An Analytical Study of the Epidemiological Transition and Its Implications for Primary Healthcare in South West Nigeria

South West Nigeria is undergoing an epidemiological transition characterised by increasing non-communicable disease burden alongside persistent infectious disease challenges, creating a dual burden that primary healthcare systems are unprepared to manage without strategic reorientation. This study analytically examined the epidemiological transition in South West Nigeria and its implications for PHC service delivery. A secondary data analysis methodology was adopted, drawing on fifteen years of morbidity and mortality data from HMIS, NDHS, and LUTH/UCH hospital records (2008 to 2023) for Lagos, Oyo, Osun, Ogun, Ekiti, and Ondo States. Disease burden trends were assessed using joinpoint regression to identify inflection points in incidence and mortality trajectories for communicable and non-communicable conditions. PHC capacity to manage NCD conditions was assessed through analysis of National Primary Health Care Development Agency facility assessment data. Results showed that NCD conditions now account for 38.6 percent of outpatient morbidity in South West PHC facilities, up from 21.4 percent in 2008, while malaria and respiratory infections retain the highest single-disease burden. PHC facilities offering NCD management services increased from 12.3 percent to 29.7 percent over the same period, significantly lagging behind demand. The study identifies a structural PHC reorientation gap and recommends a dual-burden-adapted PHC service package, evidence-based task-shifting for NCD management, and community-based NCD risk reduction as three pillars of a South West PHC transformation strategy.

Keywords: epidemiological transition, non-communicable diseases, primary healthcare, South West Nigeria, dual burden