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NMA and the Need to Embrace Integrated Healthcare & Patient Centered Care

The Nigerian Medical Association (NMA) has called on the Federal Government to shelve its planned harmonisation of salaries of health workers in the country…”  It came as a rude shock and disturbing moment for me when I read the above in a Nigerian tabloid.

Furthermore, the statement read by the NMA president, Dr. Mike Ogirima continued: “What we are against is the fact that everybody cannot be equated to be equal. In the animal kingdom, all animals are equal; but some are more equal than others.” Reading about this sounded like I was watching an animal kingdom themed movie.

One would have thought that the overall health and well being of the citizens of a Nation like Nigeria would be priority in times like this. We do not have enough doctors in Nigeria to serve our ever growing population; the need for integrated healthcare cannot be over emphasised.

According to the World Health Organisation, “an overall working definition of integrated service delivery is “The management and delivery of health services so that clients receive a continuum of preventive and curative services, according to their needs over time and across different levels of the health system.”

I believe it is high time the NMA began to have an open mind as to how we can run the healthcare system in Nigeria in other to make it a patient centered one. Hierarchy for healthcare professionals should not be top of the scale of preference at the moment going by the realities of inadequacies in the area of Health care delivery in Nigeria.

Talking about ‘everyone trying to accept the title of doctor’ would sound a bit odd to some people. Some doctors I have worked with don’t mind being called by their first name, I’m not referring to junior doctors, and I mean consultants and Professors.

The table below should be of great worry to any individual or association that has the desire to improve Healthcare delivery in Nigeria, the NMA inclusive.

WHO Statistics on Nigeria

Total population (2015) 182,202,000
Gross national income per capita (PPP international $, 2013) 5
Life expectancy at birth m/f (years, 2015) 53/56
Probability of dying under five (per 1 000 live births, 0) not available
Probability of dying between 15 and 60 years m/f (per 1 000 population, 2013) 357/325
Total expenditure on health per capita (Intl $, 2014) 217
Total expenditure on health as % of GDP (2014) 3.7

We should be more bothered about the fact that the citizens of our country are engaging in medical tourism more than before – going to countries like India to seek medical intervention. The NMA says it’s not against the proposed harmonisation of health workers salary in the country, but it should be ‘relative’.

And I say let all healthcare professionals in Nigeria come together to deliberate on how to deliver excellent healthcare across the Nation.

In 2017 Healthcare professionals across the globe are more concerned about working together to deliver patient centered care. We all have different roles to play; the medical doctors cannot achieve this on their own!

I will advise the NMA to please consider the common man on the street when making decisions or advising the Federal Government.

To build an efficient health service delivery system, all healthcare workers salary should be revised and harmonised so that people can be rewarded as well as gain some fulfillment for the services they offer. The focus should not be relativity or superiority in my opinion.

Every year Healthcare professionals leave the shores of Nigeria in their thousands in search of greener pastures; the harmonisation of salaries will reduce this outward exodus for all I believe.

All Healthcare professionals in Nigeria should engage in CPD-continuous professional development to attain the much needed clinical skills to function effectively in their chosen area of competence.

‘For health, care and support to be ‘integrated’, it must be person-centered, coordinated, and tailored to the needs and preferences of the individual, their carer and family. It means moving away from episodic care to a more holistic approach to health, care and support needs that puts the needs and experience of people at the centre of how services are organised and delivered’.

The health of many Nigerians is at risk due to poor chronic disease management – lack of education on lifestyle advice, lack of self-care and lack of awareness on minor ailments which can transform to major diseases if left untreated.

There is need for more Integrated healthcare in Nigeria where every member of the healthcare team i.e. Doctors, Pharmacists, Nurses, physiotherapists, occupational therapists, Dieticians, community healthcare assistants and other healthcare professionals work together to contribute their own quota to excellent health promotion and healthcare delivery.

Let’s focus on Integrated Healthcare & Patient centered Care. In the words of WHO Director-General in 2007, “We need a comprehensive, integrated approach to service delivery. We need to fight fragmentation.”

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