaetcbroonormasra tmWitoioonindtahsalo teudhstea vvBinputs from other sectors out usigdee boufr dtehne Thesseu psptroartte goife Ps HinCit iianl lNy icgoernitar.i bunstoeadute rtdco e f tuhbnead siesm aopnfl edgm omevnaettreanrtmiioaelnsn ,ot pfa rPnodHv iCtdh eeoel orridepmbemrpysea ,ntc hPtt eead ptsh acfrtiortnnepdmeeer esros nf ad Inntohdtuee sr lNnpyar GotoiOgonrns a aPmls,Hum FcCeah .i tbhaInys- dn5wueya ed personnel and organized training in PHvem s Cae brlm’oses pr aasedss d e u ow cfa b ce nelh adlsse ed saac slo tsimhm on the to mprpyeru ornsvwiote nymd nheas eee vnl.aosht l l oTti uhnhtion ofrt -wmel ioevparerksodleg e rrsshwa ’ ecm althittohrmva eienr care th aianegl ges eo if t vn r oreos entmic b ttuo u e1rttta0di eorn si nwveorlev ee sttha ebi nliL nGoA list.t leIn wfraaysstr. uTcrtuemree nwdaosu sm parsosgivreelsys stlhehgeo arplt cobolaimccykin iangsgs ,iw nwe thlhli eca hslo hicnaaaslid ziemaqtpiuolaintce ao tfmi oPenHass Cufo rteros t thfhoee r Nigerian coln %etedin in8 01%98 4im tom 8u5n fosurcseta iwniitnhg wthhei cxpcht,ra otpchghaerca ailpmtlaertnomiggoeern.as s%iohzfae itdnit,o h 1wne9 h9cip0ocr vho(e Lgbrraaeamggmeab nmof ,ote o2r 0dcc1huh5ueil) rd.nS trH oeo nouc wteu leIrnavtdraeTgeirner, Y 5rseu. gpipmFoerat c o(tfno oGrnse -nRg.oe Svsapenronnnmis Aiebnbletaa cFlh aoanr (d TL iahnmete bIrnnoa,c ta2ipo0n1aa5cli) t cafoutlirlaborations) by donor organ m Aiiznmpa atteihro tec n fasdrn eoVl asmoirgpg nteeh lrEayean tdepd,ur oietmhg Rterpoa l wmethmimethe eudnsnrt aapltwaoicopaknul loooarfff 5.1. pLcAoualnercsntkiuon igounhefg ed ptn hotaoel i tevbitice sa aipoll onw(l 2ioitl0iflc 1:Pi 4zSH)eu,dC c tc.hw eAeshrspieicp vhrhe oa gvNsra eilbga ete othrniea rOn undermined the already attainIed feat of PHC in Nigeria. and r efg lPoeavhsecer nIonmYf Nefnuigtnsed rhsi aaUfvo er nrooutN tsinheo wacnt iavditeiqesu aotfe tchoem pmroigtmraemntm teo hthaes psai sntrsutacbtuilriet ly affeRcts the realization of the goals of PHC. As observed by auctrtochrcigibeervuasetsmaembm sy ecosoc,m caspsiainorcenede dts oub cytch eefsr espiqrvuoeev nisRgti oocvnhe aronnAfeg mneg eoginonrtd esg a htoeevrae lretnhmm pseehnravts iiwcse hsoi.nc h Tt hhaeel s osci otaunstruction of gigantents regardless Iof Bwhat neglect of exi fafteioctns itsh ew sourssetanienda bb iiclyi typp hooylifst iitcchaaell 5.2. aIansp awdoeu s recorde d Lin the implementation of t to qAcludoa nhltecae lvNt uoFed itebnh eaetehn inacn tiet nexirgnpv:aee dcgnetitevqidoeu.nna totehf efdi nceeavnnetlcroianplgimt yes pnoetf lpalsa sinrtPit nnHgeNCr isp g rsesouurgiccarhha mahasam sRv