Constructing a Participatory Framework for Community Engagement in Primary Healthcare Governance in Kogi State

Background: Community engagement in primary healthcare governance is internationally recognised as essential for accountability, responsiveness, and equitable service delivery. Theoretically coherent and contextually grounded participatory frameworks for community health governance in the North Central geopolitical zone of Nigeria are absent from the literature. This study constructs and evaluates a participatory framework for community engagement in primary healthcare governance in Kogi State. Methodology: A participatory action research design engaged community members, health facility committees, local government health workers, and state officials in three iterative action-reflection cycles across six communities. Framework development used co-design principles, and evaluation employed developmental evaluation methodology over 24 months. Results: The Kogi Participatory Primary Health Governance Framework emerged across three phases: governance mapping, co-design of community accountability structures, and pilot evaluation. Framework implementation demonstrated improvements in community voice in health planning, service complaint resolution times, and facility resource allocation transparency. Conclusion: This study produces an original, co-designed participatory governance framework grounded in the Kogi State primary healthcare context. Its adoption could transform the relationship between communities and health systems across the North Central geopolitical zone, with generalisability implications for similar rural Nigerian contexts. Keywords: participatory framework, community engagement, health governance, Kogi State, primary healthcare