Transcript RESEARCH AND DEVELOPMENT: REPOSITIONING …

HEALTH CARE DELIVERY AND
RESEARCH IN NIGERIA: PERSISTENT
CHALLENGES
BY
TOLU ODUGBEMI, MD, Ph.D, FRCPath, PNMC, FAS, NNOM, OON.
Professor of Medical Microbiology & Parasitology,
Vice-Chancellor,
University of Lagos,
LAGOS, NIGERIA.
Fifth Kola Olafimihan Endowed Lecture, College of Health Sciences,
University of Ilorin, Nigeria on:
Thursday, December 11, 2008 at the New University Auditorium,
Permanent Site, Ilorin, Kwara State
Health care service delivery to be
efficient and effective depends on
commitment and sincerity of man
working with appropriate tools in a
conducive environment or setting.
The number of training health institutions has
increased considerably over the years. The
curricula of training of health professionals
vary from one institution to another.
How effective?
Medical Training In Nigeria
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Teaching Hospitals
Specialists Hospitals
General Hospitals
Regulatory and Examining bodies:
National Postgraduate Medical
College{NPMCN}
West African Postgraduate Medical
College{WAPMC)
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Health research and development should be based on
diagnoses of common diseases:
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Those that account for high rates of morbidity and
mortality in the community with
Those with serious economic burden inflicted on the
society.
For compiling research data, there should be
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well equipped and professionally trained staff in the healthcare facilities,
laboratories and research institutes
THE NATIONAL HEALTH POLICY AND
STRATEGY
The three tiers of health-care system were clearly
spelt out as:
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Primary Health Care at Local Government
Level
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Secondary Health Care at State Level.
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Tertiary Health Care at National Level.
Note that teaching hospitals are special tertiary health centres, which
serve primarily as practical grounds for training health
professionals in the College of Medicine.
HEALTH AND RESEARCH
There is a need to undertake research at each
level of our healthcare using appropriate
technology.
TABLE 3: COMMON CAUSES OF VISITS TO
HEALTH CARE FACILITIES (%)
Infective and Parasitic diseases
38.2%
Respiratory diseases
12.7%
Diseases of nervous system and organ
9.9%
Ill-defined conditions
9.2%
Skin disease
8.4%
Digestive system
4.7%
Accidents
3.1%
Muscles and skeletal diseases
2.9%
Genitourinary diseases
2.7%
Blood diseases – anaemia etc
2.5%
Nutritional and metabolic diseases
1.8%
Others
3.9%
Focal Areas of Research
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Basic or Biomedical
Clinical
Operational
Pharmaceutical-Drug trials
Immunological-Serological surveys
Laboratory –based
Field studies
Applied
Basic Aspects of Research
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Title: Identification of The Health Problem
Introduction and Literature Review
Aims and Objectives
Materials and Methods
Results
Discussion
References
Acknowledgements
Role of Research
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Important and vital
Adds to knowledge
Confirms old ideas
Corrects old views
Modifies accepted views
Creates new concepts/hypotheses/theory
POLICY OBJECTIVES
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To promote research in basic, clinical, public
health sciences at primary, secondary and
tertiary health care levels in order to enhance
quality of health amongst all Nigerians
Research Institutes
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Medical Research Institutes should be more
effective. Medical Research Institutes in
America and Europe serve as role models for
other research centres. For example, the
Centers for Disease Control and Prevention, at
Atlanta Georgia, USA is in the forefront for
health research, development and Diseases
Control and prevention
Research Institutes continued
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Reference laboratories should be established at
each geographical zone of Nigeria.
Health institutions should be well-equipped
and properly staffed.
Active collaborative research works should be
encouraged among the various institutions at
local, national and international levels
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Training
Effective and good training of our students at postgraduate
and undergraduate levels with up-dated curricula
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Community-Based Education and Service
(COBES) programme (Ilorin Model)
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Re-training
Trainers need to be retrained to prevent a ‘blind leading the
blind’ situation. The introduction of Continuing
Professional Education by some bodies is a most welcomepractice
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Funding
There should be adequate funding of our various diagnostic
centres
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Ethics
Ethical practices should be enforced at all levels of
our health-care diagnoses and research
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Information
There should be adequate and proper means of
dissemination of scientific findings through peerreviewed journals, bulletins and presentations at
scientific conferences
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Monitoring, Standardization, Evaluation
and Implementation
Personnel, equipment, supplies and laboratory
infrastructures need to be regularly monitored to
ensure quality control and quality assurance which
should be adequately backed by internal and
external assessments
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Policy and Guidelines
To ensure good research development, each
laboratory must have guidelines and policies on all
procedures, practices and safety
Akinkugbe, 1998 - “Through the present decade,
Primary Health Care has been dramatized in a
way as never before to the detriment of the other
tiers of care. It is as if you have to pull the others
down in order for PHC to thrive. Yet the
successful prosecution of PHC not only depends
on secondary (SHC) and Tertiary (THC), but on a
vast and varied array of social infrastructure
concomitants: Food, Shelter, the Environment,
Education, Roads, Water, Communication and
the Alleviation of Poverty”.
CONCLUSION
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Break the jinx! – individual Nigerians are nice
but collectively in this nation, Nigeria remains
“a developing country”
There should be teamwork, commitment and
sincere service to our nation in any one of our
callings