Catalyzing community ownership and engagement for functional primary healthcare facilities in Nigeria

TY - JOUR

T1 - Catalyzing community ownership and engagement for functional primary healthcare facilities in Nigeria

AU - Mbaegbu, Casmir C.

AU - Agwu, Prince

AU - Etiaba, Enyi

AU - Onwujekwe, Obinna

N1 - Publisher Copyright: © The Author(s) 2025.

PY - 2025/7/3

Y1 - 2025/7/3

N2 - Introduction: Community Ownership and Engagement (COE) foster the functionality of primary healthcare (PHC), reflecting the value community members place on their health. The extent to which COE is successful is predicated on ‘whole-of-community’ (WoC) strategies, which are nuanced and unique to diverse settings. Compilation of feasible and operational WoC strategies that catalyse and sustain the functionality of PHC facilities, especially in resource-constrained contexts, is vital for enhancing community health system. Methods: Relying on the phenomenological research paradigm, 90 in-depth interviews and 12 focus group discussions (FGD) were used to collect data on COE lived experiences in healthcare. The study was conducted in six Local Government Areas (LGAs) across southern and northern Nigeria, with representation from urban and rural areas. Participants were sourced from groups of health service users, healthcare providers, policymakers across sectors, and private sector players. Data were analyzed following thematic protocols. Results: Through COE, primary health activities like sanitation and hygiene were enforced, and the functionality of health facilities was sustained. Although community indigenes tended to drive COE more than non-indigenes, we observed the possibility of exclusion if not managed. Despite PHC facilities with more COE functioning better, COE has yet to become a standardized model and integral to the default operations of PHC in Nigeria. Conclusions: The WoC approach to scale up PHC efficiency is a no-brainer for resource-constrained regions. This has become more than necessary given ongoing global health funding cuts and in-country health budget constraints. Alternative/supportive models like COE for enhanced PHC performance cannot be overstated, calling for more documentation about its practicalities. Clinical trial number: Not applicable.

AB - Introduction: Community Ownership and Engagement (COE) foster the functionality of primary healthcare (PHC), reflecting the value community members place on their health. The extent to which COE is successful is predicated on ‘whole-of-community’ (WoC) strategies, which are nuanced and unique to diverse settings. Compilation of feasible and operational WoC strategies that catalyse and sustain the functionality of PHC facilities, especially in resource-constrained contexts, is vital for enhancing community health system. Methods: Relying on the phenomenological research paradigm, 90 in-depth interviews and 12 focus group discussions (FGD) were used to collect data on COE lived experiences in healthcare. The study was conducted in six Local Government Areas (LGAs) across southern and northern Nigeria, with representation from urban and rural areas. Participants were sourced from groups of health service users, healthcare providers, policymakers across sectors, and private sector players. Data were analyzed following thematic protocols. Results: Through COE, primary health activities like sanitation and hygiene were enforced, and the functionality of health facilities was sustained. Although community indigenes tended to drive COE more than non-indigenes, we observed the possibility of exclusion if not managed. Despite PHC facilities with more COE functioning better, COE has yet to become a standardized model and integral to the default operations of PHC in Nigeria. Conclusions: The WoC approach to scale up PHC efficiency is a no-brainer for resource-constrained regions. This has become more than necessary given ongoing global health funding cuts and in-country health budget constraints. Alternative/supportive models like COE for enhanced PHC performance cannot be overstated, calling for more documentation about its practicalities. Clinical trial number: Not applicable.

KW - Community engagement

KW - Community ownership

KW - Health facility committee

KW - Primary healthcare

KW - Whole-of-community

UR - https://www.scopus.com/pages/publications/105010124709

U2 - 10.1186/s12982-025-00747-8

DO - 10.1186/s12982-025-00747-8

M3 - Article

AN - SCOPUS:105010124709

SN - 3005-0774

VL - 22

JO - Discover Public Health

JF - Discover Public Health

M1 - 380

ER -