Health Care System In Nigeria Research Articles

Pharmacovigilance in Nigeria: Addressing challenges in ensuring drug safety and monitoring adverse effects

This paper examines the specific challenges faced by Nigeria in implementing pharmacovigilance measures to ensure drug safety and monitor adverse effects. Despite the critical importance of pharmacovigilance in safeguarding public health, Nigeria grapples with several obstacles in its implementation. Through a nuanced exploration of literature and regulatory frameworks, this study sheds light on the unique hurdles encountered in pharmacovigilance practices within the Nigerian context. Challenges in Nigeria's pharmacovigilance landscape include limited awareness and understanding of pharmacovigilance principles among healthcare professionals and consumers, resulting in underreporting of adverse drug reactions. Additionally, there is a lack of robust infrastructure and resources for pharmacovigilance activities, including inadequate funding, shortage of trained personnel, and deficient pharmacovigilance databases. Regulatory enforcement and oversight are also hindered by issues such as weak regulatory frameworks, fragmented reporting systems, and suboptimal collaboration among regulatory agencies. Furthermore, Nigeria's pharmacovigilance efforts are compounded by factors such as the proliferation of counterfeit and substandard medicines, informal drug markets, and cultural beliefs influencing healthcare-seeking behaviors. These challenges pose significant barriers to effective pharmacovigilance implementation and compromise patient safety and public health outcomes in Nigeria. Addressing these challenges requires a multifaceted approach encompassing regulatory reforms, capacity building initiatives, public awareness campaigns, and collaboration with international partners. Strengthening regulatory frameworks, enhancing healthcare professional training on pharmacovigilance, establishing robust reporting systems, and fostering partnerships between regulatory agencies, healthcare institutions, and pharmaceutical companies are essential steps toward improving pharmacovigilance practices in Nigeria. Through a thorough examination of the Nigerian context, this paper aims to raise awareness of the specific challenges hindering pharmacovigilance implementation in the country and stimulate dialogue on potential solutions to enhance drug safety and monitoring of adverse effects in Nigeria's healthcare system.

Health Outcome and Economic Growth: The Case of Malaria in Nigeria

This study has examined the influence of health outcome on economic growth in Nigeria: the case of malaria. The purpose of the study is to investigate the efforts of government on health care system in Nigeria as it influences real gross domestic product within the period of review. Econometrics analyses were employed to carry out the investigation using Autoregressive Distributed Lag (ARDL). The findings revealed that current health expenditure has an unfavourable effect on economic growth, while gross capital formation and secondary school enrolment have positive influence on economic growth in Nigeria. It is, therefore, recommended that the government should endeavour to double her investment in health care system in Nigeria. There are lots of capital outflows as a result of poor expenditure on health care system in Nigeria. The only way to curb this is for the government to be deliberate in her will to invest in this particular sector of the economic which will stimulate improvement in economic growth in general.

Web-Based Geographic Information System for Location Based Healthcare Service Delivery within Akure Metropolis

Purpose: This research project addresses the pressing issue of healthcare access within Akure Metropolis, Nigeria, through the development of a web-based Health Geoinformation System (HGS). Akure, like many urban centers in developing countries, faces significant challenges in healthcare delivery, including uneven distribution of facilities and limited access to reliable health information. In response to these challenges, this study leverages Geographical Information System (GIS) technology to create an innovative solution aimed at enhancing accessibility and information dissemination. Grounded in the context of Nigeria's healthcare system, the research identifies the need for an integrated approach to address the complex spatial dynamics of healthcare provision.
 Materials and Methods: Methodologically, the project combines primary data collection on the characteristics of health facilities in Akure with secondary data sources, including existing health records. A total of 100 healthcare facilities were located and identified for this study, with comprehensive information collected through three sets of questionnaires directed to healthcare facility managers and professionals, hospital management bodies, and the public. The data collection process employed Binary Logistic Regression to test research hypotheses, with charts utilized to represent public responses to the posed questions. Spatial representation and analysis were central to this study, with techniques such as Nearest Neighbor Analysis employed to assess the distribution and accessibility of health facilities.
 Findings: The results from this analysis revealed significant spatial patterns and disparities in healthcare facility distribution within Akure Metropolis. Notably, the study found that a developed web-based system having user-friendly functionalities like facility search, mapping, and route selection, among others, aids individuals in making informed decisions about their healthcare options.
 Implications to Theory, Practice and Policy: The results underline the potential of web-based systems to enhance healthcare access and decision-making processes in urban areas like Akure and further emphasize the significance of incorporating GIS technology into healthcare service delivery.

