The Conceptualization And 実施 Of PHC In Nigeria
The Conceptualization and 実施 of 最初の／主要な Health Care (PHC) in Nigeria
Abstract最初の／主要な Health Care (PHC) is a grass-root 管理／経営 approach to 供給するing health care services to communities. Since 全世界の leaders published the the PHC 概念 in 1978, さまざまな countries have 達成するd さまざまな levels of 進歩 in 器具／実施するing the 戦略. This paper reviews the historical 概念s that have driven 最初の／主要な health care in Nigeria. 現在の 成果／努力s at 活力を回復させるing 最初の／主要な health care in Nigeria 含む the Midwives Service 計画／陰謀 (MSS), PHC Reviews, 国家の Health 管理／経営 （警察などへの）密告，告訴（状） System (NHMIS), and the Maternal Newborn and Child Health (MNCH) Week. In all, the 役割 of the people, 政府, and health 労働者s as 批判的な stakeholders needs to be 井戸／弁護士席 defined and 追求するd to maximize the 利益s of 最初の／主要な health care jamb expo system.
Introduction
After 全世界の leaders 宣言するd 国際連合’ “Health for All” 協議事項 in 1978, Nigeria 可決する・採択するd its 最初の／主要な health care (PHC) system and 受託するd universally to use the ヒース／荒れ地 care 管理／経営 approach to 会合，会う this lofty goal. The world will only become healthy when we 達成する Health for All- the developed and developing nations alike, the poor and the rich, the literate and the uneducated, old, and young and women, children, and the 年輩の. The 最初の／主要な health care system is a grass-root approach meant to 演説（する）／住所 the main health problems in the community, by 供給するing 予防の, curative and rehabilitative services (Gofin, 2005, Olise, 2012).
As defined in the Alma Ata 宣言, 最初の／主要な health care is the “必須の care based on practical, scientifically sound and socially 許容できる methods and 科学（工学）技術, made universally accessible to individuals and families in the community through their 十分な 参加, and at a cost that the community and country can afford to 持続する at every 行う／開催する／段階 of their 開発 in the spirit of self-依存 and self-決意” (世界保健機構, 2012).
The 原則s of 最初の／主要な health care 強調する the excellent value of the approach. These 原則s which 含む 必須の health care, community 参加, 公正，普通株主権, intersectoral 共同, and use of appropriate 科学（工学）技術 are the 運動ing 軍隊s behind the efficiency of 最初の／主要な health care as the hope of 達成するing 全世界の／万国共通の health ニュース報道. This means that 最初の／主要な health care is meant to 供給する services to people based on needs without geographical, social, or 財政上の 障壁s through their 関与 in the planning, 実施, and evaluation of health programme. It 暗示するs 製図／抽選 資源s from within and outside the health 部門 and 利用するing 科学（工学）技術s based on Waec Expo suitability.
The History and Conceptualization of the 最初の／主要な Health Care (PHC) in Nigeria
Nigeria 統合するd its 最初の／主要な healthcare as the 国家の Health 政策 of 1988 (FMOH, 2004). The PHC became a cornerstone of Nigeria’s health system as part of 成果／努力s geared に向かって 改善するing 公正，普通株主権 in 接近 and utilization of basic health services. Since then, 最初の／主要な health care in Nigeria has 発展させるd through さまざまな 行う／開催する／段階s of 開発. In 2005, 最初の／主要な health care 施設s （不足などを）補う over 85% of hea lth care 施設s in Nigeria (FMOH, 2010).
