The report provides an in-depth and systemic review of the implementation of the Basic Health Care Provision Fund (BHCPF), compliance of the states with the National Health Act and National Health Policy, and a ranking of health system performance reveals the state of primary healthcare delivery across the 36 states and the Federal Capital Territory. 


The research also includes recommendations for how state governments should strengthen their fragile health systems, enhance the existing implementation of the BHCPF, and raise strategic and operational planning for health in order to promote access to and utilization of primary healthcare services.


In 2014, the National Health Act established the Basic Health Care Provision Fund (BHCPF) to address funding gaps hampering effective primary healthcare delivery across the country. The BHCPF comprises 1 percent of the Nigerian government Consolidated Revenue Fund (CRF) and additional contributions from other funding sources. It is designed to support the effective delivery of Primary Healthcare services, provision of a Basic Minimum Package of Health Services (BMPHS), and Emergency Medical Treatment (EMT) to all Nigerians. 


Despite the provisions of the BHCPF, the report’s findings expose the precarious state of healthcare in Nigeria, where access to and utilization of health services continues to be marred by systemic challenges across the states.


“The public health facilities in all 36 states and the FCT are deficient, and the experiences of community members seeking health care at public facilities are consistently awful,” the report read in part.


“The Basic Health Care Provision Fund (BHCPF) was poorly implemented in 13 states. Zamfara is the most difficult state in Nigeria to access primary healthcare. 


“The basic causes of Nigeria’s deteriorating health care system are the country’s weak governance structures and operational inefficiencies.”


The report ranks Federal Capital Territory, Enugu and Anambra as the top performing states in primary healthcare service delivery among the lot. 


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