Introduction
There
are many challenges confronting the healthcare industry in Nigeria, which Muhammad AbdullahiWase Teaching Hospital did not escape. But these challenges can be
categorized into two, the general challenges that manifested in almost all
Nigerian health institutions and challenges that are specific to AbdullahiWase
Teaching Hospital.
The General Challenges
- Higher Demand for secondary and tertiary care facilities
This means that people
tend to bypass the primary healthcare facilities in search of better care in
the secondary and tertiary facilities. This results in inefficiencies (because
these centers are overburdened with medical issues that can be addressed at the
primary level) and inequities (because care is more expensive at the secondary
and or tertiary care center and the average individual cannot usually afford this
care.
- Lack of Proper Funding
Without
the proper financing, gains in development in the Nigerian healthcare sector
will continue to be stifled. With that said, the amount of money Nigeria should
invest in healthcare depends on several factors, such as the health challenges
the country’s population is currently facing, different health inputs (e.g.,
public health staff, existing technology, etc.), and the level of investment to
maintain or improve the country’s health status.
The
sector’s growing challenges will lead to the unfortunate practice of medical
tourism, where the more privileged Nigerians participate in the $1 billion
industry by seeking better medical care outside of the country. Since the
majority of Nigeria’s population is unable to participate in this practice, as
a society, we have a moral obligation to take care of the population, because
your place of birth should not determine your prognosis.
- Out-of-pocket expenditure:
As
of today, 72 percent of total health expenditures in Nigeria are out-of-pocket
expenditures. In fact, out-of-pocket payments for healthcare services account
for a significant percentage of household expenditures in Nigeria. Nigeria is
amongst the countries that rank high for out-of-pocket expenditure.
The
Nigerian national insurance scheme only covers employees working in the federal
government, which is roughly 3 percent of the population. Furthermore, only
about 5 percent of the population have “prepaid” health care through
government-provided health insurance or a voluntary private insurance plan.
- Lack of Properly Trained and Compensated Staff
Another
major challenge in the healthcare sector is that there are not enough properly
trained staff to meet demand. The few well-trained doctors are overburdened and
most of the medical staff are not compensated well. These factors make staying
and working in the healthcare system a less desirable option.
In
fact, adequate compensation is lacking so much in this sector that the Joint
Health Sector Union (JOHESU), an association of all health workers apart from medical
doctors and dentists, called a nationwide strike to get the government to heed some of its major demands. These demands included salary adjustments,
promotion arrears, and an improved work environment for members. Unfortunately,
these strikes have left a lot of Nigerians who rely on the public healthcare
system without healthcare assistance during the duration of the strike.
- Weak Facilities/Infrastructure:
Arising
from the gross underfunding of the health sector institutions is the weak
infrastructure and logistic supports which are weak, obsolete, and defective.
This is due to inadequate maintenance of buildings, medical equipment, and
vehicles, shortage of drugs, faulty compounding of drugs, poor management of
drugs, the expiry of drugs and vaccines, and other essential requirements for
patient care.
The
utility Boards in Nigeria often make the problem worse by engaging in irregular
supply of water, erratic or rather epileptic supply of electricity, and poor
telecommunication services. Absence or inadequacy of equipment has been found deficient in most Nigerian Hospitals. Some of the public hospitals
visited some time ago had no X-ray machines.
- Poor Motivation of Health Workers
The
health professionals in Nigeria are yet to be adequately remunerated like their
counterparts in other advanced countries of the world. The consequential effects of poor motivation
are facile. Such effects include frustration, poor service delivery, psychological warfare at work, industrial strikes, and brain drain, just to
mention a few absurdities arising from poor motivation.
- Political and Bureaucratic Corruption
Unarguably,
corruption is a misnomer that replaces meritocracy with mediocrity. Corruption
in the health sector has gone far in such a way that teaching hospitals have been visited for accreditation of their facilities and human resources and the Chief
Medical Director hired temporary specialists e.g. cardiologists, image
scientists pediatrics psychiatrists, etc. just to meet the percentage set by
the visitors and after the accreditation, it is back to square one – shortage
of human resources.
Another
example of corruption and ethical indecency is the diversion of patients to
privately owned hospitals by a public hospital doctor pharmacist or nurse.
This is unethical behavior.
