Opinion
Mobilising Community Participation To Strengthen PHC Delivery
Community participation is a cornerstone of effective primary healthcare delivery. By actively involving communities in health planning and implementation, we can create more responsive and sustainable healthcare systems that truly meet the needs of the people. The Alma-Ata Declaration, adopted in 1978 at the International Conference on Primary Health Care (PHC) in Alma-Ata (now Almaty, Kazakhstan), was a landmark global health policy that emphasised Primary Health Care as the key to achieving “Health for All” by the year 2000. Key highlights of the declaration are:
· recognises health as a fundamental human right,
· defined Primary Health Care (PHC) as essential, community-based, and universally accessible healthcare,
· stressed importance of intersectoral collaboration, including education, agriculture, and social services, in achieving health goals,
· called for government action, international cooperation, and community participation in strengthening PHC.
The 1978 declaration underscored that health care should be accessible, affordable, and involve the community in planning and implementation.
Specifically, VII.5 of the declaration states that “primary health care requires and promotes maximum community and individual self-reliance and participation in the planning, organisation, operation and control of primary health care, making fullest use of local, national and other available resources; and to this end develops through appropriate education the ability of communities to participate.” This.” Thisately aims to create more effective, sustainable, and culturally appropriate health care delivery systems.
The World Health Organisation (WHO) defines community participation “as a process by which people are enabled to become actively and genuinely involved in defining the issues of concern to them, in making decisions about factors that affect their lives, in formulating and implementing policies, in planning, developing and delivering services and in taking action to achieve change.” In Nigeria, the Nigerian National Health Policy and the Sustainable Community Engagement Strategy highlight the importance of community participation in PHC delivery. These documents outline strategies that support communities in health planning, management, and monitoring.
Over the years, the Nigerian government has continued to design impactful community programmes aimed at strengthening primary health-care delivery in the country. Examples of these include:
· The Community Health Workers (CHWs) Program (1978 – present): This initiative was introduced to bridge the gap in healthcare provision, particularly in rural and underserved areas. Community Health Workers (CHWs) were trained to provide basic health services, conduct health education and immunisations, and help manage common diseases, including malaria, diarrhoea, and respiratory infections. Community engagement with CHWs has resulted in a 50 percent increase in family planning service uptake and expanded access to other primary health care services, including maternal and child health services, and chronic disease management.
· Community Influencers, Promoters, and Services (CHIPS) Program (2018 – Present): The CHIPS Programme focuses on enhancing community health participation by training community health influencers and promoters to deliver health education, promote healthy behaviours, and assist communities to access essential health services. CHIPS workers, often members of the local communities, are deployed to engage with the communities, conduct health outreaches, facilitate health campaigns, and promote family planning, immunisations, and maternal health. CHIPS agents have effectively promoted healthy behaviours and facilitated access to essential health services, leading to improved health indicators.
· COVID-19 Community Response and Health Education (2020 – 2022): In Nigeria’s response to the COVID-19 pandemic, community participation played a vital role in the public health response. Community health workers (CHWs) were mobilised to provide health education, assist in contact tracing, and distribute COVID-19 preventive materials. Local community leaders, religious groups, and influencers helped spread vital information regarding the COVID-19 pandemic, including safety measures like mask-wearing, social distancing, and hand hygiene.
· Strengthening Community Engagement and Accountability for PHC (SCEAP) Project (2021 – present): Implemented by BudgIT Foundation with support from the Bill and Melinda Gates Foundation (BMGF), this project aims to improve primary healthcare delivery through community-led advocacy and monitoring, and empowering community actors to promote transparency and improve healthcare facilities and services.
The collaborative partnership between the community-based organisations, stakeholders, village heads/representatives, WDCs, women leaders, facility in-charges, and community members has proven instrumental in addressing healthcare challenges and enhancing service delivery. There is also an increase in service utilisation at the PHCs, which is evident in increased patient turnouts that have been observed since the start of SCEAP, with a 55 percent increase in the number of participants visiting the PHCs weekly and a 30 percent increase in the monthly visits to the facilities. Additionally, there has been a 70 percent increase in outpatient consultation and antenatal care services in most facilities.
· Ward Development Committees (WDCs) and Village Development Committees (VDCs) (2001): were created as community structures to support planning and monitoring of health care services. These community structures have facilitated community involvement in healthcare decision-making, leading to more tailored and accepted health interventions, and enhanced monitoring of health services, which has contributed to improved accountability and service delivery.
. Basic Healthcare Provision Fund (BHCPF) (2019 – present): This is a funding mechanism designed to provide financial support to primary healthcare centres across Nigeria. It aims to improve the quality and accessibility of PHC services by ensuring adequate funding for essential health services, including immunisation, maternal and child health, and disease surveillance.
