Lack of funding, poor patient education, affecting Nigeria’s healthcare delivery – Experts

Chijioke Iremeka

Medical experts say lack of patient education and access to funds are major challenges bedevilling Nigeria’s health sector in the past five years.

They identified lack of education and inaccessibility to funds as the two major ones.

A consultant Gynaecologist and Obstetrician, Dr. Abayomi Ajayi, who is also the Managing Director, Nordica Fertility Centre, Lagos, said patient education is the major as people who lack the basic knowledge of how their body system works will consider healthcare to be a doctor’s business only.

He urged the patients to get involved in anything that concerns their body because the burden would always be on them (patients), if there are mistakes, adding that doctors will only apologise and move on.

“I always tell patients to be involved in their medical exercises. So, it is important for the patients to also have basic knowledge about how their body works and other basic things they need to know,” he added.

The fertility expert further noted that accessibility to healthcare is a big challenge in the country as there have always been complaints that healthcare in Nigeria, like in other countries of the world costs money.

“Unfortunately, somebody has to pay, either the government or the people. And we know that in Nigeria, it might not be possible for the government to pay for obvious reasons. So, these are the two main problems that I see,” he said.

According to Dr. Ajayi, one challenge is easier than the other because the masses can try to come together to address it, although the cooperation of the public is needed as well in addressing both.

He said, “Patients have to read, listen to doctors and ask questions. There are even some people who go for consultation yet they don’t know the name of the doctor that attends to them, meanwhile, they know the name of their bank manager. They know the name of even the teller in the bank.

“So, they just lack interest in healthcare issues. The easiest way to make people sleep in a congregation is if you start talking about healthcare. It’s important for us to take an interest in our health. We need to ask questions like – What can we do? What can we not do? What kind of doctor do I need to see if I have this type of problem? These are basic things that we should know.

“Then we should also decide. It’s either we are paying for healthcare, in which case you need to have a budget for it or we are involved with the Health Maintenance Organisation. We should make allowance for healthcare because we are also like machines.

“Imagine that your body has been working for 40 years as a machine and there is no provision for it. In one day, something will go wrong. This is what we do; we don’t make any provision for health care. So, I think it’s important that we plan for healthcare.”

Speaking on the knowledge gap between the patients and the professionals in reproductive medicine, Dr. Ajayi said, “I think the most important thing is the time we are in. I see a lot of people even in their 50s coming to me, saying they want to store their eggs. And some of these people are graduates.

“When graduates can talk like this, it shows me that our knowledge of reproductive medicine is very low. If you are not careful; if you tell that kind of person that it’s too late to start storing her eggs, she can get upset because she is not coming from a point of knowledge but from a point of emotions. That is the difference between a woman in Nigeria and a woman in the UK or U.S.

“We tend to believe more about what pastors say rather than the facts surrounding whatever they want to do. So, the more people can avail themselves of the facts, the better guided they will be because what they do is like buying a car and wanting it to fly.”

Affirming Dr. Ajayi’s position, a family physician at the Federal Medical Centre, Asaba, Delta State, Dr. Ovie Efekodo said most patients are scared to discuss their treatment with the doctors, believing that only doctors can know what they are passing through and not them.

He said, “In my practice as a medical doctor, I have discovered that the majority of patients that come to the hospital and are given medications barely know their names. If you ask, they won’t tell you because they don’t know.

“It is that bad because when there is an issue to investigate because the patient doesn’t have the necessary knowledge of what medicine he or she has taken, it affects the outcome. Some of them don’t even know the sickness that they are being treated for.”

However, in a work by Timothy Patrick and his team titled, ‘Improving health outcomes through patient education and partnerships with patients,’ published in the National Library of Medicine, the authors said to improve health care outcomes, physicians must spend more time with patients.

“The teaching physician’s interaction with the patient must be enthusiastic, motivated, and responsive to the individual patient’s needs. For individual members of our society to realise the benefits of physician health education, there is a need for a robust, hearty engagement between patients and physicians,” it added.

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