22 Feb 2017

The Six Biggest Issues with Healthcare Services in Nigeria, and How Facilities Management Can Help

It is no news that one the major channels through which Foreign Exchange earnings leave Nigeria is medical tourism. In fact, a 2013 BusinessDay report revealed that 47% (18,000) of Nigerians, who visited India that year, did so for medical reasons and expended up to N41.6 billion.

In addition, no one needs to be told that in spite of the fact that approximately 60% of the country’s health services are provided by the private sector, the general state of the Nigerian healthcare infrastructure facilities still leaves much to be desired.

Experts say this declining status and the attendant lack of confidence in the healthcare system in Nigeria can be traced to inadequate planning of the Integrated Healthcare Facilities Management Model (IHFMM) of most healthcare institutions before construction.

Ironically, Nigerian doctors and healthcare professionals rank at par with their counterparts in most of the countries where Nigerians seek medical attention. In fact, available record showed they are in large numbers practicing in most hospitals abroad, where they give good accounts of themselves. This is fueling an increase in brain drain, as most of them have to go abroad to get expose to modern medical equipment, which are lacking in Nigerian hospitals.

So if Nigeria must reduce the rising capital flight on account of medical tourism, improve the state of its healthcare facilities to earn patient’s confidence, and retain some of its brilliants medical experts to develop its healthcare sector; here are some of the areas to focus, and how Facilities Management will help:

  1. Unavailability of Modern Equipment and Obsoleteness of Existing Ones

This is about the biggest issue with the Nigerian healthcare system. It is responsible for why foreign medical trips remain the only option for affluent Nigerians or patients in dire need of the right diagnosis. It is common place to trace the root causes of most of the wrong diagnoses to lack of the right equipment or the faulty nature of existing ones.

Rather than just focusing on outright purchase and installation of these life-saving equipment without recourse to their lifecycle management and Service Level Agreements (SLAs) with manufacturers, FM can come to the rescue by defining processes around the required SLA, and planned scheduled replacement of the obsolete inventory.

These can help keep existing equipment in good shape and adequately plan for the disposal and replacement of outdated or faulty ones.

  1. Avoidable Harm to Patients

It is not unusual to hear stories of medical errors and how they have accounted for avoidable deaths in some Nigerian medical facilities. This is also one of the many reasons why most Nigerians remain uncomfortable with healthcare practices in the country and will rather go abroad for medical attention.

Ironically, medical errors are not peculiar to Nigeria; in fact, a landmark study in the U.S once revealed that between 44,000 and 98,000 Americans died annually because of medical errors committed in hospitals. But patients’ confidence in Nigeria’s healthcare keeps dropping due to unavailability of operational procedures, or lack of clear processes to ensure procedures are followed, where available.

Specialized FM service can help curtail the spate of medical errors by defining and implementing processes that will ensure that the procedures are sufficiently adhered to.

  1. Facilities Maintenance

It is usually said that 90% of the lifecycle of any asset is dependent on FM. Looking around today; this notion becomes instructive, as most public health institutions are mere shell buildings, and new private ones are also fast giving way to wear and tear. The reasons for these remain that all the attention was given to the design and construction of these facilities, while less though went into the life of the buildings after construction.

The dilapidated nature of most of these assets is responsible to the inconducive environment and the shortened lifespan of most healthcare facilities

However, where FM is introduced, healthcare assets can fulfill their lifecycle, maintenance cost can be tracked to continuously ascertain the profitability of the asset, equipment failure can be predicted and prevented to improve productivity, and downtimes can be minimized to reduce the total cost of maintenance.

  1. Integrated & Effective Heating,Ventilation and Air Conditioning (HVAC) system:

Anyone who has visited healthcare facilities in the country will admit that HVAC is a major challenge. Very often the air released and which permeates the healthcare environment is odious and capable of infecting otherwise healthy people with new disease(s), due to microbial and fungal growth within the circulating air.

However, FM can help improve this condition with a well integrated and effective HVAC system, which often ensures internal climate controls (temperature, humidity, air flow, and air filtering), and identify energy-saving opportunities through an implementation, monitoring and evaluation plan. The energy management system as a result of this improvement is also known to check fungal and allergens growth that could easily lead to asthma and other health challenges.

  1. Effective Waste Management System

A common observation in most healthcare institutions is the uncoordinated approach to waste management. It should be taken for granted that healthcare facilities implement a sustainable process that properly separates regulated from non-regulated medical waste at all times. Unfortunately, only few medical institutions could boast of an effective system than manages both solid and liquid wastes.

For FM, an effective medical waste management process will encompass a regular collection, handling, storage, transportation and processing of waste. This, in addition to creating conducive environment, can significantly reduce the transmission and spread of microorganism infections in healthcare facilities.

  1. Efficient Structure Process and Output (SPO) Model

Every organisation is expected to rely on a mix of functions and services to provide the supporting essentials to its core business operations. Ensuring that these supports are available in the right form, at the right quality and for the right cost is a major task for Facility Management.

At another level, the there is a major void in efficient management of process that integrates the entire activities that happen within the healthcare facilities. For instance, in most of our existing health institutions, it is difficult to specifically speak to what a process is in the reception of an emergency, assures efficiency through the treatment period and keeps a patient comfortable through the recovery phase.

However, FM can come to the fore with a well defined SPO model that can enable improved operational structure, clinical process, and enhance patients’ outcome.

In all, current economic realities and state of Nigeria’s healthcare system is beginning to call for improved healthcare system that can save the country from the increasing capital flight and improve the productivity of its people.

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