eeots ht aemar yieg tirrhnaattdd eipirctoniaoarttinteoiaonnlnd a oplf ofen rno pctto hhtlaehin oent m gaoytfivoeolerni rt.ni nsMm oeavorneseltt D IBApleast 5% of grGceorNvouepnPnet rutrio ee .fsh u eTsnatchilltitlih r s o ocfnas aaili srnl se n ogt o( a, O ti imms oliipne nsleec at,el 2wpt0roicatehi0t d seh7 u u)tL.h c n G tTe a sshtoanudlda rbde ecvoemnd medwqoihutoteaemntde dtffoeouv rnt ehdPleioHn phgCee tda.o l W tcthohchueae nrsrteuer,iac eNscs e iWscgsoe HrmoiOfam a ainrnte ydac spom rmhooimjgsethec d nta, it will be service for health workers which avhAcaecsi o li edv armtdbhpiienllmiigtcy sat eotoil ovfLn eam som afab trteoher iis(as2 ltis0rs u 1tag5hng)ad ltii nsPf gaHac nCitoloi tti hisese susrt ravfarasivcv etewod re o olflnfo farui sntn htpdeeosr n ofraarei lqllcuyuor iensg s idt s ee 1 tl0fhoo%aprti nioatgsft 5.3. paPdsiaos rwoctiirecp lullsil nyar enerated water, ianans lr eyh duyre igbanyal tstryt sh h ib s ese, ane rtvcuwitrsoea-erlà naa-reas wherd houv nsitdishn oegc to colla eb tohrea oifti oPnH Cof, wimhperroep tewr oc odoirfdfeinreantito na gaesn wcieelslh l (ae lOawsri b btrw o hieo r ale ansvtutivaea, o r n bnttui nblskgee ct owtsfoe ertcehstn eoo rdfp sirn:fo afblems2007). Poor setPyironHenenCratg ls wreylei cfa si betso d sreiu. etwsn:ct ehege nonadvs e etedhr to be operated on a multi- 5.4. Paroisoers c(oAmlemnougnhietyn ap eatr atilc, i2p0a1t4io)n. : from iitoesfd c roemnsicoseuspiroctienos n rd eiunfue ts hteoed Adtuolmp lsaihc aAartteiao nidn eofcofl dneeumsfcefeoa nrtsitteos ca.n tn,To darhs gen rrohiecna uw-vlgeteou rvrereee ,isr nuneslmcttoaeenldnoc tgeianysl, pwwrahosivc ihisn iitonennd diovefid dt huteaoil rs b oaewn dcno fmhaemmailultihnecista yar-eso.s ruTiemhneete rddeo,s cpsuuomcnhsei nbtthi ldaitety s tchfroeirb pethdee ocipro lome wmthnue hnmeits r ayel tlphva ea m arsrtna a idta t cir iooen n a even wi pwaet(lic1ofat9nirv7 eae8 s a) poa hfr enthde tWf n n ope rHrr the ostOch eoi, n Pnsss e eH t e bhoC d yef 97 J VISooSulrN.n5 a82l,4 o22f02 1H-89e4 a1lt9h , M Aend iIcninteer nand Nursing www.iiste.org pemthnaeegr ttehcicnooidmdpesamr t oeus funb ssiytut y a,t iaonnadl Pdeeevr-erelovipew tehde J ocuarpnaalc ity to DcOI: 10.7176/JHMN 5.5. bDreeeqtfw paps uicierieetn di nthf oepr ge oraesivfnofe saoribrnsting in problem identificatencn tim elfileto:yn r ptaP eanHrndsdCo bn.t henOteet nelc reoo murim tmihlpieuzoanarltittitahoyn n twa tive implementation of P ipoooonl n t raibnud osofr kt etcehnorestni t eo tthoe rth aesipr eccotms omfu hneitaylt hdevelopment. Communities taParlirH beouC ftt hecsdeoe mrtpvomii