歴史的に, there were three major 試みる／企てるs at 発展させるing and 支えるing a community and people-oriented health system in Nigeria. The first 試みる／企てる occurred between 1975 and 1980. The 支点 of this period was the introduction of the Basic Health Services 計画／陰謀 (BHSS). The Basic Health Services 計画／陰謀 （機の）カム into 存在 in 1975 as an integral part of Nigeria’s Third 国家の 開発 計画（する） (1975 – 79) (Dungy, 1979, Adeyomo, 2005) and was structured along “basic health 部隊s” which consisted of 20 health clinics spread across each LGA, which were 支援するd-up by four (4) 最初の／主要な health care centres and supported by 動きやすい clinics serving an approximate 全住民 of 150,000 each. The drawback of this 試みる／企てる was the 非，不，無-関与 of 地元の communities who were the 受益者s of the services. This led to the 無（不）能 to 支える the 計画／陰謀 at the の近くに of the third 国家の 開発 計画（する） period. A second 試みる／企てる led by late Professor Olukoye 身代金-Kuti occurred between 1986 and 1992 (Kuti et al, 1991). This period characterized by the 開発 of model 最初の／主要な health care in fifty-two (52) 操縦する 地元の 政府 areas all of which were 器具／実施するing all eight 構成要素s of 最初の／主要な health care. A 重要な result of this 免除 was the attainment of 80% immunization ニュース報道 for fully immunized under-five children. Meticulous 使用／適用 of the 原則 of active community 参加 and 焦点（を合わせる） on 問題／発行するs relating to health systems 強化するing (HSS) was 責任がある
the success 記録，記録的な／記録するd.
The 国家の 最初の／主要な Healthcare 開発 機関 (NPHCDA) was 設立するd in 1992 and 先触れ（する）d the third 試みる／企てる to make basic healthcare accessible to the grassroots. During this period, which spanned through 2001, the 区 Health System (WHS) which 利用するs the 選挙（人）の 区 (with a 代表者／国会議員 councilor) as the basic 操作の 部隊 for 最初の／主要な health care 配達／演説／出産 was 学校／設けるd. This was in 返答 to the devolution of 最初の／主要な Healthcare to the 地元の 政府s by the then 軍の 政府. The 区 最小限 Health Care 一括 (WMHCP) which 輪郭（を描く）s a 始める，決める of cost-効果的な health 介入s with 重要な 衝撃 on morbidity and mortality was also developed. The 一括 took into cognizance the nation’s 重荷（を負わせる） of 病気, 現在の 傾向s in 病気 prevalence and 優先 病気s of 国家の importance. The 区 最小限 Health Care 一括 was developed within 状況 of the 区 Health System and 提携させるd with the millennium 開発 goal (MDG) 的s of Nigeria. To 運動 this new 政策 over five hundred model health 中心s were 設立するd across the nation by the 連邦の 政府 (NPHCDA, 2012). These 中心s served as a 支点 for the 設立 of the 区 Health System and the community 動員 as 区 開発 委員会s, which is 構成するd of selected community representa tives, were 設立するd around the model 最初の／主要な health care 中心s.
The 国家の 最初の／主要な Healthcare 開発 機関 (NPHCDA) was 設立するd in 1992 and 先触れ（する）d the third 試みる／企てる to make basic healthcare accessible to the grassroots. During this period, which spanned through 2001, the 区 Health System (WHS) which 利用するs the 選挙（人）の 区 (with a 代表者／国会議員 councilor) as the basic 操作の 部隊 for 最初の／主要な health care 配達／演説／出産 was 学校／設けるd. This was in 返答 to the devolution of 最初の／主要な Healthcare to the 地元の 政府s by the then 軍の 政府. The 区 最小限 Health Care 一括 (WMHCP) which 輪郭（を描く）s a 始める，決める of cost-効果的な health 介入s with 重要な 衝撃 on morbidity and mortality was also developed. The 一括 took into cognizance the nation’s 重荷（を負わせる） of 病気, 現在の 傾向s in 病気 prevalence and 優先 病気s of 国家の importance. The 区 最小限 Health Care 一括 was developed within 状況 of the 区 Health System and 提携させるd with the millennium 開発 goal (MDG) 的s of Nigeria. To 運動 this new 政策 over five hundred model health 中心s were 設立するd across the nation by the 連邦の 政府 (NPHCDA, 2012). These 中心s served as a 支点 for the 設立 of the 区 Health System and the community 動員 as 区 開発 委員会s, which is 構成するd of selected community representa tives, were 設立するd around the model 最初の／主要な health care 中心s.
