The history of Public Health System in Nigeria is linked to two important periods in the country, namely: Colonial and Post-Colonial eras. These eras were marked by drastic changes in the approach to public health care delivery
The Colonial era marks the period from the early Sixteenth Century up to the time Nigeria had independence from colonial rule in 1960. A rudimentary but organized medical care was managed by Missionary Agencies around the coast of West Africa with their stations on the offshore islands such as the Canaries, Cape Verde, Fernando Po (Equatorial Guinea) and St. Thomas. In the early Nineteenth Century, these Missionary Agency owned health facilities expanded further into the interland with the establishment of hospitals in Lagos and Abeokuta (1895). During the same era, government organized health care facilities sprang up in Calabar (1898) and Military health facilities in Asaba (1888). The facility in Calabar (St. Margaret’s Hospital) provided the initial structures for the establishment of the University of Calabar Teaching Hospital (UCTH). With this humble beginning, these health care facilities transformed into West African Medical Services, Government/ Colonial Medical Services and became fully functional in the beginning of the Twentieth Century. In 1954, the creation of the Regions brought with it the Regional Medical Services, which remained operational through independence in 1960.
POST COLONIAL ERA
The Region-based health services in Nigeria were succeeded by the State Health Services domiciled in the State Ministries of Health in the created States (1967 and 1975). The Basic Health Services Scheme (1975 – 1980) was a major attainment in the Public Health sector in the country as it increases coverage, accessibility and utilization of health services, especially to the rural areas and peri-urban settlements. This was indeed, a great vision which predated the Alma-Ata Declaration on Primary Health Care, as a strategy to provide health care for all. The pit-fall of this Scheme was its focus on the provision of health facilities and training of health workers without giving much attention to community participation; inter-sectoral cooperation in planning and implementation; and utilization of appropriate technology, which are the mainstay of Primary Health Care. The herald of Primary Health Care (PHC) through a joint Conference on PHC sponsored by the World Health Organization (WHO) and the United Nations Children’s Fund (UNICEF) on the twelfth day of September, 1978 held in Alma-Ata, Russia recognized this innovative health strategy as a key to achieving a state of physical, mental and social well-being for all the people across the globe.
Nigeria, a member of the United Nations, keyed into this Declaration and in its National Health Policy, adopted in 1988, stated that the goal of the policy is to achieve a level of health that will enable all Nigerians to achieve socially and economically productive lives. The policy has as its objective the provision of access to primary, secondary and tertiary health care through a functional referral system. The policy which hinges on primary health care approach emphasizes measures aimed at prevention and promotion which are integrated with the treatment and rehabilitation in a multidisciplinary and multi-sectoral approach. Its thrust is also on equitable distribution of health and health resources down to the under-served and those at greater risk bearing in mind the rights of every citizen to participate individually and collectively in the planning and implementation of health services (individual and community participation).
reference: History of public health in nigeria by Dr. Inyang Ating (2021).