lctlhueaensr .ip toTyrfo hpbPeal HerbmtCirces.i a p okrafed tspiooerwanimrn cl aihoer,fsy a mihsn eu waittluelThey extent ofst ha lal pce b asasriusrl oiep ot.nyp t hn ot er erolt Npmeqriaogramavaugtiiecltarhaibb aPll eehH m adCesi, s swi perstur n oiif c ntbfh leuun ret dceiooidnnm gf rm ootfhem enh sepnuarar HC oltatbihtonal population size d wepheincdhs c hlaarnggeelsy oovne r tthime es. cHopeen cea,n dth ecroev iesr angeee dt htoe T 6.h e Rabeovvaem fpaicntgo rPs rliamrgaerlyy Hal,ce icanolttuehnr-ctc aafroderr eItn el ce womwnosofr lrkirkcaeftnrossg,r icpbneoag so sefrudr ijo toamobbn ls ieann taefidoseferda q.ct uhtTiaeohc nisysc ( ooAhpfa leesp neonorfosg othh neebnaneelaetlh n,e c utat nahrelee,q 2ncu0eaite1saed4b.;) l .eRa naddtihs tearrlis,b ouP teHionCnsu oirnef ggogoerneni nanetgar at nibloelyyen d.ta h lTt eodh peerve efcevoulalollmipoamwpri iettnihnegets . apoSprfcogra6.1. Strong commitmep nthrhtoo etla m oacNr hspi me guhse e b a ,av rgeei vhid ree N een dn igiettiesffer iceaiaedt n: o vtCrfaa orPliinotHtyueC sxt o’sts -t trBhaaaeitme sesd a Insdsu oebs j ectives in Nigeria. However, there is rdeesleivaercryh , apnadr tiuctuilliazralyti oinn tihne rNailairicneg a ehc reoi caano ltmtiehsxmendof he atet lhadtehnu dcal e aaidtcts ika oc snh stnd hoe afaa l rnlacetelthdon mg gtgoheiie eshs e tfhaolatrth iwcmairlpelr bodevetiltnievgre aPrydH daCrne dsas ni tdtsh heae spasrolotchbicalaetremed odimfe lPpivHaecCrtys, poasno ltyepn itvthioaetl . f iomSrumpclaihcl aeetdidouunccasa/ttbiioounrn,d besnuh toa aunlldsdo h itonhwcel uitnodf epo rraemwvaealn rete dnthueecsisar t icicona menr sa: ei ol.t tf mh Pte hrrnoeetp s geeteroan riemocreation aboutr r hap: A mc loop Nrmrtiiaomgnri atijzoart ipo Y of the need to promp cidence. This will Vine cosretniia l snlh hE,ie onu runsoli bdnol Rgef me douf cShaetiaoltnhI caanTrde education such as is b a plteho bp ptelrhe oea ba cc lcreooemmardlsmi,ez duat nhtinieotoiynrt toSwhriheime iglnielata epirdd lby eew,n thtiwilefley aehlitnnehg indige process should la p rlt eshgoseee ianarr entcilohnyu g ms saedevka nhceelpd wasi lla inldl- pwerhceenp titohne ya bhoauvte PhHeNCal tshe rpvIircoebsl eamnsd. fUaclitliimtiaeste lbyy, bmriadsgsiinvge bmedical practitioners an eirmrdoa otut can influ treea cucduasatlut tasbu erewse .i i natPhnterodonu m‘stalien’ primary healtUhcare, thereby promoting care utilization. intensive res lti giidoeunst ilfeyaidnegAr i foswitteaihdnki gRcef hhihr osepltad otlelotYirh csp y rr esoausvnec idahdr ecp ahdlsa e enecsnpopienmercg miu nderstanding of health problems, PHC in Nige s, whose