While it was 論理（学）の that 最初の／主要な Healthcare, which is community oriented, be 設立するd around the tier of 政府 perceived to be closest to the people, the sudden devolution of 最初の／主要な health care to the 地元の 政府 areas may have had 消極的な 関わりあい／含蓄s on sustainability of 質 as that level of governance is also known to have the weakest technical capacity. Again, the 連邦の 政府’s 介入 by building model health 中心s for the 地元の 政府 areas, though 井戸／弁護士席-conceived, was paradoxical to the newly 始めるd 原則 of devolution of healthcare. While this 介入 may have been 維持できる under the unitary 軍の 独裁政治, its sustainability was challenged by the advent of 僕主主義 in 1999.
器具／実施するing 最初の／主要な Health Care (PHC) in Nigeria
The 広大な／多数の／重要な idea of grass-root health care 配達／演説／出産 as encapsulated in the 原則s of 最初の／主要な health care 要求するs the strong かかわり合い of all stakeholders to make it work.
Stakeholders are those persons or groups that have personal 火刑／賭ける in the 配達／演説／出産 of 最初の／主要な healthcare services and in healthcare 決定／判定勝ち（する）s (AHRQ, 2014). The 重要な 最初の／主要な health care 火刑／賭ける 支えるもの／所有者s 含む the people, the 政府, and the healthcare 労働者s. The people need to own 最初の／主要な health care th rough 適する community 動員. Community 動員 is the 過程 of 誘発するing the 利益／興味 of the people and encouraging them to 参加する 活発に in finding 解答s to their problems (Olise, 2012). When the communities engage in the planning, 実施, and evaluation of 最初の／主要な healthcare services, they will not perceive them as 軍隊d 決定／判定勝ち（する）s. Community 動員 is a veritable 道具 for engendering support for 最初の／主要な health care, 特に in the 田舎の areas where over 66% of the Nigerian 全住民 live. 田舎の areas have the worst health indices, findings 示す (NPC and ICF 大型の, 2009; FMOH, 2010). 面s of community 動員 含む community 入ること／参加（者）, community 対話, and 操作／手術 of 開発 and health 委員会s. 政府 at all levels must 表明する, in practical 条件, political かかわり合い through 基金ing, capacity building and system support. They must put money where their mouth is and translate the 広大な／多数の／重要な ideas behind 最初の／主要な health care into 広大な／多数の／重要な programmers and 広大な／多数の／重要な services. 最初の／主要な health care services are not third-class services meant for third-class 国民s. Therefore, 適する 準備／条項 must be made in 国家の, 明言する／公表する, and 地元の 予算s for 質 healthcare 配達／演説／出産 using the 最初の／主要な healthcare system. The 役割 of 政府 is 批判的な in 促進するing 接近 to 必須の and 質 health services (FMOH, 2010). This can be channeled through the building and 維持／整備 of 組織／基盤／下部構造, training and retraining of the 全労働人口, and 準備／条項 of 構成要素s and 器具／備品 for 効果的な health care.
Health care 労働者s 伴う／関わるd in 最初の／主要な healthcare 配達／演説／出産 in Nigeria 含む doctors, nurses/midwives, community health 労働者s, 研究室／実験室 scientists/専門家技術者s, and health assistants の中で others (Africa Health 全労働人口 観測所 AHWO, 2008). To make 最初の／主要な health care work, 労働者s need to 与える／捧げる their 割当 to 改善するing 質 service 配達／演説／出産 and 達成するing （弁護士の）依頼人s’ satisfaction. This they can do through innovative utilization of 利用できる 資源s, encouraging 患者 参加 in their care, and 促進するing healthcare 労働者-患者 communication (Babatunde et al, 2013). The disposition of healthcare 労働者s is 特に important in 高めるing public perception and utilization of 最初の／主要な health care services. かかわり合い to 義務, empathy, and a listening ear are 望ましい traits in 最初の／主要な health care 労働者s that can 高める service 配達／演説／出産.
