While the issue of patient safety has gained global attention, with efforts directed at reducing medical, human errors, improving healthcare outcomes, and ensuring that hospitals provide secure environments for treatment, a lot of factors continue to pose significant risks to patient safety in Nigeria.
Lack of healthcare infrastructure and resources has been identified as one of the major factors as many hospitals, especially in rural areas, are under equipped, with outdated medical equipment and insufficient facilities to meet the growing population’s health demands.
News learnt that even in tertiary hospitals, patients often encounter long wait times for essential diagnostic tests or surgeries due to shortage of skilled healthcare workers and limited resources. This delay in treatment can worsen patient outcomes, increasing the risk of avoidable complications or fatalities.
Nigeria faces a serious shortage of healthcare professionals, exacerbated by a persistent brain drain. Many doctors, nurses, and other medical practitioners are leaving the country in search of better working conditions and pay abroad.
The World Health Organization (WHO) recommends a ratio of one doctor per 600 patients, but in Nigeria, this ratio is alarmingly skewed, with some estimates suggesting a ratio of one doctor to 2,500 patients. This shortage compromises patient care, leading to overworked and overstressed medical staff, which in turn increases the likelihood of medical errors.
Medication errors, ranging from incorrect prescriptions to dispensing the wrong drugs, are a common patient safety issue in Nigeria. The lack of stringent regulation on pharmaceutical practices, coupled with counterfeit drugs flooding the market, places patients at high risk. Healthcare providers sometimes face challenges in verifying the authenticity of drugs, leading to adverse effects on patient health.
Meanwhile, healthcare workers have warned of more medical errors, even as a recent study has put the latest prevalence rates at 89.9 per cent.
The study titled: ‘Documentation of Medical Errors in Nigeria: A Review’ analysed seven electronic database of studies on medical errors by healthcare practitioners in hospitals in Nigeria. Findings of the study showed a high prevalence of medical errors which ranged from 42.8 to 89.8%.
Reacting to the findings of the study, medical doctors have linked the high prevalence rate on long working hours caused by the ‘Japa Syndrome’ even as they have called on the government to employ more doctors to replace those who have left the country for greener pastures.
The World Health Organisation (WHO) predicts a 10 million shortage of health workers by 2030, mainly in low income countries like Nigeria. According to latest figures from the Federal Ministry of Health and Social Welfare, Nigeria has a skilled health worker density of 1.83 per 1000 patients, far below the WHO recommendation. Factors contributing to this include low production of health workers, poor management, and political and economic crises.
Doctors who spoke to our correspondent averred that the long working hours is having a torn not only on their health, but in their ability to carry out their functions effective, while warning that the frequent burnout is leading to many errors in diagnosis and treatment.
The regular working hours are intended to be from 8:00 am to 4:00 pm every day, according to Dr. Bimbo Olamide, who works at one of Nigeria’s public hospitals. While Olamide acknowledged that there are several classifications of doctors and various medical specialities, she also stated that a doctor who is on call must work for a full day, which is not supposed to be so.
“Due to the Japa Syndrome, which is causing havoc in the medical field, physicians may be called upon up to three times a week as there is a shortage of replacements for those who have fled the nation. For example, one doctor is currently handling duties that should be performed by five. Without a doubt, the one doctor will be unable to handle the workload, which could lead to mistakes in diagnosis and treatment,” she averred.
She advised that the best course of action would be for the federal and state governments to start aggressively hiring medical staff for the various healthcare facilities. “If doctors are making N200,000 a month, that’s less than $200, a peanut to our colleagues abroad who are making over $4,000 to $7,000 annually,” she said. They utilise half the money for taxes, one may argue. They are still earning more than 100 per cent of what they would have in Nigeria, even if they only spend half of the funds. Now you understand why it is so difficult to address the Japanese syndrome. In addition to the economic factor, many of our doctors are facing serious insecurity issue, as they are not immune to kidnapping.
“All of these problems, particularly the ones with compensation and insecurity, must be addressed by the government. The government should first replace all of the doctors who have departed the nation, raise the pay of the doctors who have consented to work here, and provide them with excellent care. For example, the Nigerian government’s decision to increase salaries by 100% would deter many doctors from leaving the country since, as they say, there is no place like home.
