Strengthening Primary Health Care through Local Partnerships: A Community-Based Approach to Achieving Universal Health Coverage

Strong local partnerships in primary health care boost trust, coordination, and outcomes—key steps toward achieving Universal Health Coverage by 2030.

[Ebenezer Agbana is a physician. He studied the Master of Clinical Research: International Health Track at ISGlobal, University of Barcelona.]

Why Local Partnerships Matter in Primary Health Care

The World Health Organization (WHO) says that to achieve Universal Health Coverage (UHC) by 2030, we need strong primary health care (PHC). UHC means everyone can get basic health services without going into financial hardship. In many low-resource settings like Nigeria, PHCs are the foundation of the health system.

This article explains why we need what I call “360-degree” local partnerships at the PHC level. These include:

• Interinstitutional partnerships–between PHCs and referral hospitals
• Intra-PHC partnerships–collaboration between neighboring PHCs
• Community-level partnerships–cooperation with local leaders and influencers

Together, these layers create a support network that builds confidence in the community health workforce and helps us move closer to UHC.

Based on my work as a National Health Fellow in Northern Nigeria, where I lead social accountability and support PHCs, I’ve seen the importance of building a strong collaboration system. These partnerships improve morale, make health services more effective, and highlight the key role of health workers in achieving health for all

1. Connecting PHCs to Referral Centers: Interinstitutional Partnerships

“We sometimes refer patients to secondary health facilities, but our referrals aren’t honoured. It’s really frustrating. There are cases that are too complex for us to handle, we need help most times,” said a Community Health Extension Worker (CHEW).

This is a common problem. PHCs often rely on referral hospitals to handle difficult cases. But when referral systems don’t work well, patients suffer and health workers feel unsupported.

If referral hospitals inform PHCs about the best days to send patients and which specialists are available, it helps everyone plan better

A strong referral system is key. For example, if referral hospitals inform PHCs about the best days to send patients and which specialists are available, it helps everyone plan better. When referred patients are expected and scheduled, they get quicker care and the system runs more smoothly.

This kind of coordination improves service delivery, reduces stress for patients and health workers, and builds trust between PHCs and referral centers.

2. Sharing Strengths: Intra-PHC Partnerships

PHCs can also partner with each other. Instead of working alone, health workers can share tools, skills, and staff to improve care across communities.

For example, consider immunization. If one PHC does not have a working cold chain (to keep vaccines safe), it can team up with a nearby PHC that does. That way, children in the first area still get their vaccines on time. This helps reduce missed doses and promotes vaccine equity.

Another example: PHCs in hard-to-reach areas, due to security problems or social barriers can pair with more accessible PHCs. If one PHC is often closed due to banditry or flooding, the nearby PHC can help. It might send outreach teams or share medicines. This ensures care continues even in challenging situations.

PHCs can also partner with each other. Instead of working alone, health workers can share tools, skills, and staff to improve care across communities

These kinds of partnerships are practical, flexible, and powerful. They make PHC teams stronger and more responsive, especially in low-resource settings.

As the WHO puts it: “Anchoring the pursuit of health in engaged and empowered people and communities brings to life the commitment of PHC to refocus on the whole person and entire communities rather than diseases.”

3. Working with Local Leaders: Community-Level Partnerships

Local leaders like youth heads, religious leaders, and traditional rulers play a big role in their communities. People listen to them and often trust them more than formal institutions.

That’s why involving these leaders in PHC planning is so important. Their support can make or break a health initiative.

When leaders are included in decisions and planning from the start, they help create programs that fit community needs and values

PHCs should go beyond just informing these leaders. They should include them in decisions and planning from the start. When leaders are part of the process, they help create programs that fit community needs and values.

For instance, in one rural area, when traditional chiefs helped promote a vaccination campaign, turnout increased by 40% in just two weeks. This shows how powerful local leadership can be.

Building a Resilient, Community-Driven PHC System

To reach Universal Health Coverage, we need more than just clinics and policies. We need strong partnerships at every level of the PHC system.

By linking PHCs with hospitals, encouraging cooperation between PHCs, and working closely with community leaders, we create a support system that lifts everyone.

These partnerships help health workers do their jobs better and ensure that people get the care they need, when they need it.

In the end, a strong, connected PHC system is our best chance at achieving equitable, community-driven health care for all.