Governance and Economic Impact of a Public-Private Partnership on Primary Healthcare (PHC) Revitalisation in Rural Nigeria
1
Aig-Imoukhuede Foundation, Abuja, Nigeria
Popul. Med. 2026;8(Supplement Supplement 1):
ABSTRACT
BACKGROUND:
The resilience of primary healthcare systems is a critical determinant of public health outcomes, particularly in low-resource settings where governance challenges and economic constraints often lead to systemic failure. In Edo State Nigeria, the Evbuodia PHC exemplified this crisis, with collapsed infrastructure, chronic medicine stock-outs, and minimal service utilisation prior to October 2024. This case study analyses the impact of the Adopt-a-Healthcare Facility Programme (ADHFP), a public-private partnership, on reversing this decline through a structured governance and financing model.
METHODS:
The intervention, implemented from October 2024, employed a multi-component approach: comprehensive facility renovation, guaranteed supply of essential commodities, healthcare worker training, and activation of a community-based Ward Development Committee to enhance oversight and demand generation. Programme effectiveness was evaluated using a pre-post analysis of routine Health Management Information System data from January 2024 to April 2025, tracking key performance indicators for maternal and child health services.
RESULTS:
The partnership yielded rapid and significant improvements. Antenatal care first visits increased from a pre-intervention maximum of 11 to 52 per month. Facility-based deliveries rose from zero to nine monthly. By April 2025, 104 women received complete malaria prophylaxis, 554 children were fully immunised in one month, and 298 children were protected by insecticidal nets. Critically, the facility recorded zero maternal and zero under-five deaths in the seven months following the intervention, demonstrating a direct impact on mortality reduction.
CONCLUSIONS:
The ADHFP model demonstrates that well-structured public-private partnerships can effectively address governance and financing gaps in primary healthcare. By aligning resource investment with community engagement and systemic oversight, this approach offers a replicable framework for rapidly strengthening health systems in resource-limited settings. The results underscore the potential of collaborative governance models to achieve tangible health outcomes and contribute to the broader discourse on sustainable health financing and effective public health governance.
The resilience of primary healthcare systems is a critical determinant of public health outcomes, particularly in low-resource settings where governance challenges and economic constraints often lead to systemic failure. In Edo State Nigeria, the Evbuodia PHC exemplified this crisis, with collapsed infrastructure, chronic medicine stock-outs, and minimal service utilisation prior to October 2024. This case study analyses the impact of the Adopt-a-Healthcare Facility Programme (ADHFP), a public-private partnership, on reversing this decline through a structured governance and financing model.
METHODS:
The intervention, implemented from October 2024, employed a multi-component approach: comprehensive facility renovation, guaranteed supply of essential commodities, healthcare worker training, and activation of a community-based Ward Development Committee to enhance oversight and demand generation. Programme effectiveness was evaluated using a pre-post analysis of routine Health Management Information System data from January 2024 to April 2025, tracking key performance indicators for maternal and child health services.
RESULTS:
The partnership yielded rapid and significant improvements. Antenatal care first visits increased from a pre-intervention maximum of 11 to 52 per month. Facility-based deliveries rose from zero to nine monthly. By April 2025, 104 women received complete malaria prophylaxis, 554 children were fully immunised in one month, and 298 children were protected by insecticidal nets. Critically, the facility recorded zero maternal and zero under-five deaths in the seven months following the intervention, demonstrating a direct impact on mortality reduction.
CONCLUSIONS:
The ADHFP model demonstrates that well-structured public-private partnerships can effectively address governance and financing gaps in primary healthcare. By aligning resource investment with community engagement and systemic oversight, this approach offers a replicable framework for rapidly strengthening health systems in resource-limited settings. The results underscore the potential of collaborative governance models to achieve tangible health outcomes and contribute to the broader discourse on sustainable health financing and effective public health governance.
| eISSN: | 2654-1459 |
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