器具／実施するing 最初の／主要な Health Care (PHC) in Nigeria
The 広大な／多数の／重要な idea of grass-root health care 配達／演説／出産 as encapsulated in the 原則s of 最初の／主要な health care 要求するs the strong かかわり合い of all stakeholders to make it work.
Stakeholders are those persons or groups that have personal 火刑／賭ける in the 配達／演説／出産 of 最初の／主要な healthcare services and in healthcare 決定／判定勝ち（する）s (AHRQ, 2014). The 重要な 最初の／主要な health care 火刑／賭ける 支えるもの／所有者s 含む the people, the 政府, and the healthcare 労働者s. The people need to own 最初の／主要な health care th rough 適する community 動員. Community 動員 is the 過程 of 誘発するing the 利益／興味 of the people and encouraging them to 参加する 活発に in finding 解答s to their problems (Olise, 2012). When the communities engage in the planning, 実施, and evaluation of 最初の／主要な healthcare services, they will not perceive them as 軍隊d 決定／判定勝ち（する）s. Community 動員 is a veritable 道具 for engendering support for 最初の／主要な health care, 特に in the 田舎の areas where over 66% of the Nigerian 全住民 live. 田舎の areas have the worst health indices, findings 示す (NPC and ICF 大型の, 2009; FMOH, 2010). 面s of community 動員 含む community 入ること／参加（者）, community 対話, and 操作／手術 of 開発 and health 委員会s. 政府 at all levels must 表明する, in practical 条件, political かかわり合い through 基金ing, capacity building and system support. They must put money where their mouth is and translate the 広大な／多数の／重要な ideas behind 最初の／主要な health care into 広大な／多数の／重要な programmers and 広大な／多数の／重要な services. 最初の／主要な health care services are not third-class services meant for third-class 国民s. Therefore, 適する 準備／条項 must be made in 国家の, 明言する／公表する, and 地元の 予算s for 質 healthcare 配達／演説／出産 using the 最初の／主要な healthcare system. The 役割 of 政府 is 批判的な in 促進するing 接近 to 必須の and 質 health services (FMOH, 2010). This can be channeled through the building and 維持／整備 of 組織／基盤／下部構造, training and retraining of the 全労働人口, and 準備／条項 of 構成要素s and 器具／備品 for 効果的な health care.
Health care 労働者s 伴う／関わるd in 最初の／主要な healthcare 配達／演説／出産 in Nigeria 含む doctors, nurses/midwives, community health 労働者s, 研究室／実験室 scientists/専門家技術者s, and health assistants の中で others (Africa Health 全労働人口 観測所 AHWO, 2008). To make 最初の／主要な health care work, 労働者s need to 与える／捧げる their 割当 to 改善するing 質 service 配達／演説／出産 and 達成するing （弁護士の）依頼人s’ satisfaction. This they can do through innovative utilization of 利用できる 資源s, encouraging 患者 参加 in their care, and 促進するing healthcare 労働者-患者 communication (Babatunde et al, 2013). The disposition of healthcare 労働者s is 特に important in 高めるing public perception and utilization of 最初の／主要な health care services. かかわり合い to 義務, empathy, and a listening ear are 望ましい traits in 最初の／主要な health care 労働者s that can 高める service 配達／演説／出産.
結論
The 概念 of 最初の／主要な health care is still 関連した to 達成するing equitable and 質 health care for all Nigerians. However, a 執拗な 成果／努力 at 実施 at all levels is necessary to maximize the 利益s of this people-oriented approach to health care.
The 概念 of 最初の／主要な health care is still 関連した to 達成するing equitable and 質 health care for all Nigerians. However, a 執拗な 成果／努力 at 実施 at all levels is necessary to maximize the 利益s of this people-oriented approach to health care.
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