Strengthening Healthcare System: Enhancing Local Autonomy and Resource Allocation for Effective Universal Health Coverage in Lagos State

Lagos, Nigeria's economic capital, has 319 primary health care centers (PHCs) serving over 20 million residents. To improve healthcare governance, the Lagos State Government decentralized the central Primary Health Care Board (PHCB) into six localized Health Districts (HDs), aiming to streamline processes and better address residents' healthcare needs. However, to ensure the effective functioning of these HDs, empirical evidence is needed to understand the local contexts of the communities they serve. This study investigated healthcare delivery across the HDs focusing on seven thematic areas;   Infrastructure, services, and staffing;   Burden of communicable and non-communicable diseases;   Drivers of PHC visits and factors promoting utilization;  Quality of basic healthcare services;   Awareness and participation in Ilera-Eko Health insurance scheme.