Digital Healthcare Tools in Nigeria: Strengthening Public Health and Pandemic Preparedness - Insights from the COVID-19 Crisis

This review explores the transformative impact of digital healthcare tools in Nigeria's healthcare system, with a particular emphasis on lessons learned from the COVID-19 pandemic. Nigeria, a country grappling with healthcare disparities and limited access, has seen digital healthcare tools play a crucial role in enhancing public health and pandemic preparedness. The review begins by setting the stage for the relevance of digital healthcare tools in Nigeria, acknowledging the country's complex healthcare challenges. It outlines its objectives and research approach, ensuring transparency and precision in source selection, including Nigerian databases. The examination of digital healthcare tools in Nigeria highlights their potential to address healthcare access issues. The review also delves into the regulatory framework governing telemedicine in Nigeria, recognizing the need for a delicate balance between regulation and innovation, given the nation's unique infrastructure challenges. This provides insights into the factors influencing telemedicine adoption among both healthcare providers and patients in Nigeria. While acknowledging challenges like infrastructure limitations and regulatory complexities, the review also identifies opportunities, such as improved healthcare accessibility and cost-efficiency, brought about by digital healthcare tools in Nigeria. Concrete examples of successful digital healthcare initiatives within Nigeria are presented, offering actionable insights and a roadmap for future endeavors. The review concludes by emphasizing the essential role of digital healthcare tools in addressing Nigeria's healthcare challenges and providing tailored recommendations for policymakers, healthcare providers, and researchers. Ultimately, this comprehensive exploration goes beyond current achievements and challenges, envisioning a future where digital healthcare tools revolutionize Nigeria's healthcare landscape, identifying promising research avenues, and anticipating innovations that can shape the nation's healthcare for the better.

Preventive Nursing, Community Engagement, Health Promotion: The Pathway to Improving Health Care in Nigeria

The article explores the many obstacles that the Nigerian healthcare system encounters and suggests a holistic strategy that includes preventive nursing, health promotion, and community participation to improve healthcare provision. The research underscores the significance of community participation, emphasising its function in cultivating a feeling of affiliation and possession, as well as establishing a connection between the community and healthcare programmes. The text extensively examines the notion of preventative nursing, highlighting its multiple character as both a specialised nursing practice and a subject rooted in public health. The objectives and constituents of preventive nursing are delineated, highlighting its function in timely identification, proactive interventions, and its influence on national health results. Health promotion is presented as a vital component of healthcare reforms, with the goal of enabling people to make knowledgeable decisions about their well-being. The article outlines the objectives of health promotion, with a particular focus on minimising risk factors and encouraging a proactive approach to maintaining good health. The text discusses strategies for efficacious health promotion in Nigeria, including the engagement of community leaders and the use of both conventional and digital approaches. The text examines the notion of community participation, characterising it as a multifaceted and all-encompassing process that entails a dynamic interchange of ideas and resources among many stakeholders. The research highlights the significance of active community engagement in decision-making processes, emphasising its role in fostering inclusivity and collaborative decision-making. The paper finishes by underscoring the crucial significance of nurses in the domains of preventive nursing, health promotion, and community involvement. This highlights the need of adopting a comprehensive and interdisciplinary strategy to tackle the difficulties encountered by the healthcare system in Nigeria. The report promotes urgent and cooperative measures, emphasising the potential of the suggested ways to improve healthcare in Nigeria.

