The Primary Health Care Under One Roof (PHCUOR) policy initiative of the Federal Government focuses on integrating the management of Nigeria’s Primary Health Care. This policy initiative was launched in partnership with development partners to overcome the fragmentation of the Primary Health Care system in Nigeria. The PHCUOR policy was approved by the National Council of Health in 2011 and has since been implemented in at least 30 states.

Key elements of the PHC Under One Roof policy include:

  • Principle of “three ones” (one management body, one plan and one monitoring and evaluation system).
  • Single management body with control over services and resources (human and financial).
  • Enabling legislative framework.
  • Decentralized authority, responsibility and accountability with appropriate span of control.
  • Integrated supportive supervisory system managed from a single source.
  • Integration of all PHC services under one authority.
  • Effective referral system between/across the different levels of care.

Recommendations for bringing primary health care under one roof in the context of integrating management of Nigeria’s Primary Health Care include:

  • Political will and commitment is essential.
  • Considerable time is needed – fragmentation is quick, integration is lengthy.
  • The devil is in the detail of implementation.
  • Working at the governance/ systems interface is key.

With the inauguration of the pioneer Governing Board of the Akwa Ibom State Health Development Agency in 2018, Akwa Ibom State commenced the implementation of Primary Healthcare Under One Roof in the State. AKSPHCDA is saddled with the responsibility of implementing this policy.