domain are though o amuulltnuysis itdtty he no hoosefte a tbdthhesea , mtf oraaerrdnmeoe a.we lp Tnhih deaeterl matrhdei oissteleiooacgrntcoyah-rl , 6.2. ptkFreleoaeaccptuem .sd A eioCnsnetu a rapsapeNtr eereinavarce.ce nh tt hivveiLes p- àreoples’ perRcep -avtIihse Bsri ttuhaatino ncautli roaannt aiavlnyeds ciusat irilsei z:i anptdiroiesnvp eeannntsdiav obefl ceco aturoer strhee,e f tephrreso stpoue srmt areienavasabumirlepistiy nt gho afo tP fa HsrueC st.t aaIkinnedaneb etldoe, BA Drtahhan cure pisv reao nacdcah oreeth eorn health problems at bay, in order to guide against their occurrence in the first I eermeelaap ltitoinhvwd eiielnsyrpfe ’re.la den F sststs oar cubrushroceluetsu oogrihune n r s , pc tpe i hm nrsie v ub.sil n thteihmene tim izvoeaet nh craeaogrts ehtmhse are anntndhtd ao innvolves the use of therapeutics, including diagnostic and roles as active partners i inIcrm e thghpeaeraor dlovt hve(m eJereedagnlueltc d PaientH,i on uf u clthturiealth problems. As the saying goes, ‘pC2n0,, 0wt2i mrta)i.oative careo tely imh ‘i pcnIhrn,o dsdaailuvnscioidet pau tw’ raiolo i hathss vln,le , rhwetohdaueuts ece the burde iimr opwlicne qrh uhaoaenlldaiationd tls yt o of s haft onhsdreo r el cinpfo euo t no thheam tbs lmtui ftrc he tevunhh e ieea ntion is ta ilelrptseeh ao sdsphytlor e f,br aewgtititelher 6.3. pD hey alsa repovlg stainab oil iptyla auyotl efdv g itithbeaeesl pNtthhaieerg rte aerrclaioeamp ohmmfa esei. mn n t icularly inop oofr ttarnacdei terofolere a low l t nd stter aeva necclgcl otiohmrf d eue iootdwi ntthhral medicine vis-à-lizaeeadr teiiiont idnwo inegeasseltpn eemorcnuei sad mlimlcyeie dnidie vicias lm syedstiecmal opfl ucroamlimsmun: itthiees v. eHryo wcoenvceer,p tt hoef pPrHogCr apmromvied eins rscauetpnhtpeulrre imtehsea nn(t S cfu c oobmre tpdreia,td it1iit9oio9 n non2 fab )l.et rtmaDwdeueidteeiin oct niopna relaw cumetniaedtkideo irncr eeaasrln so s iyatnhnsetede mirisut s r wwaalseh aslicocreohcami asit etes( Oedwl lfsii tcshheiae , nsm2 c0fueu0c, n7htch) t.ed ioT irsnheterleuedrvse taa insac nnede tehsdau tst opit i rcdeieocsone,g rnvaienzsde, ammdoedddrieecrsansli nspgeer tvrhsieco enpsne eirsls oasn unmcehal jpoarrso ibsblseiurmteh s aurr iteasstetplefen.c dHiaanolltwys , ei onvbf rc aoe etrth nhn egee b e a rtm se, uswereoatn tl e m tsar yos osdern mre ft aeamsmn edwsd .h ipcFesa eld picluinrea lisshmo,u gldu , care must be takroyeernc th ihntioeas ttaraloicnscccta eelp,ci tzatahenn e ci s gdos keandi llyvo a lbs iable e and y blo oe ufctn i o u osPpeHedrC aa tsifo onar 98 or context ltguirz aaadlwitiziatoeiyon tn hoianefl JV ISooSulrN.n5 a82l,4 o22f02 1H-89e4 a1lt9h , M edicine and Nursing operati oAnn Ionfte rtnraatdioitniaol nPaeel r-mre v i e w e d J o u r n a l D O I : 1 0 . 