This book aims at understanding the performance of primary health care providers and the variables driving this performance using the World Development Report (WDR) 2004 accountability framework. It is primarily based on quantitative surveys at the level of primary health care facilities, health care personnel, and households in their vicinity. The surveys were implemented in four states: Bauchi, Cross River, Kaduna, and Lagos. Despite large Government efforts, the delivery of quality primary health care services remains a challenge in the country. The condition of the infrastructure is poor; many facilities do not have the required equipment or the pharmaceutical products to offer quality care. In addition, household satisfaction with services is low and very few outreach services are provided. The three levels of government, Federal, State, and local governments have some responsibility in the provision of health services. The division of roles and responsibilities between...