“The government must also provide our public hospitals with the equipment they need to function. Travelling overseas exposes most of us to new technologies and skill sets. The government needs to constantly implementing the newest medical technologies and retraining and retraining physicians in order to keep us informed about the most recent advancements in medicine. With these in place, we think more doctors will stay, and if that happens, the workload will be lighter, which will lessen medical errors in the system,” she advised.
September 17 every year has been set aside as World Patient Safety Day. The theme for this year’s World Patient Safety Day’s is focused on improving diagnosis for patient safety, using the slogan “Get it right, make it safe!.
This year’s theme has further highlighted the role of medical laboratory scientists in patient safety. Speaking on this, the national president of the Association of Medical Laboratory Scientists of Nigeria (AMLSN), Dr Casmir Ifeanyi, urged the government on recruitment of medical laboratory scientists into public healthcare institutions, teaching hospitals, Federal Medical Centres, specialist hospitals, general hospitals at the state level, on the use of the Workload Indicators of Staffing Need (WISN) method developed by WHO, saying that will ensure even distribution of staff as well as eliminate human errors as much as possible.
“The weakest link in our healthcare system is the medical laboratory. We have thousands of primary healthcare centres in Nigeria that do not have medical laboratory component and that is the first point of care for our people. It doesn’t require rocket science to resolve the issue of providing medical laboratory components in our primary healthcare.
“Between 2013 and now, I can tell you on good authority that there have been efforts to undermine the employment of medical laboratory scientists in teaching hospitals, Federal Medical Centres and other specialised hospitals. It is worrisome because this goes against the WISN of WHO.
According to Dr. Casmir, one of the appropriate ways of ensuring patients safety is institutionalising quality management system. “You are able to strive when errors occur and you are also able to do what we call corrective process. Now for every human endeavor, error is not lacking and according to the United Nations Institute of medicine, there is human errors that impact one out of every 10 persons globally, so the impact of human error in patient care is actually very endemic and these errors are actually the reason behind inappropriate care for patients.
“It is also this human error in failure of patient safety that accounts for inadequate reportage of both communicable and non-communicable diseases.
“Infact, it is summarily put that 1/98 thousand persons die as a result of human error in the cause of care for patients. When you look at the impact of human error in one out of every 10 patients, you find out clearly that 1/10 means 10 Percent and that is quite high because in quality element system, 1/10 error is consider really high because it will mean like failure in delivery of over 400 babies; It’s means about 400 babies will fall off the hands of the midwives in the cause of delivering, so that is an unacceptable submission of error,” he said.
Dr. Casmir also expressed concern over the rate of quackery in the sector, describing it as suicide mission, while calling for requisite regulations and framework.
He said: ” In the last three years or thereabout, the Medical Laboratory Science Council of Nigeria have been without a governing board, the same, even though not up to one year, were the case for Medical and Dental Council, the Pharmacy Council of Nigeria, the Nursing and Midwifery Council of Nigeria. So we are urging President Bola Ahmed Tinubu to expedite action in the reconstitution and inauguration of these boards because that is one sure way of providing the requisite regulatory framework and governance that can help curtail effectively, the activities of quackery.
“We are asking management of hospitals to put an end to the recruitment of persons who are not part of the human resources for heath and deploying them to the laboratory. Recruiting lab technicians technology amid others and dumping them in the medical laboratory to provide care for patients, It is noting but a suicide mission.”
He told Newsmen that the association is open to partnership with various agencies of government including law enforcement agencies to drive their campaign against quackery.
“We have been partnering media organisations to raise awareness about the issue of quackery but awareness as good as they are are not sufficient enough to deal with the issues of quackery. We need the requisite regulations and framework to be in place,” he added.
Speaking further, he lamented that Nigeria is a dumping ground for fake and substandard diagnostic kits, chemicals used for testing. “Improving medical diagnosis in Nigeria will require sanitising the testing devices, sanitising the testing reagents, sanitising point of care testing devices.
Addressing the underlying issues of inadequate infrastructure, shortage of skilled professionals, poor hygiene, medication errors, and systemic corruption will be key in ensuring that patients receive the high-quality and safe care they deserve.