SPECIFIC CHALLENGES
- Space Constraint
one
of the major challenges facing Muhammad Abdullahi Wase Teaching Hospital is the lack
of space, it’s a well-known fact that the hospital is located within the Kano
metropolitan, in Nassarawa GRA (Government Residential Areas), which was
already been congested. The hospital is surrounded by many buildings and now as
a teaching hospital, they need the space to build and develop many new
departments and units.
- Lack of adequate personnel:
As
a Teaching hospital, the hospital now more than ever need professional in a different area of expertise, in both academics and clinical orientation. Not
only that but they also need adequate nurses and other low cadre personnel.
- Retirement of experienced doctors and Nurses
The
retirement of experienced nurses and doctors is one of the major challenges that
the hospital is experiencing. The retirement of these experts and constrain
by the government about employing new staff, put the hospital in an awkward situation. Even with the employment of those graduates, before they accumulate this expertise and experience like those who are retiring will not be easy.
- Lack of Adequate bad space
MuhammadAbdullahiWase has only 228-bed capacity, which is very low compared with Aminu
Kano Teaching Hospital with about six hundred (600) bed capacity. This is
challenging because, the expectation of the hospital is very high, and as the
best hospital under the Kano State Government it will be competing with specialist
and General hospitals like Murtala Muhammad Specialist Hospital.
- Burglary and Theft
As
the hospital is in the midst of a vast metropolitan city, with different
neighborhood, the hospital face the challenges of burglary and theft. Despite
many major employed to checkmate any security threat, but we still face the
problem of burglary.
RECOMMENDATION
As
Adam Smith (1759) asserts “No society can surely be flourishing and happy
of which greater part of its members are unhealthy, poor and miserable”. This
scholar solicits unreserved support and full commitment of the political
elite, health policymakers, and power elite in charge of public affairs to
accord topmost priority to issues bothering the health care delivery system
in Muhammad Abdullahi Wase Teaching Hospital in particular and any other hospital
in general. To solve the already suggested problem the following recommendations
are suggested;
1. Provision of
adequate funds: The Kano state government must provide
adequate funding to the hospital, through providing a considerable amount of
money in its annual budget, which will allow the hospital to boost its human
and material capacity. Another way of getting the appropriate fund is through collaboration with Non-state Actors both profit and nonprofit-based
organizations. Through a good agreement between them, Muhammad AbdullahiWase can
develop to the best it’s meant to be.
2. Build New
Facilities: the problem of space can be managed through the relocation of some departments to new facilities that are outside
congested areas by the state government. There are many places in Kano where that
can be gone with the will of the Kano state government. Another way of achieving
that objective is to buy the residents surrounding the hospital and
reconstruct or demolish them which will be very expensive. The last resort
based on our understanding is to give the Nassarawa orphanage Home the hospital,
which is under the Kano State government, and relocate them to another palace.
3. Signing Contract
with Retired expert: those expert nurses and doctors should be
allowed to help in training the newly recruited nurses and residential doctors, which
will help in inculcating the practical aspect of the jobs, teach them to acknowledge
and practicalize the good virtues that were taught in schools.
4. Collaboration with
Community to tackle Security: the issues of burglary
and theft can be solved through collaboration with the neighborhood community
organization. So add the number of private security guides and attend to
their welfare because underpaid workers can steal in the name of theft.
5. Invest in the welfare
of workers: the government should increase the
investment in the welfare of medical practitioners will reduce the level of brain drain in the hospital, and increase the level of commitment of the
work to their duties.
Reference
Adam S (1759), The Wealth of Nations, London, Penguin
Books, 1759
Chandra S. S (2008) Hospital Organization Structure,
ResearchGate, https://www.researchgate.net/publication/292519299
https://tribuneonlineng.com/kano-govt-converts-nasarawa-general-hospital-to-maitama-sule-varsity-teaching-hospital/
https://www.vedantu.com/biology/hospital#:~:text=Function%20of%20Hospital&text=Medical%20hospital%20%2D%20medical%20hospital%20includes,directly%20related%20to%20patient%20care.
Interviewed with Bashir Ahmad Chief Medical Adversary
Committee, who is also the Chief Medical Officer
Interviewed with Safiyanu Musa Baba; Chief Planning
Officer
M.G. SMITH (1997) GOVERNMENT IN KANO 1350-1950,
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Richard Cavendish (2003) The Fall of Kano, https://www.historytoday.com/archive/fall-kano
Taleat B.A. (2018) Contemporary issues and challenges
of the health sector in Nigeria Omoleke I.I., Research Journal of Health Sciences
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