Adéṣẹ́gun Olútáyọ̀ Adéolú Ọṣìbánjọ
This report examines the high mortality rates in Nigeria’s health care delivery system, focusing on public health institutions at the level of General hospitals and privately owned hospitals. These institutions are critical in addressing the population’s health needs, yet systemic challenges—such as inadequate staffing, poor health management practices, and lapses in regulatory oversight—severely undermine their effectiveness.
It highlights the urgent need for the Coordinating Minister of Health & Social Welfare, Professor Muhammad Ali Pate, to deploy a special intervention taskforce to address the high mortality rates caused by poor healthcare management practices. This intervention is essential to bolster the “Renewed Hope” agenda of President Bọla Tinubu’s administration, ensuring that healthcare delivery aligns with the administration’s vision for improved national well-being.
Two case studies illustrate these challenges: the first discusses a 79-year-old woman who was discharged by her Son from a private hospital for better evaluation by a specialist Haematologist after prolonged ineffective care on second admission in the same facility where deaths also happened on the increase. The second case involves a middle-aged woman who tragically died from an overdose of medication prescribed by a General practitioner (GP) at a General hospital. These cases underscore the systemic issues leading to preventable fatalities and offer insights into how such challenges can be addressed.
Introduction
The health care delivery system in Nigeria is burdened by inefficiencies that contribute to the nation’s high mortality rates. Public health institutions at the level of General hospitals and privately owned hospitals serve as pivotal points of care for many citizens. However, these facilities face challenges, including manpower shortages, poor health care management practices, and limited oversight, all of which undermine their ability to deliver quality care.
This report emphasizes the need for immediate intervention by the Coordinating Minister of Health & Social Welfare to address these systemic issues. Such action is critical to reducing mortality rates and supporting the “Renewed Hope” agenda of President Bọla Tinubu’s administration.
Background
The Nigerian healthcare system operates across three tiers:
• Primary Health Care (PHC): Basic health services provided at local levels.
• Secondary Health Care: General hospitals managed by State governments, offering advanced care.
• Tertiary Health Care: Specialized care provided by federal institutions, often serving as referral centres.
This report centres on the second tier—General hospitals and Privately owned hospitals—which play a vital role in the nation’s healthcare framework. Despite their importance, these institutions are often plagued by staffing shortages, poor management, and insufficient regulatory oversight, contributing significantly to high mortality rates.
Case Studies Highlighting Systemic Failures
Case 1: A 79-Year-Old Woman at a Privately Owned Hospital
• A 79-year-old woman with Anaemia (shortage of blood) was admitted to a privately owned hospital. Over 10 days, her condition did not improve, as her case was not escalated to a specialist. Despite spending ₦1.5 million on care, no resolution was achieved.
• She was ultimately discharged and referred to a specialist Haematologist for better evaluation. This delay in proper care could have worsened her condition, exposing the gaps in health care management.
Case 2: A Middle-Aged Woman at a General Hospital
• A middle-aged woman was prescribed a drug overdose by a GP at a General hospital. Three days after taking the medication, she was rushed back to the hospital in critical condition.
• The senior doctor on duty discovered the overdose and expressed alarm, but it was too late to save her. This tragic incident highlights the risks posed by mismanagement and inadequate oversight.
Key Issues Identified
• Manpower Shortages: Public general hospitals and privately owned hospitals lack sufficient staffing due to the migration of Medical personnel seeking better opportunities abroad.
• Inadequate Health Management: General practitioners often manage cases that require Specialists, leading to poor outcomes and preventable complications.
• Resource Deficiencies: Hospitals lack essential tools and equipment to deliver effective care.
• Regulatory Oversight Gaps: Weak monitoring mechanisms enable substandard practices to persist in health facilities.
• High Financial Costs: Patients often face exorbitant expenses without receiving quality care, further delaying access to necessary treatment.
Recommendations
• Deploy a Special Intervention Team:
- The Coordinating Minister of Health & Social Welfare, Professor Muhammad Ali Pate, should setup a special intervention taskforce to address the systemic failures in healthcare management.
- This taskforce should focus on reducing mortality rates by improving oversight, enforcing standards, and ensuring accountability in both public and private hospitals.
• Establish Universities of Medical Sciences: - Create institutions focused on training medical personnel to address staffing shortages in public and private hospitals.
- Align training programs with local health care needs and global standards to ensure competency.
• Improve Health Care Management Practices: - Implement statutory protocols requiring immediate escalation of complex cases to Specialists.
- Provide training programs for General practitioners to improve diagnostic and Case management skills.
• Enhance Regulatory Oversight: - Conduct stricter audits and inspections of both public and private hospitals.
- Develop accountability frameworks to reduce medical errors and improve outcomes.
• Retain Medical Personnel: - Improve working conditions and remuneration to discourage the migration of medical professionals.
- Offer financial incentives and career advancement opportunities for Specialists working in underserved areas.
• Empower Patients: - Increase awareness about Patient rights and the importance of seeking Specialist care.
- Establish channels for reporting malpractice and ensuring accountability in health care delivery.
• Improve Resource Allocation: - Ensure hospitals are equipped with modern diagnostic and treatment tools.
- Provide essential medications and emergency response facilities to enhance service delivery.
Conclusion
Public General hospitals and privately owned hospitals are integral to Nigeria’s health care delivery system. However, challenges such as manpower shortages, poor healthcare management practices, and inadequate oversight significantly contribute to the high mortality rate.
The cases of a 79-year-old woman, who thankfully is still alive, a middle-aged woman who tragically passed away due to overdose prescriptions, and countless other inestimable tragedies resulting from Care mismanagement and inadequate oversight underscore the urgent need for systemic reforms. Professor Muhammad Ali Pate, the Coordinating Minister of Health and Social Welfare, must take decisive action by deploying a special intervention Taskforce to address these challenges. Such an intervention would not only reduce mortality rates but also strengthen President Bọla Tinubu’s ‘Renewed Hope’ agenda, ensuring that Healthcare delivery aligns with the administration’s vision for a healthier and more prosperous Nigeria.
Collaboration among Government agencies, Private stakeholders, and Communities is vital for creating a more effective and equitable healthcare system.
God bless Nigeria!!!
© Engr. Adéṣẹ́gun Olútáyọ̀ Adéolú Ọṣìbánjọ BENG, MBA, MNSE, MNIEE, MCIPSMN
Lead Consultant, MaakBeat Transnational Ltd, Lagos.