Family Planning Services Digitalization: Implications to Nursing

This research examines the changing nature of family planning services in Nigeria, investigating the complex interaction between traditional practices, cultural influences, and the continuous integration of digital technologies. Although there has been notable improvement, the availability and use of family planning services continue to encounter ongoing obstacles that are deeply founded in cultural attitudes and structural shortcomings within the healthcare infrastructure. Historically, family planning in Nigeria has mostly depended on traditional practices and cultural beliefs, which have impeded the widespread use of contemporary contraceptive technologies. The intricate interplay of cultural elements leads to a significant percentage of the population being deprived of a wide array of family planning options. The issues are worsened by the healthcare system, which is characterised by limited resources and geographical inequality. The use of digital technology into family planning services offers a revolutionary chance for change. Contraception monitoring applications, wearable gadgets, and telemedicine provide novel methods to improve the accessibility, accuracy, and effectiveness of reproductive healthcare. The research highlights the significance of artificial intelligence and machine learning in customising preventative interventions. Nevertheless, the implementation of digital family planning services presents obstacles such as privacy issues and the need for fair technology availability. The objective of this research is to conduct a thorough analysis of the intricacies related to digitalization, while considering both the advantages and disadvantages. The future of family planning services in Nigeria hinges upon not only technology advancements, but also on cooperative endeavours, cultural awareness, and meticulous strategizing. This article explores the ramifications of digitalization on nursing practice, education, and administration, with a particular focus on the crucial role that nurses play in adapting to this transformational environment. This research provides significant insights to facilitate the successful incorporation of digital technology into family planning services, with the aim of creating a more accessible, patient-centered, and technologically advanced reproductive healthcare system in Nigeria.

Modelling female nurses’ career sustainability towards career competency development and teamwork using self-efficacy as a mediator

The current state of the healthcare sector in developing countries such as Nigeria has resulted in a significant number of highly skilled health workers migrating overseas for a more fulfilling career. Stakeholders are concerned about this development, emphasizing its impact on healthcare service delivery. While some studies point to role conflict and a lack of family support as the primary causes of female nurses' unsustainable careers, others claim that individual, contextual, and institutional factors can all impact career sustainability. Various factors influence an individual's career sustainability, such as their career skills, ability to work in a team, and confidence in performing tasks successfully. This study aimed to investigate the relationships between these variables and their impact on the sustainability of careers among female nurses. The study is grounded on the Social Cognition Career Theory as its theoretical foundation. This quantitative study analyzed a sample of 292 female nurses from a tertiary hospital in southwest Nigeria using IBM SPSS 28 and Smart PLS. The data was obtained from a questionnaire and analyzed through measurement and structural models. The study found that the professional development of career competence had a significant and positive causal relationship with the career sustainability of female nurses. However, teamwork had a negative effect on the career sustainability of the female nurses surveyed. Furthermore, the mediation analysis revealed that self-efficacy played a positive mediating role in the relationship between teamwork, competence development, and career sustainability. Study findings provide insight into how stakeholders in Nigeria's healthcare system might improve career sustainability by boosting professional career competence, increasing team effectiveness, and encouraging career self-confidence among nurses. To maintain a stable career, this study recommends that nurses focus on enhancing skills, working effectively in a team, and building self-confidence.

Agile-Omoluabi Leadership, Technology-Transfer, Government Willingness to Change, Engagement and Organizational Citizenship Behavior: Examining the Moderating-Mediating Role of Workplace Happiness in Nigeria’s Healthcare System

