Partnership for State Primary Health Care Transformation in Nigeria: Formative Phase

Timeline: June 2015 – June 2016 | Status: Completed

Kaduna, Nasarawa and Niger States, Nigeria

Project Overview

Strong primary healthcare (PHC) systems are essential to achieving better health outcomes and expanding access to quality healthcare services. Recognising the need for comprehensive reforms at the state level, the Health Strategy and Delivery Foundation (HSDF), with support from the Bill & Melinda Gates Foundation, implemented the Partnership for State Primary Health Care Transformation in Nigeria: Formative Phase between June 2015 and June 2016.

The project served as the foundation for a long-term partnership aimed at transforming primary healthcare systems in Kaduna, Nasarawa, and Niger States. During this formative phase, HSDF worked closely with government stakeholders to assess existing PHC systems, identify operational and governance challenges, and establish the strategic direction for future reforms.

Through evidence generation, stakeholder engagement, and collaborative planning, the project developed a shared understanding of priority health system challenges and opportunities for strengthening governance, service delivery, accountability, and health system performance. The work undertaken during this phase informed subsequent large-scale interventions that supported sustainable improvements in primary healthcare across the partner states.

Many state primary healthcare systems faced systemic challenges, including fragmented governance structures, inconsistent service delivery, limited management capacity, and weak accountability mechanisms. Addressing these complex issues required a clear understanding of existing gaps and a coordinated strategy developed in partnership with government stakeholders.

There was a need for a structured assessment and planning process that would provide the evidence required to guide sustainable health system transformation.

HSDF collaborated with state governments and key health sector stakeholders to establish the foundation for comprehensive PHC transformation. The project focused on:

Conducting assessments of existing primary healthcare systems.
Engaging government leaders and health sector stakeholders to identify priorities.
Analysing governance, management, and service delivery challenges.
Developing evidence-based recommendations to guide health system reforms.
Establishing strategic partnerships and implementation frameworks for future interventions.