The role of primary healthcare system in the prevention and management of chronic kidney diseases in rural Nigeria

Chronic Kidney Disease (CKD) is a key source of morbidity and mortality in rural Nigeria due to its prevalence at 19.9% Caused by factors like hypertension, diabetes, infections, and environment. This research emergently appraised the role of the primary healthcare (PHC) system in the prevention and management of CKD within rural communities, including assets and liabilities. The approach followed the qualitative research design; articles were reviewed, favoring 16 peer-reviewed journals between 2015 and 2024. These studies were chosen because they addressed the topic of CKD prevention and management, PHC care delivery systems, the development of screening programs and educational initiatives, system preparedness, and policy changes. Study design, interventions, outcomes, and levels of evidence were summarised to describe trends and gaps in the effectiveness of PHC. The analysis showed that PHC systems were central in preventing CKD through screening, health promotion, lifestyle changes, and environmental modification. Nonetheless, gaps that had been noted included poor health facilities, scarcity of skilled workers, and poor availability of basic drugs. The other barriers to the implementation of EBHC included cultural belief in the use of conventional medicine and ill-health literacy. However, such barriers as poor NGO partnerships and dismal policy revision illuminated possibilities of enhancing CKD through increased provision of resources combined with efficient coordination of services. The study highlighted a need to scale up investment in PHC, especially in facilities and equipment, engaging particular audiences in culturally appropriate and targeted education to prevent and manage CKD; and an array of workforce development programs. Enhancing the monitoring and evaluation systems also puts much focus on improving and sustaining quality health care for vulnerable groups of people. These gaps may be alleviated by identifying strategies that could help interventionists strengthen or develop PHC systems to effectively tackle CKD and the despairing health status in rural Nigeria.