The quality of care is a key component of the right to health, and the route to equity and dignity for every Nigerian in order to achieve universal health coverage, it is essential to deliver health services that meet global standards.
According to the World Health Organization (WHO), medical errors affect at least 1 in 10 patients who receive healthcare in facilities that are well-funded and technologically advanced each year.
That translates into tens of millions of injuries and deaths annually, and billions of dollars in additional medical expenses.
Globally, it is estimated that about 142,000 people die every year from preventable medical errors. There has been little progress in reversing this trend.
The lack of integration among healthcare providers, insurers, patients and communities at large means that providers do not have full access to patient information, nor do they have a culture that supports such openness.
Hospitals and other providers themselves are unable to capture and analyse medical errors and, therefore, lack the ability to understand the root causes.
With growing pressure to identify potential patient safety issues the global landscape of health care is changing and health systems operate in increasingly complex environments.
While new treatments, technologies and care models can have therapeutic potential, they can also pose novel threats to safe care.
Patient safety is now being recognized as a large and growing global public health challenge. Global efforts to reduce the burden of patient harm have not achieved substantial change over the past 15 years, despite pioneering work in some health care settings.
To this end, speakers at the 2019 Future of Health Conference organized by the Nigeria HealthWatch with the Theme: ‘’Time to Focus on Quality Healthcare: Improving Outcomes’’, shared insights from various perspectives where quality healthcare delivery can be improved upon in Nigeria.
The Key areas highlighted at the conference included: quality maternal health, partnerships, patient-centred care, inclusive healthcare, and quality in healthcare standards.
Dr. Ngozi Azodoh, Head of Special Projects, Federal Ministry of Health who was a guest speaker at the event lamented that about 10 to 15 per cent of all deaths in low-and middle-income countries have been as a result of poor quality of healthcare.
“Approximately 8.6 million people in low-middle income countries die each year from inadequate access to quality care. Out of the 8.6million, about 3.6million never got any health service at all, and 5 million die because of poor quality’’, she said.
Dr. Ike Anya, Nigeria Health Watch Curator who sought answers on how to change the narrative about healthcare delivery in Nigeria emphasized that good quality care is not all about money but by treating and providing services in a way we like to receive care.
“we have been talking about our Universal Health Coverage, we have been talking a lot about reducing maternal mortality and morbidity and improving health for mothers and the reality is that the more access we provide, we also have to be sure that what people are going to get when they get to those health facilities is good quality care.
“Good quality care is not necessarily about money, it starts from the gate of the facility; how the security man welcomes you, how the staff treats you, how clean the environment is. A lot of that is simply about treating and providing service in a way that we ourselves would like to receive care,” Dr. Anya said.
Dr Anya described as “unfortunate that healthcare service delivery in Nigeria has failed to yield the desired results over the years.
‘’Our health system is not yielding the improvements in our health indices, our improvements in patients outcomes as expected in Nigeria, so it is imperative to consider the standard of healthcare being received.
‘’Quality healthcare should minimize risk and harm to patients while providing effective services using evidence- based- guidelines. Quality healthcare should reduce the delays clients face in receiving care and maximize resources to avoid wastage.
‘’Discussions at the 2019 future of health conference will explore the dimensions of quality healthcare, in addition to looking at service delivery and ways to integrate quality at all levels of healthcare delivery in Nigeria.”
Similarly, Dr. Mary-Ann Etiebet, Lead of MSD for Mothers, noted that for quality in healthcare to improve, government should implement policies that would be favorable to all Nigerians, especially those residing in rural areas.
“We need national leadership policies; we need local leadership and champions to make it happen on the ground. We need institutions and structures, like accreditation systems’’.
She added that while Nigeria records about 23% of the deaths globally to maternal mortality, there has been remarkable work done in the country.
“Earlier this year, teams in Cross River State in partnership with Pathfinder International, reported that they have reduced maternal mortality rate by 66% in 3 years throughout the state.
“Because of the work that they did, 90% of the women in that state are less than 2 hours from high-quality emergency obstetrics services.
We have successes we can build on. Nowhere else in the world has experienced 66% reduction of maternal mortality death except for Cross River State. And that is what we should be proud of and work on duplicating it in other states as well as outside Nigeria”, she said.