7 1 7 6 / J H M N www.iiste.org 6.4. pMfreooomnp litethose r aidnnidgm edicine as part of the PHC programme due to variation of its practice across uaawcnnrcdfeoo celukdvn eaotdslfu fiatonhtr aeca ulture ieo tnhp ncnrsudoimo genruva o (M ae un&dla (fStl iutuvhabeet,ei sodionni,cs: ti 1aat9lhlm 9es2 ceci)neo. tnlaAlcla egppsasr.ie on c,o epfs rsPoper research would be required in this case, especially heneaglatghecdar ein dtehvee lopm m monEeeist)n m oi rtoa efb. Thrinaflegger e sns etcwa yrouandtae s (e oNe tfii nPtPe andvalhHuHeaCrtC iDao ba p nAsf fe) e oa n rifit i iHoondCcri ac tpdo caoidhc imetncaioktnit,io mhnrae aptwlr pehteaointc i hams nuwpddaa dcsse ttn ontlcohykte - ootparbr ksooiegvnrregvar emnwdi mghuhienct th.w i lI mhtt higocernh ai vdtpiourartariultnlagyl teshevece triMyo ns&sta Eog fep tdrhoeece empsrseo.d g Trnahemcisem swsea.i lrlCy ,ha areenlp dm aauts sctthe bret eas iatnam ke rs th eefnf n c t ie tmtchote o antp jrnuoongwcrta idoman ly the M&E process. ei v eaensnssueusrresin magn u mw lwteni,-si dt ahoips ncae irtxphtt leeif nrrcnaooarmuilt n yMtt rhay&en. dETm mhaeenux alnptgaie-etrsirtoesscn taasolhtr opivaurlailimrdtiy oaryd efficiency while improving strategy buianes 6.5. NafIimcniqgap t atteunen ritrcr o iioiea va .le mPdcor afomtiepnrmeancn musti rabi ltefsmu inne(gpandd , itir nueaggfnf sdii,c/s oi vervna ept and efd to makcrricyoni pngkee etrshy ,u e t fielicztaitvioe nu otifl ifzuantdiosn h aosf bfueonef ndq sua: a mslittaayjro voraf tc isaoeunrsv erice through the checks of tfhreeem a, sp paortsisciubllaer;l yg itvheons et hien gthene erruarlalyl ahr t vo theiegreaehhsm i.lc euEl vnef s esef ucce l)ro ,ao rttfiss ot s panm sf ffuouov s l efmt im r thayaeln sa p apol lto ehbwm ewe ermno tationd its iraamkdnepedr ls nt o da ortmtif PHicatirvoaaenck tefit e hCose.uf lpFtpirurnoongggd rfrsara momamrmme eienn .fae adeSidelpuqeerduec a iittaonel 6.6. vTCemeronanbdisenoczriiznsol guews da h aenosf df oio spir nettsyrc aplmutiecsuasl to hf omwoesvt eprr objee cmts aidne N aingder icah. e cks put in place, to ensure vot erht ,heh aiepnta r ltoothhgrRedcr aaefmrrue nmt ouSde tsim laiaozsr ateicIt vionoasTontte-t. Y Srcweaiilnttaehctg ei huge potentialslevel vo oetrhyfly e oycafo f anfhrofeeirad dbleatunhbscclieean r ieofo ounprtr s ooitdhvfe eiPd terahertesve afniomstr empmaianseligd lh yicoe iaafn vltPeah Hi slsaeCeblcl letieorn rs a Nncidnoig ntaoescr