How tertiary hospitals can strengthen primary health care in Nigeria

Page | 519 Implementing this proposal is not likely to be much of a challenge. Most tertiary hospitals are operated by the federal government, while in most cases PHC facilities are operated by local governments, sometimes with the support of their state governments. Local governments are typically weak (as state governments are in control of their revenue)4 and will likely welcome support from federal government-owned tertiary hospitals. In 1992, the Nigerian government made provision for federal support for PHC through the National PHC Development Agency.8 Federal support for PHC can be extended to include support through tertiary hospitals run by the federal government. Indeed, similar initiatives were implemented by the early generation of teaching hospitals in Nigeria, which operated rural PHC practices in order to expose their undergraduate and postgraduate trainees to real life PHC, and conducted health research in these communities while fulfilling an articulated social responsibility to rural communities.9 We believe these token initiatives can be formalised and scaled up to all tertiary hospitals in Nigeria.