The establishment of the BHCPF has enhanced accountability in fund utilisation, thereby improving the management and delivery of PHC services. The BHCPF has also improved access to basic healthcare services, especially for vulnerable groups such as women of childbearing age and children under five years of age. A study found that most patients (98.2%) were satisfied with service delivery, which influenced patient utilisation of PHC facilities.
The Aig-Imoukhuede Foundation recognises the critical roles that community structures like the CHIPS and WDCs play to ensure effective delivery of PHC to communities. As a result, we are taking clear steps to support government interventions and improve community participation for PHCs through our Adopt-a-Health Facility Programme (ADHFP), which aims to strengthen PHC systems, improve service delivery, and enhance community engagement.
These steps include:
1. Providing periodically structured training programmes to WDC members to strengthen their leadership and governance capacities.
2. Support existing structures for multi-stakeholder review and engagement meetings between WDCs, local government health authorities, and community stakeholders.
3. Strengthen mechanisms between communities, WDCs and PHC workers.
4. Advocatetee private sector involvement in strengthening community structures to improve PHC.
By strengthening community-based structures like the WDCs to improve primary healthcare service delivery, we envisage:
1. WDCs will be better equipped to co-design, track progress, and monitor the implementation of programme work plans, mobilise resources for community initiatives, and oversee the activities of community health workers. This will improve transparency and oversight and can lead to better outcomes at PHCs.
2. These activities will engender a culture of continuous improvement because community concerns and health priorities can be addressed promptly, improving service delivery and patient experience.
3. Trust between communities and healthcare workers will be improved, and this can lead to an increase in service utilisation.
4. Funding and resource availability for healthcare programmes is expanded as community members can advocate and raise funds for primary health programmes.
Businessday.ng
By Ismail Omipidan
The return of Governor Siminalayi Fubara after the expiration of the six-month emergency rule has been widely applauded by many Nigerians. To avoid any unguarded utterances, the governor, on his return to the state, appeared to tactfully distance himself from his army of supporters who had thronged the Rivers State Government House on Thursday. Instead, he showed up yesterday, and promptly delivered a statewide broadcast to the people of the state.
Before his return, there were concerns over the details of the peace deal that paved the way for his reinstatement. While some argued that he would serve only one term, others insist that the arrangement heavily favours his estranged godfather and current FCT Minister, Nyesom Wike.
Wike was on Politics Today with Seun Okinbaloye on Thursday. He declined to reveal details of the peace deal. But any peace deal whose terms remain shrouded in secrecy cannot, in my view, be regarded as fair or just. I stand to be corrected.
For now, it appears that only Wike, Fubara, and perhaps President Bola Ahmed Tinubu know the exact contents of the peace deal or understanding.
However, as a trained political communication specialist, I find that Fubara’s statewide broadcast offers a glimpse into parts of the agreement. This is particularly evident in paragraph 10 of his speech, where he stated: “To those who have expressed genuine fears, frustrations, and uncertainty over the nature of the peace process, I assure you that your concerns are valid and understood.” In essence, the governor acknowledged that the public’s fears and doubts about the peace deal are not unfounded. By validating these concerns and admitting that he understands them, Fubara tacitly concedes that there are indeed contentious aspects of the arrangement.
The governor was, however, quick to add that “nothing has been irretrievably lost; there remains ample opportunity for necessary adjustments, continued reconciliation, and inclusiveness.” My understanding of these lines are these: One, even if there is a clause for now in that peace deal that would prevent him from seeking a second term, his good behaviour and willingness to play ball, going forward may make change their minds, thereby adjusting the peace deal to allow him seek a second term. Two, certain things that he was not too pleased with could equally be adjusted as time goes by, once he showed genuine reconciliation efforts. And by shunning the crowd on Thursday, the governor appears to be ready for a genuine reconciliation.
For me, the only reason Fubara may be willing to fight again is if, after abiding religiously by the terms of the peace deal without reservations, he is still denied a second-term bid.
Already, he has been stripped of critical levers of power: he has no control over the local governments in the state, he is not in charge of the House of Assembly, and, if the feelers I’m getting are anything to go by, he is unlikely to be in full control of his cabinet either. Having been politically weakened on all fronts, it would be unwise and indeed provocative to further deny him a re-election ticket. In our recent political history, the only governor who was denied a second-term ticket on the basis of non-performance was Chinwoke Mbadinuju of Anambra State under the PDP in 2003. So far, no one can say Fubara hasn’t performed, as such, non performance cannot be adduced as a reason should they decide to strike. My point is, if they do, as being planned, it will be on the basis of politics, a development that may trigger another round of political unrest in the state.