ticittaheu,se tse eip sbaprl oeegc gotirooaad llpm ybr omIuivtn eiV nd:te ehPg eacl etaaecErrnteeet ad f mN o obref ud plckieco oiovpnfele erw a swogerelhlk.ei fcrToshrh coiiessr srtheoevm asemcthipmeimnegse .oc hf aPrHacCte rini aezansensdd d mf blpeyexo nmip baualnlelapd,r r siawtocymot imcienetei smn,t ,h etehmsie rcaRy hn caayorr ameoc fmstY ettrurhainezteimetgdy i coboaUpylfel hyroa otppmeoe ersaai stst eieiodrtnvi nt.io ce erAca o(lntAnth tmovriuezbgnauhdtt eoa trnhismde aimRrn adeozn puesenmerljayo, t y2ito 0ohn1 it 4ghi)hes. 7Ththe.h eae la tSdhttiucasamicnruemms sdeaienorltnyi v otAefhr nuiytsd,s tfCghaoero anpplrclusio nN igeria, if oRnly thAey can be trained, legally incorporated and regulated as part of manner it was implemNentsree.od sbA,e lnoleLttnmhs o talhuineeIg doh B o vtiPhneHre ivrtC ishe lwapono cdosas.fl eiSNzspasi etgsiceotirrnfaii atcteno gc htihheeaseal lltNethhnai ggpt eeocsrloi iaacunnyld d:c PohsHnhavtoCeerxt catc onhomdan n ittgnheed p trhoeb lfeamces omfi lhiteaatlitnhgc agaNigeria were id are a innsdt BiartnhodtalvoeAto itcanhac ettc ehodDdeuu fndoote rbl itetvh Ar e eaenirdn y tipit fcoieoo i rcf en udphoal ,eil ra a an amrtliette dhdide cr isa e icn r cieono fetm o at mto thhtnehe ednda e f opNNraiitg t mge ieoenrrnalt ii a s Pam nnwere aHe Cpdsoei cosciyipnosle d-et ec vssmu e aclln,tal c uen e wrrnas dol wto sbnhilehce oeho c onohneva w.sev oreI t len h imb e dseatpie i tth s iun s nat uioe hges oonfe un t hhea nPdH, Can gs izn sre caonaedl c .ro n eaTgn b shendaei e zr pcle bedaegp sasettl ah, trra a krt d ihee d nc dp ehroroe r inegg toshe lfdsn g oe r , eiirt dawr ,meiso m anwtma y k hwe ai nnidn I faunndd einffgi caienndt phreoa parrogvu oeeas gdes oi tnofs htrevamping it, d REFietuEaltRtihoEcnaaNrleiCz iaEntS iNo p lntaeihg s roc aseafr ur imael pae. e du rdenvilcciisvhaieilon rnpgy l uviprniaas -dlNià s-itmgvoei srio sivap a.er orHhhpioaeguwrh lleiMynv ge&r ertE,c hot.eh m Ienerm nec teioinrsned gc ehlrduee saafitolo trnhn ei ,m esPdepHc rttooCov r r.ere emU-mvelitansiiimtnt isatnh t aeet hl yvp,ir aotbhgler e qua ea l imdttoyemo valee nl fodwop rui mttehief lifanze tavc ttaiiieonvwdne AAbbdioudaHlnrueadnah lsAettherJ.ma t(Me 2Ig0.a i1nSe0as.,g ) f.O.o ,P rl1a ae2ptni(ie1hpn)aot:n s A3‟c9 i.Sn -R5gat.4 it.ash fnead cu tAsieom nb oywd tiuht heM Qr.u uOraa.ll i2cty0o 1mA2mt.tPrurinbimiuttiaeerssy o hfealth care services in Nigeria: Critical issues AAlmenzoashttgt,rt hapJet.:e /na/gawni,ed ws IR w., a.azAarunpimgdjob , uiOrrecn.m oa2nlo0ssl.1tecr4noa.,mi nMA tse. dOi.c,ia nla bSeoijcmeigopallohegm, yCn it.na taionnd. IEntbeornreaitmioen,a PlE r.i m2Jao0ru1yr4 nH.a elP arlitmho afC ryar Ceh oeSamelrtmvhi uccneaistr yein iNnR igneeisgreieaa. J. A9f9ri ca. London: Springer rricah: Journal of Health, M AVI SoSulN.d5u 82,,4 22D021-.89T4 .1,9 O A end iIcninteer naantdio Nnaulr sPineegr - r e v jua, T.A iew e d J o u r n a l D O I : 1 0 . 