Public hospitals fighting against crumbling infrastructure and brain drain: CEO of Duchess Hospital

The Executive Director of the Duchess International Hospital, Dr. Adetokunbo Shitta-Bey, speaks with VICTOR AYENI on how the nation’s healthcare delivery can be made affordable for the common man and how to stop the growing brain drain and medical tourism, among various other topics

Can you tell us about yourself and your mission?

I am Dr Adetokunbo Shitta-Bey, CEO of Duchess International Hospital at GRA, Ikeja, Lagos. He was born in Lagos on April 13, 1972 and studied at King’s College Lagos, University of Nigeria, Nsukka, King’s College London and Cranfield University School of Management where he obtained a Master of Business Administration.

I am a specialist family doctor and academic general practitioner by training. I have a Masters in Primary Health Care and am a Fellow of the Royal College of General Practitioners, UK.

I am interested in health and socioeconomic issues that affect the wealth of local communities and I am passionate about clinical governance, medical education, administration and policy of health care systems. My personal mission is to help build safe and sustainable healthcare delivery systems in Nigeria and low- and middle-income communities, one practice at a time.

He recently described his medical center, Duchess Hospital, as a “one-stop-shop for primary, secondary and tertiary care services.”

Duchess International Hospital is in fact a “one stop shop” for primary, secondary and tertiary healthcare services. This was from the beginning, identified as an aspiration and a firmly defined goal. The mission of the hospital is: “to reverse medical tourism by providing the highest standards of care, using the most advanced technology and treatments to give our patients the fastest and most convenient access to the best medical experience available anywhere in the world” .

Our services are deliberately located in the heart of Ikeja and a few minutes from the local and international airports. It costs N5,000 to register as a patient at the Duchess and N5,000 for a consultation with a specialist GP.

Many Nigerian elites have lost confidence in the public health system due to dilapidated infrastructure, lack of medical equipment and dilapidated facilities. What are the ways to regain their confidence in our health sector?

We are now discovering that there is a collective desire among Nigerians across all spectrums of society to seek robust and reliable healthcare solutions within our own country’s shores. Vice President Professor Yemi Osinbajo’s recent account of his decision to undergo orthopedic surgery at Duchess International Hospital in July this year was a major confidence boost for both the public and health care establishments in Nigeria.

Our focus at Duchess International Hospital, therefore, is to rebuild that sense of trust in the Nigerian healthcare system, strong delivery of high-quality healthcare services, strong clinical and administrative governance, world-class expertise. led by specialists and affordable prices of our services for all Nigerians.

We are committed to providing “Access to World Class Affordable Healthcare” on behalf of all Nigerians through five key priorities and objectives which are: reduce the cost of access to essential hospital services, maintain quality health care based on evidence, 24/7 access to emergency medicine and intensive care, a wide range of services and treatments directed by specialist consultants and prioritizing direct attention to the needs of the population.

The Nigerian Medical Association has said the country spends $1 billion a year on medical tourism. This is a huge sum of money. How can this trend be reversed?

These figures from the Nigerian Medical Association, if accurate, are quite significant. Of course, they have yet to be fully verified, but the figures quoted by the NMA may well turn out to be an underestimate of the actual fact. To put it in context, this roughly translates to about 50,000 Nigerians each year spending an average of $20,000 per trip.

You are absolutely right in stating that the essential problem that defines the tendency to seek medical treatment abroad, the so-called medical tourism, is the loss of confidence in public health services or what I prefer to call “lack of confidence”. ”

This lack of trust, by the way, is not the preserve of the elite of society. It is a prevalent and perennial feature of healthcare seeking behavior in all strata of Nigerian society, mediated, as you say, by dilapidated healthcare infrastructure, lack of medical facilities and other factors such as regulatory environment suboptimal in which health care operates. , the general economic situation and the exacerbated mass exodus of doctors and allied health professionals from the country in recent years.

There have been reports of an alarming increase in doctors, nurses and other healthcare workers migrating en masse to foreign countries. What is your reaction to this?

Nigeria is currently experiencing another massive wave of ‘brain drain’ of intellectual and clinical resources with a significant undermining effect on the state of healthcare delivery in primary, secondary and tertiary care.

Physicians and allied health professionals should be provided with the best training opportunities available at home and abroad for reasons of professional fulfillment and for the ultimate benefit of our health care system in Nigeria.

I understand we now have a ratio of 1 doctor to approximately 10,000 people across the country. According to the latest figures from the NMA, around 6,000 doctors have left the country in search of greener pastures abroad in the last eight years.

What needs to receive more careful consideration is a structured policy framework that allows the training of health professionals to occur, perhaps off the coast of the country, if necessary, but also provides a mechanism to facilitate timely return. of these highly trained resources.

This ideal is inextricably linked to issues related to remuneration, health infrastructure, the environment for undergraduate and postgraduate training in public institutions, taxation and incentives, to name a few.

In fact, this is a very complex and multifaceted problem, made no less difficult by the prevailing socioeconomic circumstances and the fact that today we are graduating far fewer doctors and allied health professionals than a few years ago.

Reversing the brain drain and possibly achieving a “brain gain” position in the long term will require us to directly address these prevailing issues as well as carefully looking for more innovative ways to deploy our vast untapped and highly qualified resource of trained personnel. scientists, allied health professionals and other support staff, in support roles and newly developed assigned tasks where unique skill sets, training and professional backgrounds can be fully utilized.

Maternal mortality is quite high in Nigeria, the United Nations Child Education Fund showed that Nigeria had the fourth highest maternal mortality rate in the world at 576 per 100,000 live births. What are the ways to get out of this problem?

The lifetime risk of dying during pregnancy, childbirth, or after an abortion for a Nigerian woman is 1 in 22, compared with 1 in 4,900 in developed countries; and according to the World Health Organization, Nigeria accounts for more than 34 percent of maternal deaths globally.

Infant mortality follows a similar pattern, and mortality rate differences for both indices occur across regions of Nigeria, depending on socioeconomic patterns and distributions, and access to high-quality, affordable maternal and child health care at health care facilities. primary and secondary education available in local communities.

By one estimate, 70 percent of Nigerians are mired in poverty and the majority of Nigerians finance their healthcare needs through out-of-pocket expenses. Are there ways to make healthcare more affordable?

Health follows a social gradient. If you are poor in Nigeria, and in most of the developing world, you are much more likely to suffer from poor health outcomes and poor access to quality, affordable health care.

Therefore, providing quality and affordable healthcare is the existential issue facing healthcare delivery in Nigeria today. Making these services “accessible” to the population is the job of the health administration. Adequate financing of health care is the central component in solving the problem of access.

We at Duchess International Hospital have received significant financial support from the Federal Government through the Central Bank of Nigeria’s health intervention fund. Precisely for this reason, we are able to pass the benefits on to local communities of ordinary Nigerians by committing to long-term competitive low rates on a wide range of services available at the hospital.

The tremendous goodwill and support received from the Federal Government and CBN have made it possible for us to provide our high-quality services and unique specialties accessible to the public, helping us to fulfill our mission of providing: “the fastest and most convenient service.” access to the best medical expertise available anywhere in the world.”

In direct response to your question, therefore, regarding ways in which health care delivery can be made more affordable in Nigeria: The solution to this problem requires strong and sustainable health care funding and financing mechanisms, as well as astute innovation, organization and leadership in the design and delivery of quality healthcare.

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