CHALLENGES AND STRATEGIES FOR ENHANCING WARD DEVELOPMENT COMMITTEE PARTICIPATION IN GRASSROOTS PRIMARY HEALTH CARE SERVICES

P rimary Health Care (PHC) in Nigeria relies on Ward Development Committees (WDCs) to foster community participation, accountability, and effective service delivery at the grassroots level. Despite their strategic importance, evidence suggests suboptimal performance due to persistent systemic, institutional, and operational challenges. This study examined the challenges hindering effective participation of WDCs in PHC services and identified strategies for improving their participation at the grassroots level in Kaduna State, Nigeria. A descriptive cross‑sectional mixed‑methods design was employed. Using Cochran's formula, 152 WDCs were selected from 255 wards across three senatorial zones via multistage sampling. A structured KAP questionnaire was administered to one WDC member per ward, complemented by in‑depth interviews with PHC service beneficiaries. Quantitative data were analysed using descriptive statistics and one‑sample t‑tests (p<0.05). Qualitative data were thematically analysed. The grand mean for challenges was 3.35 (SD=1.195), with poor communication with higher health authorities (M=3.99), low meeting attendance (M=3.84), and inadequate community trust (M=3.64) identified as the most critical barriers. The grand mean for strategies was 3.62 (SD=0.465), with regular capacity building (M=4.04), stronger staff collaboration (M=4.01), increasing women's membership (M=3.84), and adopting digital tools (M=3.83) as the most endorsed interventions. Direct financial incentives were not prioritized (M=2.71). A multi‑level strategy integrating standardized training, structural inclusion in PHC planning, gender‑equity enforcement, and digital communication is essential to transform WDCs into genuine co‑managers of primary health care facilities, thereby advancing universal health coverage.