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The degree of decentralization among federalist countries differs and this invariably demonstrates the dynamics of federalism in practice. The idea of federal system of government demands that there should be constitutional division of powers among the different tiers of government. To this end, in Nigeria, the federal, state and local government have their powers embedded in the constitution. However, the Nigerian constitution created much incertitude which allows local government to merely operate based on the reserved rights, disposition, prescription and discretion of the higher tiers of government. These constitutional uncertainties have no doubt created intergovernmental challenges and conflicts on areas of; tax jurisdiction, revenue allocation, fund transfers, illegal removal of government officials, autonomy, and inconsistent local government elections among others. Beyond these plaints which have been expressed in copious literature, this study tries to take further steps in analyzing how Nigeria’s intergovernmental status has impeded the operation and performance of primary healthcare system, which has invariably brought about poor health outcomes in the country, as evident in her pitiable health indicators. This work therefore establishes a nexus between local government decision space and primary healthcare systems in the country.
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. Ojofeitimi, T. (1992). Challenge of New Local Government in Nigeria. Administrative Staff College of Nigeria, Occasional Paper.
. Adeyeye, M. (2003). Democracy, Local Government and the Crisis of Autonomy in Nigeria. In J.A. Yakubu (ed), Socio-Legal Essays in Local Government Administration in Nigeria. Demyaxs Law Books, Ibadan
. Adewale, A. (2003). Fiscal Relationship between the Federal, State and Local Government Areas in Nigeria: An Appraisal. In J.A. Yakubu (ed), Socio-Legal Essays in Local Government Administration in Nigeria. Demyaxs Law Books, Ibadan
. Adediji, B. (2003). Master – Servant Relations between State Government and Local Government and Local Government in Nigeria: A Contradiction between Desire and Reality of Accountability. In J.A. Yakubu (ed), Socio-Legal Essays in Local Government Administration in Nigeria. Demyaxs Law Books, Ibadan
. Adamolekun, L. (2005). The Nigerian Federation at the Crossroads: The Way Forward. Publius, Vol. 35(3). pp. 383-405. Oxford University Press.
. Eme, O. (2009). The Fourth Republic and Local Government Creation. In Odion-Akhaine, S (ed), Local Government Administration in Nigeria: Old and New Visions. Centre for Constitutionalism and Demilitarization. Panaf Press, Abuja
. Obiyan, S. (2009). Revenue Allocation System and Crisis in Local Government Administration. In Odion-Akhaine, S (ed), Local Government Administration in Nigeria: Old and New Visions. Centre for Constitutionalism and Demilitarisation. Panaf Press, Abuja
. Otoghile, A., & Edigin, L. (2011). Local Government Administration and Development: A Survey of Oredo Local Government Area of Edo State. International Multi-Disciplinary Journal, Ethiopia. Vol. 5 (3).
. Rohde, J., Cousens, S., Chopra, M., Tangcharoensathien, V., Black, R., Bhutta, ZA. And Lawn, JE. (2008). 30 years after Alma-Ata: Has Primary Health Care Worked in Countries? Lancet 13;372(9642): 950-61
. Oviasuuyi, P., Idada, W., & Isiraojie, L. (2010). Constraints of Local Government Administration in Nigeria. Journal of Social Sciences, 24(2), p 81-88
. Awofeso, O. (2004). Issues in Local Government Administration in Nigeria, Lagos: LIS Johnson
. Akintayo, J. (2003). A Legal Analysis of the Political and Administrative Structures of Local Government in Nigeria. In J.A. Yakubu (ed), Socio-Legal Essays in Local Government Administration in Nigeria. Demyaxs Law Books, Ibadan.
. Nigeria 1999 Constitution. Resources Publishers.
. Onyekpere, E. (2019). NFIU and Local Government Financial Integrity. Punch Newspaper, May 13, 2019
. World Health Organization, Regional Office for South- East Asia. (2010). Decentralization of health-care services in the South-East Asia Region: report of the regional seminar, Bandung, Indonesia. 6-8 July 2010. New Delhi.
. Liwanag HJ, Wyss K. (2018). What conditions enable decentralization to improve the health system? Qualitative analysis of perspectives on decision space after 25 years of devolution in the Philippines. PLoS ONE 13(11): e0206809.
. Miharty, S., Holzhacker, R., & Wittek, R. (2016). Decentralization and Primary Health Care Innovations in Indonesia. In R.L. Holzhanker et al. (eds.), Decentralization and Governance in Indonesia. Development and Governance 2.
. Jongudomsuk, P., and Srisasalux, A. (2012). A decade of health-care decentralization in Thailand: what lessons can be drawn? WHO South-East Asia Journal of Public Health 2012;1(3):347-356
. Bailey, E. (2016). Healthcare access under health system decentralization in Honduras: A mixed methods study. Master’s Thesis in Arts in the Graduate School of The Ohio State University
. Adeyemo, D. (2005). Local Government and Health Care Delivery in Nigeria: A Case Study. J. Hum. Ecol., 18(2): 149-160
. Friedberg M., Hussey P., & Schneider C. (2010). Primary care: a critical review of the evidence on quality and costs of health care. Health Aff (Millwood); 29(5): 766-772.
. Macinko J., Starfield B., & Shi L. (2003). The contribution of primary care systems to health outcomes within Organization for Economic Cooperation and Development (OECD) countries, 1970–1998. Health Serv Res; 38(3): 831-865.
. Macinko J., Starfield B., & Erinosho T. (2009). The impact of primary healthcare on population health in low- and middle-income countries. Ambulatory Care Manage; 32(2): 150-171.
. Kruk M., Porignon D., Rockers P., & Van Lerberghe W. (2010). The contribution of primary care to health and health systems in low- and middle-income countries: a critical review of major primary care initiatives. Soc Sci Med; 70(6): 904-911.
. Demaio A., Nielson K., Tersbol B., Kellestrup P., & Meyrowitsch D. (2014). Primary Health Care: a strategic framework for the prevention and control of chronic non-communicable disease. Glob Health Action, 7.:24504 http://dx.doi.org/10.3402/gha.v7.24504
. Muhammad, F., Abdulkareem, J., & Chowdhury, A. (2017). Major Public Health Problems in Nigeria: A review. South East Asia Journal of Public Health, 7(1), p. 6-11
. WHO. (2019). Countries and territories certified malaria-free by WHO. Retrieved from: https://www.who.int/malaria/areas/elimination/malaria-free-countries/en/ (Assessed, May 29, 2019)
. Abdulaziz, A. (2019). Local Government Funds: Governors rise against NFIU, write Buhari. Premium Times, May 23, 2019.
. Tukur, S. (2019). LG Funds: Amidst complaint by governors, court refuses to stop NFIU directive. Premium Times, May 31, 2019
. Onanga, A. (2019). Row over NFIU guidelines on local government funds. The Nations Newspaper, May 21, 2019.
. Anaba, I., & Ojelu, H. (2019). Lawyers divided over NFIU directive on LG fund. Vanguard Newspaper, May 23 2019.
. WHO. (2012). Nigeria launches 'Saving One Million Lives' by 2015 initiative. Available at https://www.who.int/workforcealliance/media/news/2012/1mlives/en/ (Accessed on 25th June, 2019).
 Owoseye, A. (2019). Nigerian government disburses $49 million to Yobe, Osun under ‘save one million lives’ fund. Available at https://www.premiumtimesng.com/health/health- news/304875- nigerian-govt disburses-49-million-to-yobe-osun-under-save-one-million- lives-fund.html (accessed 25th June, 2019).