With the benefit of hindsight, Fubara would have already seen the end of Wike’s dominance in Rivers politics, if not for Wike’s current status as a minister, backed firmly by the very man who appointed him.
By Kola Odepeju
I doubt if Shola Fasure will ever cease to amuse the people in his blind defense of his paymaster, Ogbeni Rauf Aregbesola who was recently described as “Asín ti kò mò pé òhun n rùn” (the shrew that doesn’t know that it smells) by governor Adeleke of Osun for verbally attacking his benefactor, PBAT. But little can one be surprised about Fasure’s blind defense of his boss because he must justify his earnings and secondly, since he himself lacks integrity, it’s easy for him to always come out to come up with drivels in the name of defending his boss.
Fasure’s continued attempts to distort history only shows that he’s either a poor student of history or he’s simply being mischievous. But I like to believe more in the latter being in his DNA. Just like the leopard that doesn’t change its spots, so will a person given to mischief comes out regularly to ply his/her trade. This is the case with Fasure who himself doesn’t believe his own stories with respect to Tinubu/Aregbesola political relationship. Fasure has been trying so hard to distort history though; misinforming the public that Aregbesola is the one that made Tinubu but not vice-versa, he subjects himself to ridicule each time he comes out to turn history upside down and to do surgery to the already battered image of his boss.
One of Nigeria’s veteran journalists, Mayor Akinpelu came out recently to call a spade a spade by telling the public the truths about Aregbesola/Tinubu political relationship. Of course his narration wasn’t in any way different from what the general public had already known before about Aregbesola and his relationship with Tinubu. There was no addition or subtraction in what Mayor Akinpelu said about Aregbesola. All what he said about him are nothing but the truth. No attempt did he make – in the least – either to blackmail Aregbesola or tarnish his image. So my question is; when has saying the truth become an offense under the sky for Fasure to now come out again from his shell and be attacking Akinpelu, an apolitical person who was just doing his job as a social commentator?
Like Akinpelu said in his article, was Aregbesola not scruffy looking prior to his being catapulted by Tinubu? Wasn’t he a pauper before his path crossed with that of Tinubu? Was his usual and regular wear then not Jalamia? Wasn’t his car rickety and smoky like a locomotive? The point is that Aregbesola was a complete pauper before he met Tinubu, a fact known to so many people – except only Fasure – and a fact Aregbesola himself testified to in some occasions; that it was Tinubu that God used to uplift him. I recall here that Aregbesola said in one of our media meetings with him at the State House in Osogbo when he was governor that “if l had not met Tinubu, l would have also still be struggling like you people by now”.
Ogbeni Aregbesola had also said in a video which is in public domain that after God, he owes whatever he’s today to Tinubu. So only God knows where Fasure conjures his own side of the story from which l see as only tales by moonlight different from reality. His story can only be believed by fools and accepted by idiots.
Comparing Aregbesola’s case with that of Yemi Osibajo, Babafemi Ojudu and other names he mentioned in his write-up is preposterous and doesn’t align with common sense in the least. One, these are people who had recorded appreciable successes in their chosen careers and living comfortably before their paths crossed with Tinubu. They were accomplished professionals on their own as at the time their political relationships with Tinubu started; unlike Aregbesola who was a nobody by the time he met Tinubu. I say this without any fear of contradiction because l was on ground at Cresta Laurel where these people served on the transition committees set up by Tinubu then as the governor-elect.
Two, even though these people may have at one time or the other had disagreements with Tinubu, did they ever insult Tinubu as Aregbesola did? Did they display insolence to Tinubu like Rauf? Disagreements are normal in politics but attacking your God-sent benefactor is the most unwise and stupid thing to do by anybody. This is where Shola Fasure’s boss disappointed many of his admirers including this writer.
In conclusion, Shola Fasure in his warped thinking opined that “Batists have slavery in their DNA”. This, to me, is a fallacious opinion of a mind filled with ingratitude. Rather than proving Mayor Akinpelu wrong with evidence about what he (Akinpelu) said about Aregbesola, Fasure was busy attacking him and calling Batists names.
This is a fallacy of ad hominem. Of course Fasure cannot pretend not to know that politics is about hundred percent loyalty. It’s either you’re completely loyal or you take the exit door. Batists are loyal to Tinubu because he deserves it as he has proven to be a reliable and dependable leader. But if Fasure in his wrong perception of Batists as having slavish mentality in their DNA still holds on to this fallacy, then they’re by far better than Aregbesola’s followers who have ingratitude in their DNA just like their leader.
● Odepeju, newspaper columnist and political activist writes from Lagos.
The Christ Apostolic Church (CAC) has issued a strong rebuttal to comments made by Pastor Biodun Fatoyinbo regarding the life and ministry of its first General Evangelist, Apostle Joseph Ayo Babalola.
