As a result, countries across the World, have clear structure for organizing their healthcare systems. This places responsibility on Government to ensure the provision of good health care system for its people. In Nigeria, the health system is decentralized into three tiers with responsibilities at the Federal, State and Local Government levels. Local government are responsible for primary health institutions with health services organized through the ward.

The social target of governments, international organizations and communities across the World is the attainment by all peoples of the world a level of health that will permit them to lead a socially and economically productive life. Primary health care was identified as the key to attaining this target. Despite this, the tale in Nigeria primary health care institutions and including those in Anambra State has been largely a tale of underperformance, a reason the project was conceptualized.

PHCs facility assessment was undertaken to ascertain the actual status of facilities at the PHCs. Centre LSD developed a checklist based is expected in every Primary Health Centre in terms of water and sanitation. As technical lead, Centre LSD developed the checklist with the agencies including JDPC Nnewi and Community Empowerment Network (COMEN), as part of the process for sills transfer. The checklist guided and paved way for a seamless engagement of the assessment process.
The outcome of which, enabled the development of a terms of reference for the researcher on PHC policy review in Anambra State.