On the backdrop of the aggressive move by the healthcare workers in Nigeria to foreign countries to ply their expertise, the country has suffered her worst brain-drain episode leading to been labelled among the 55 countries experiencing healthcare short in Africa. This is right and it call for an array of contextual issues including; leadership, technology transfer, government willingness to change, engagement, organisation citizen behaviour and workplace happiness to tackle this rather unfortunate incidence. A validated questionnaire was employed to gather data from 408 health-care practitioners including doctors, nurses, pharmacists, technologists and administrators in public-owned hospitals in Nigeria. A path analysis was used to examine the six-way direct, mediation, and moderation hypotheses. Results showed that agile-Omoluabi leadership, government willingness to change and technology transfer had positive and significant effect on engagement (Adj R2 =0.685, p=0.000, Q2 =0.484), workplace happiness stood as a positive and significant intervening variable mediating the interaction between agile-Omoluabi leadership and organisation citizen behaviour (β=0.257, t= 2.033, p= 0.043) as well as serving a moderator for the linkage between engagement and organisation citizen behaviour (β =0.300; p< 0.000, Q2 =0.365). The findings of this study as practical implication for the ministry of health in Nigeria because it offers strategic information which confirms the twofold relevance of workplace happiness as critical to sustaining health-care practitioners’ engagement and guaranty exhibiting citizen behaviour. Also reinforce the need for government at all levels to show readiness to transform, plan and implement a systematic process of technology transfer and show a leadership that care about the health-care practitioners and one that is dynamic. This if done, should address the brain drain and improve the lost glory of the health-care system in Nigeria.

FOREIGN AID IN NIGERIA: A DEPARTURE FROM ECONOMIC DEVELOPMENT IMPACT TO SOCIAL DEVELOPMENT IMPACT

Discussions around foreign aid although contradictory have mostly been on its impact on economic development of recipient countries leaving social aspect of development poorly attended to. Moving away from this common path, this paper aims to explore social development impact of foreign aid in Nigeria. Utilizing secondary sources of data, the paper decomposed social development into specific measurable variables such as poverty eradication, healthcare system and human security. The findings of the study demonstrate that foreign aid has not significantly impacted on larger components of social development investigated. It is also highlighted in the study that there is conflicting evidence regarding the impact of foreign aid on healthcare system in Nigeria. The result equally reveals that varying interest of foreign aid actors constitutes a serious challenge to the performance of foreign aid in the country. As a panacea, the paper recommends for global attitudinal change campaign to foreign aid actors.

AN OVERVIEW OF THE PRIMARY HEALTHCARE SYSTEM IN NIGERIA

This paper describes the structure and operation of the primary healthcare system in Nigeria, the sequence of its evolution from inception to what is obtainable now and the effectiveness of the system. Prior to that, a detailed description of the WHO targets through its Alma-Ata declaration in 1978 was explained and evaluated in comparison with the Nigerian healthcare system. Emphasis was laid on the concept, principle and element of the primary healthcare system as well as the challenges and the current state of the system. In conclusion, Primary healthcare in Nigeria, particularly in rural areas, has come a long way, but more work is undoubtedly still needed to realize the objective of universal health now and in the future. Priority should be given to improving people's living conditions beyond the current poverty level in order to promote healthier living. Local governments, as well as all other levels of government, must increase their allocations to the health sector among other things.

Navigating the Legal and Ethical Terrain of Artificial Intelligence in Enhancing Patient Safety in Nigeria

The emergence of Artificial Intelligence (AI) significantly impacts the understanding of medical errors, minimizes their occurrence, and provides contextual solutions for patient safety in Nigeria.Given the country's expanding population and constrained healthcare resources, the potential significance of AI in enhancing patient safety in Nigeria cannot be overstated. There is a rapid trend to integrate AI into Nigeria's healthcare system, however, this raises concerns about algorithm bias and privacy. This study explores the ethical and legal implications of deploying AI for patient safety in Nigeria and assesses how the existing Nigerian legal frameworks address these concerns. This research shows that although bias and discrimination are generally prohibited by the Constitution of the Federal Republic of Nigeria and other legal instruments, algorithmic bias which arises from the use of AI is not catered for by these laws. In addition, despite current privacy and confidentiality safeguards, AI in healthcare presents unique and novel challenges that the legislation does not yet address. Therefore, developing a new legal and governance structure to address both present and prospective challenges of AI in the health sector is extremely useful.