7 1 7 6 / J H M N www.iiste.org AEmw Healthcare in NigErineoo,sP siBOr khuo ao.lIs ,.pL , eO.U cH.tcAseh..a e Al,t1 chO9a 9inswark Press d.A8e.m. ue , r r.iaai ,a nnIc .Jdc sRe hU eor, D.G., and Heaoltuhar se cnnshda ar oel m, co hIfa. onciolnBIona.gtg ey2e Hr 0dd um f1 iocs4a A.ar ebnB aiiutrniiie l,Nds Ciiangn.gAed r .aiS,a o.S2 cAo0i1al3 S. cIineenqcueasl ivtoy l.a3n, dN oC.1la6s,s 4 D5 ifference in Access to Jegedseo,c iAa.lS i.n e2q0u0a2l.i tyP.r oInb lIesmiusg haon-dA pbraospects r co ipfu lnhiinevaaerlrytsh iSctiateursed, i edcs lon iVdlnl e oHIglb ee3asad l(at6ahn)n dPC oahsreteg arSlayds tMemed i.n 2 0N0i5g;e3r:i4a:0 –C6h allenges and Lambino ,s oEc. io2l0o1g5y.. PLraimgoasr:y M haelatlhtohu csaer pe elivery in Nigeria t:h -isresulaetse di ni npsotliittuitciaoln se.c oInjeobmuy-O adned: NigerFaoinnaan ctutubPaeolsr oidpmkar)iyaRmr, ye8a trtrhyiHe Dhveeeeaadcllte thhm bcaCerrae, r 2eL0 e1cP5tu n:rr ieehrs eeosa, f Ll Uittihim.eeCs i.tN,,e cIdasht aiaomlnleaanhl g,P eArsi. mNana. rday n tdHh eeA awdlteahsy iC nFaao,r erJw .DOae.r dv(e.e dlAosp) pmCaeupnrertre Andtgesle ianvncedyr e p(dNe raPstpH tehCcetDi v1Aess)t Obioh1hRat8ot,tp://ww at the Shehu Musa Yar’Adua Centre, Wuse Zone 4, Abuja Oyibochm ha EJ,a .u EVlEy. .a,Oa l w2ln..e0,d p y1 , h I6M ot rL ianoe itluos a1o s yl1 .teceh: o ,,1 o M6 m.O aE / ..m co untrieosl/inciigese.r ia/(sTohceie tyL/nibigraerryia _soofc ieCtyo_npgrriemssa ryC_hoeuanlttrhy_ caSretu_d~i1e0s;0 06C.hIAtm l Wfororolmd S Gth.n 2o0 M11e.d F, 5unct n Stephaenunds tGFaiiinnllaaabnmlcee: H(IIseO atShlteRh c-DJaEreeFc l)Sa ,Vyr asSottiealoumgnmu aieon, f 5 NE A(.2iO (g)2e .)lmS,r : a i o Volum ia 7On:3 gi-Vnu8gin8s g ia(oin2dnd0e, 1 CS1–t)h r aaEltlesesgniiegense, s a nOodf. T PC.r,h imaElaldereynk giHe, se.JaI.OlEth.S RC& a JroOeu k(rPnoamHl eCo,) f OPErogramS.cLo.n o2Im01 iTci4ns. Y WSuHbeOddh eie1,av 9lJe7t.lh 1 e9 39326. Pprpi5m3a6r- ep.-Oct. 2014, PP 28-39 8oc.pa Pirnergi m bcaoernuyen fhtiretisea. ys 5 3lthJho 8eu arlnthacl aoref asnodc iomloegd iiAc ta still relevant to primary health care. Geneva, Worldcaa Hll epfaolluctrhua sOl.i srVmgao nel ixz2ea5mti op(nl4ifU,) i1es9dp7 e8icnN.i aNl eipssaIul :eV c:aa rhpeer?ao ElpBthoM saaJln,R df8o rhM emaalartcxhhicm a2rie0z i0ni8ng, ARYR N L IB DA IBA 100