Stakeholders in the health sector have called for the engagement of private investigators to complement existing regulators of health facilities in Lagos State.
Harmonisation of standards should effectively aid the monitoring of such facilities by the regulatory authorities.
The National Agency for Food and Drug Administration and Control (NAFDAC) is empowered to protect and promote public health.
It does this through a regulatory system that ensures that only the right quality food, drugs and regulated products are manufactured, exported, imported, advertised, distributed, sold and used.
Similarly, the Medical and Dental Council of Nigeria (MDCN) is mandated to regulate the practice of medicine, dentistry and alternative medicine in ways that safeguard health delivery in Nigeria.
The Health Facilities Monitoring and Accreditation Agency (HEFAMAA) was inaugurated in 2006 in Lagos state to monitor private and public health facilities and ensure their registration and accreditation.
In January 2023, the agency announced its decision to outsource the monitoring of health facilities in the state to reputable private organisations.
According to HEFAMAA’s Chairman, Dr Yemisi Solanke-Koya, the objective is to increase the monitoring coverage of health facilities and ensure improved quality of healthcare delivery to the residents.
The chairman said the selected organisations would monitor public and private health facilities in the local governments assigned to them.
Also, Dr Abiola Idowu, HEFAMAA’s Executive Secretary, told a stakeholders engagement meeting that it sealed 40 health facilities in the first half of 2023.
The stakeholders engagement meeting on “Combating Quackery in the Health Sector: Strengthening Stakeholder Collaboration and Regulatory Oversight’’, held at Ikeja.
She said that the facilities were sealed for various infractions including non-registration, lack of qualified medical personnel, practicing beyond scope of approval, improper disposal of medical waste and operating in an unclean environment.
Idowu said the agency had collaborated with relevant stakeholders to facilitate understanding of its position and what was required regarding compliance with standards.
“There is a need to understand what they are going through and see how we can come together and ensure that health facilities have high standards as well as ensure that these standards are culturally acceptable,’’ she said.
Regulatory authorities in the health sector have guidelines for the approval of health facilities.
Prof. Dipo Otolorin, member, Board of the Society for Quality Healthcare in Nigeria (SQHN), said that adequate funding, capacity building and empowerment of the authorities responsible for monitoring health facilities were required for effective operations.
Otolorin spoke in Lagos that HEFAMAA should be empowerment and well-funded to effectively discharge its mandate.
“There is also the need to constantly build the capacity of the workers in the agency through regular trainings, workshop and courses.
“It is also imperative that the mandates of the agency be reviewed to ensure it does not deviate from its responsibility of monitoring both private and public health facilities to ensure registration and accreditation in Lagos State.
“Unfortunately, the agency sometimes lacks the financial resources to execute its duties; often times, they lacked the resources to fuel the vehicles needed to be able to cover every part of the state.
“For instance, in monitoring government health facilities, a lot of gaps had been detected but the ability to close the gaps has been a big challenge,’’ Otolorin said.
He said that inadequate funding, power supply challenge and poor management were some of the factors limiting effective operations of health facilities in Nigeria.
He said that access to steady power supply was also a major challenge of most government health facilities.
“Imagine the theatre when a Surgeon is operating on a patient and trying to control blood and the power goes off. The tendency that the patient might loss his/her life is very high,’’ Otolorin said.
He called for the establishment of an alternative means of power supply, preferably the ‘solar energy’ to enhance performance of health facilities since most medical operations need power supply.
He said that some government health facilities were dilapidated and required appropriate personnel with the requisite knowledge to manage them.
According to him, the managers of some of the health facilities can be good managers of patients and not good managers of equipment and other tools needed for the effective operation.
Otolorin said that SQHN had been working with health facilities to improve quality and safety of their healthcare services through education, collaboration, training and accreditation.
He reiterated the commitment of SQHN to ensure improved healthcare services that met international standard were rendered in health facilities in Nigeria.
For Mr Wale Oladigbolu, National Chairman, Association of Community Pharmacists of Nigeria, the lack of continuous monitoring culture was partly responsible for the deplorable state of facilities in Nigeria.
He said: “There are guidelines for approval of health facilities by all regulatory authorities in the sector. Many of these guidelines are very robust.
“They can bring out the best in our systems, however, the culture of continuous monitoring is lacking.
“The lapses may well be responsible for the deplorable state of our health sector and this is why all health facilities should be monitored continuously.’’
According to him, private inspectors should be engaged to augment efforts of government monitoring and regulatory agencies.
Dr Tunji Akintade, a former Chairman, Association of Nigerian Private Medical Practitioners (ANPMP), said that the harmonisation of standards would also strengthen health facilities’ monitoring.
He said that efforts should be made for regulatory standards of the Federal and State agencies to align to strengthen the healthcare delivery system.
“The regulators must enhance their capacity to accredit, inspect, monitor, and license all health facilities, however, favouritism should be shunned in the discharge of their oversight functions.’’
He said that minimum standards for operations of facilities in the public and private sectors in Lagos should be sacrosanct.
Akintade, however, said that HEFAMAA had deviated from its core oversight functions to focus on revenue.
He urged the agency to enhance its monitoring of public and private health facilities to deepen quality healthcare delivery.
Similarly, Mr Ayo Adebusoye, Chairman, Board of Trustees, Lagos Civil Society Participation for Development, called for strengthening of the health system, effective monitoring and collaboration with local authorities to ensure standards.
“Effective monitoring and collaboration with local authorities will ensure that managers of health facilities adhere to standards. Efforts should be intensified to employ qualified medical practitioners,’’ he said.
He said that only qualified medical practitioners should be employed in health facilities.
Mr Mayowa Olaode, a Lagos resident, said that a good hospital required standard facilities and a valid licence from the relevant regulatory body.
Olaode said facilities should have adequate and qualified personnel to provide the necessary services, equipment and infrastructure for quality services.
He said that facilities must meet set standards by regulatory bodies and have a valid insurance policy to cover any potential liabilities.
Another resident, Mrs Feyisayo Adelure, said that such facilities must adhere to the applicable health and safety regulations.
Adelure said that the facility must also have a valid waste management plan and provide evidence of professional development and training of staff.
She said that the facility must provide evidence of quality assurance and performance measurement and provide evidence of effective communication and coordination with other health care providers.