Policy Brief on Primary Healthcare Under One Roof (PHCUOR) in Kano State


The concerted efforts to achieve primary healthcare under one roof is an idea to realizing universal health coverage to ensure that basic care is delivered to everyone including the underserved and socially excluded groups.

In line with national guidelines, Kano State has established the State Primary Healthcare Management Board (PHCMB) in 2012 and was assigned a management structure to coordinate all primary healthcare services across the 44 Local Government Areas as stipulated by the guideline.

Current Status

The Primary Healthcare Management Board has created few structures from the guideline at zonal and LGA levels with a functional management body at state headquarters, key positions are filled with relevant personnel, but the lack of budgetary releases has undermined the status of the board. Its operation is limited due to inability of the State Ministry for Local Government to transfer its personnel and operational cost to the board.

Key Achievements

Despite challenging take-off during the inception period, the board has achieved tremendous result such as adoption of various national policies and guidelines. This include:-

  • Establishment of Primary Healthcare Board through domestication of the national policy;
  • Adoption and approval by the State Executive Council of the Minimum service package in 2018;
  • Adoption of the task shifting and sharing policy document in 2017; and
  • The ongoing review of PHC law

Rationale for Advocacy

The major concerns of the SPHCMB is meeting the national guideline on primary healthcare under one roof is connected to lack of personnel cost and other operational costs which is still domiciled under the MFLG and there is no governing board at the moment.

Although KNSG has complied with OAU Abuja declaration by allocating 15.3% of its 2019 to the health sector but the release of the budgetary allocation is still an issue.

PHCUOR constitutes so many focus areas thus its implementation includes but not limited to infrastructure, personnel, basic equipment, drugs/medical supplies and other interventions etc which will ensure the implementation of MSP and TSTS policies

Majority of the SPHCMB personnel are not direct staff of the board; hence it has no autonomy for reward, punishment or discipline. Managing staff of a third-party organization hinders the operation of the PHCMB in Kano state.

Thus, the need to proactively champion a reform becomes very paramount to ensure that the board achieves the national benchmark of Primary Healthcare under One Roof.

Benefits of the PHC under One Roof

Public Health Benefits

  • Effective service delivery at the grass-root level
  • Data Harmonization from different sources could lead to better decision making in the state’s health sector
  • Integrated HRH system for efficiency in service delivery
  • Facilitate the attainment of the universal health coverage in Kano state.
  • Effective referral system that will ensure decongestion of the higher levels of health care

Socio-political Benefits

  • Improved human development index for the state
  • A healthy population that could add value to the state’s socio-economic development

Effective public health system at the grass-root level will reduce general health care spending and thus, other state critical health infrastructural needs can be met.

The Kano PAS Advocacy Coalition

This Policy Brief is a product of the Kano State PAS Advocacy Project.

The Partnership for Advocacy in Child and Family Health at Scale (PACFaH@Scale) project Nigeria, referred to as PAS is a health advocacy project anchored by the Nigeria non-profit, the dRPC and implemented directly by local NGOs and health professional associations. The project is not service delivery and it is not awareness creation. Its focus is limited to evidence-based advocacy.  The project’s timeline is 2018 to 2022 and the issue areas of the project are: Routine Immunization, Family Planning, Child Killer Diseases, and Primary Health Care Under One Roof. Focal states of the project are Anambra, Enugu, Kaduna, Kano, Niger, Rivers, Taraba and Lagos States.

In Kano State, the PAS Advocacy Coalition is made up of various civil society organisations led by Medical Women Association (MWAN), Women in Media Communication Initiative (WIM), National Association of Nurses and Mid-wives Kano State Branch (NANNM), Federation of Muslim Women Association of Nigeria (FOMWAN), Kano Emirate Council Committee on Health & Human Development (KECCoHD), Society of Gynaecologists and Obstetricians in Nigeria (SOGON), The Challenge Initiative (TCI), Accountability Mechanism for Maternal and Child health in Kano State (AMMKaS), Youth Environmental Development Association (YEDA) and Facility Health Committee Alliance (FHCA)