To Engr. Chidi Izuwah, Senior Director General/CEO of the Infrastructure Concession Regulatory Commission in the Presidency, partnership is a key driving progress and development in the health sector.
“There are opportunities where we can work with the private sector to provide good healthcare, in the areas of power, waste management.
‘’Private and public sector engagement would not only stimulate innovations but will improve the quality of care Nigerians have access to.
This is because the private sector have over the years enabled better health services for communities and individuals through provision of services ranging from hospitals, clinics and laboratories to drugs, vaccines and diagnostics to ancillary services like ambulances and insurance amongst others.
‘’We believe that there needs to be greater effort to improve quality in healthcare in order to increase confidence in the healthcare sector.
‘’The summit will develop strong relationships with key stakeholders to advance quality maternal care in Nigeria as well as to generate recommendations for creating an enabling environment to improve quality maternity in Nigeria’’, he said.
Dr. Adenike Odubiyi, Chief Medical Director (CMD), General Hospital Igede, said that to improve on service delivery, her team created a WhatsApp platform for their antenatal services where some staff were dedicated to monitor it.
She added that the hospital is also collaborating with primary health centres to ensure that they get good outcomes.
Dr. Olujimi Coker, Acting CEO & CMD, Lagoon Hospitals, said doctors and patients view quality healthcare differently.
“As doctors we are more focused on outcomes, whereas the patients are more focused on the processes of care and to ensure that they are safe in the environment where healthcare is provided and we must not lose sight of this,” he said.
Patience Dickson, Chairperson of the Women with Disabilities Initiative, appealed to health workers to change their attitude towards people living with disabilities.
“People look at persons with disabilities as problems, weak, and helpless, as such, need welfare. They are often perceived by the medical world as sick and a burden,” she said.
In the same vein, Christian Aid UK Nigeria’s Country Director, Charles Emmamuzou Usie who brought in the perspective of the less privileged advocated for dignity and respect in treating everyone, and for equal opportunities for both the wealthy and the poor. “Many communities do not have health centres. And we are leaving millions behind, which is against the goal of the SDGs,” he said.
The perception that infusing quality into healthcare is an expensive process is one that several speakers worked to change at the conference. Dr. Coker spoke about areas in which hospitals could improve quality and one was in the area of infection prevention and control (IPC).
“Infection control of course is extremely important, and this is one of the areas that you really don’t need a lot of money to provide quality healthcare,” he said, “Because soap and water is very cheap and the most effective way of preventing hospital-acquired infection is through effective hand hygiene, so I will recommend this to everybody’’.
President Muhammadu Buhari had assured that the Federal Government would continue to ensure that more Nigerians have access to quality basic healthcare services.
He expressed the hope that the provision of quality healthcare services would reverse the poor health indices in the country, adding that his administration would fulfil all its promises made to the people.
“I am hopeful that our women will no more be dying needlessly during childbirth; our children will no more be dying needlessly as a result of vaccine-preventable diseases or common ailment; access to health care will not be limited because of lack of money to pay.
“I want to assure Nigerians that Government will continue to ensure that great numbers of Nigerians have access to quality basic health care services. Accordingly, the provision in the National Health Act, 2014 for the Basic Health Care Provision Fund is in the process of being implemented.
“I also assure my fellow countrymen and women that our Administration will fulfil all the promises made to the people.
“The provision of quality health care service will reverse the poor health indices in the country.’’
He said that the vision of his administration is to revitalise 10,000 Primary Health Care Facilities in Nigeria using a phased approach.
“Our Administration in recognition of this promised to revitalise one Primary Health Care Centre in each of the political wards in the country.
“So far, we have commenced the revitalization of one Primary Health Care in each senatorial zone in the country.
“Our vision is to revitalise 10,000 Primary Health Care Facilities in Nigeria using a phased approach.
“The first phase of this approach is what we are flagging off today. It will signal the revitalization of the first 109 Primary Health Care facilities across the 36 states and the FCT.
“Kuchigoro Primary Healthcare Centre has been renovated as a model primary health care centre where quality health care services will be obtained at little or no cost to the beneficiaries.”