In a statement signed by Pastor Ade Alawode, Director of Publicity, CAC, the church said it was “necessary to address your recent statements… for the following three reasons: Scriptural Justification… Clarification of Truth… Defense of Legacy.”
The statement was in response to Fatoyinbo’s viral message in which he reportedly acknowledged that Apostle Babalola was highly anointed but “had no money” and went on to ask sarcastically, “Where are his children?”
Click link to read CAC’s Full Statement
Dear Pastor Biodun Fatoyinbo,
Greetings to you in the Name of our Lord and Saviour, Jesus Christ.
Ordinarily, we do not respond to social media commentaries or controversies. However, we consider it necessary to address your recent statements, which have been widely circulated on your social media platforms, for the following three reasons:
1. Scriptural Justification — The Bible permits us to respond wisely to folly to prevent arrogance (Proverbs 26:5).
2. Clarification of Truth — To correct the misleading narrative you are promoting about ministry and wealth.
3. Defense of Legacy — To address the inaccurate claims you’ve made regarding the life and ministry of Apostle Joseph Ayo Babalola, the first General Evangelist of Christ Apostolic Church.
In one of your trending messages on YouTube, you acknowledged that Apostle Babalola was highly anointed but “had no money”, and then went on to ask sarcastically, “Where are his children?” — a question that was both insensitive and ill-informed.
To equate anointing or ministerial success with material wealth is biblically flawed. The words of Jesus are clear:
“Take heed and beware of covetousness, for one’s life does not consist in the abundance of the things he possesses.” — Luke 12:15.
Yet, your teachings suggest otherwise.
In doing so, you promote what the Bible refers to as Simony — the monetization of spiritual gifts (Acts 8:18–24). The Scriptures do not teach that money is a sign of anointing. Rather, “the love of money is the root of all kinds of evil” (1 Timothy 6:10). Which Bible do you read and preach from?
On the Question of Apostle Babalola’s Children
Ethically speaking, Apostle Babalola had children. Simple arithmetic should help you understand that they would be advanced in age by now — possibly your grandparents’ age. What did you hope to achieve with the mocking question, “Where are the children of Babalola?”
Your statement reflects more on the kind of company you keep, but as a preacher of the Word, shouldn’t your conduct and utterances be guided by Scripture?
Where in the Bible does your brand of prosperity theology originate — one that demeans people for not being wealthy? Isn’t such a message encouraging greed, corruption, and godlessness, especially in a nation already struggling with moral decay?
Setting the Record Straight
For the sake of truth and posterity, let me correct the public misrepresentations you’ve made regarding Apostle Joseph Ayo Babalola:
1. Calling
Apostle Babalola was called by God on October 10, 1928, at the age of 24. His ministry spanned Western and Midwestern Nigeria, and extended to the Gold Coast (now Ghana), marked by undeniable signs and wonders.
2. Wealth and Lifestyle
He was blessed — but not materialistic or greedy. He gave lands to the Church, supported the education of many, fed the poor, and lived sacrificially. He housed more people than just his biological children.
When Queen Elizabeth II visited Nigeria in February 1956, Apostle Babalola was among the honored guests. Would a man in rags be granted such recognition by a colonial government? Certainly not.
He was no fundraiser, yet God supplied his needs. His diaries are filled with divine provisions like: “Ipese Olorun loni: £100.00, £50.00…”
He lived in a befitting home, drove one of the best Ford Jeeps of his time, and funded weddings, education, and apprenticeship programs — all without exploiting the pulpit.
3. Family
His children — Mama Eunice Wuraola Ogini and Apeke Adeniyi — are alive, blessed, fulfilled, and quietly serving the Lord in their respective churches. They are not loud, ostentatious, or greedy.
4. Legacy
Apostle Babalola’s anointing impacted generations. More than 66 years after his passing, his legacy continues to inspire and bless countless lives and ministries. That is true impact.
Let me pose a question to you:
When Peter said in Acts 3:6, “Silver and gold I do not have…” — was he still anointed or not?
I leave that for you to ponder.
5. Conclusion
The measure of a believer’s anointing is not in material accumulation, but in sacrificial service.
“For the Kingdom of God is not eating and drinking, but righteousness and peace and joy in the Holy Spirit.” — Romans 14:17.
Jesus taught:
“Whoever desires to be great among you, let him be your servant… just as the Son of Man did not come to be served, but to serve.” — Matthew 20:25–28.
Once again,
“Take heed and beware of covetousness, for one’s life does not consist in the abundance of the things he possesses.” — Luke 12:15.
May God give us all the grace to rightly divide the Word of Truth, and to walk in humility, reverence, and godly wisdom.
Pastor Ade ALAWODE (Director of Publicity, Christ Apostolic Church)
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