EVALUATING THE MANAGEMENT AND MAINTENANCE PRACTICES OF LINEAR ACCELERATOR AND COBALT-60 CANCER TREATMENT MACHINES IN NIGERIA: A COMPREHENSIVE ASSESSMENT

This research paper investigated the state of radiotherapy machines and their management in cancer treatment centers in Nigeria. The study aimed to identify the challenges faced by these centers and propose strategies for improvement. Through a comprehensive analysis of data collected from surveys and questionnaires, critical issues impacting the availability, reliability, and effectiveness of radiotherapy machines were highlighted. The findings revealed a significant shortage of radiotherapy machines across the nation, with Nigeria having less than 6% of the required number of linacs. This scarcity led to a high workload on the existing machines, resulting in long waiting lists and compromised treatment outcomes. Management challenges, such as the absence of preventive maintenance policies, inadequate personnel training, delayed spare parts delivery, and limited engagement of maintenance contractors, were identified. The research emphasized the need for supportive cancer treatment machines, including orthovoltage and superficial machines, to alleviate the burden on existing radiotherapy machines. However, most centers lacked these supportive machines, limiting their ability to provide comprehensive care to patients. Financial sustainability also emerged as a significant concern, as internal funds proved insufficient for maintenance and operations. The involvement of the government and the establishment of independent regulatory bodies were proposed to address these challenges. In conclusion, this study called for urgent action to address the gaps and challenges in radiotherapy machine management in Nigeria. It highlighted the importance of increasing the number of machines, implementing preventive maintenance policies, enhancing staff training, and securing adequate funding. By doing so, the quality of cancer care could be significantly improved, leading to better patient outcomes and a more robust healthcare system in Nigeria.

Mitigating Physician Emigration in Nigeria by Improving the Internship Experience

Nigeria faces a critical shortage of health workers, exacerbated by a growing of physician emigration. This study explored the negative internship experiences that drive Nigerian interns to migrate abroad, with a focus on the COVID-19 pandemic's impact. Interns cite excessive workload and burnout, lack of professional development opportunities, challenging work environment, and mistreatment as key reasons for considering emigration. The COVID-19 pandemic has exacerbated these challenges, leading to shortages of personal protective equipment, limited screening services, and poor hazard allowances. The paper emphasizes the importance of adopting policies that make destination countries attractive to emigrating interns. These includes creating a supportive work environment with fair compensation, professional development opportunities, and adequate resources to retain interns in the country. It also highlights the significance of addressing mistreatment and bullying in the workplace. Collaboration between healthcare organizations, policy reforms, and increased healthcare financing are suggested as potential strategies to mitigate the brain drain and ensure a sustainable healthcare system in Nigeria. Improving internship conditions and addressing the shortcomings of managing the COVID-19 pandemic are essential to retaining Nigerian doctors and combatting physician emigration. This requires a coordinated effort from healthcare systems, policymakers, and stakeholders.

Comparative Analysis of the Healthcare Delivery System in China and Nigeria: A Review

ObjectivesEquitable distribution of quality healthcare services among different subpopulations in China and Nigeria is inconsistent. This necessitates an examination of potential avenues for improving healthcare provision in both countries. A comparative analysis of both health systems was carried out to provide insights into the progress each nation has made, the obstacles they face, and areas both countries can learn from each other. MethodsWe assessed 3 key dimensions of these systems using the Hsiao analytical framework. First, we scrutinized the policy levers of the health systems. Next, we evaluated intermediate outcomes, such as access to healthcare and the quality of care. Lastly, we assessed the extent to which the health systems achieve their ultimate goals, including improving citizen health status and enhancing overall patient satisfaction with the healthcare services. ResultsChina surpasses Nigeria in terms of better birth outcomes, life expectancy, and management of communicable diseases. Both countries offer minimal protection against out-of-pocket spending on medical bills, which consequently exacerbates the poverty rate. ConclusionsChina surpasses Nigeria in every health metrics. However, Nigeria's healthcare system offers services to a larger proportion of its populace because of the involvement of the private sector in healthcare delivery. Both countries continue to experience significant challenges, such as limited access to healthcare services in rural areas and overall patient dissatisfaction with the quality of care provided.

INTEGRATION OF PUBLIC HEALTH POLICY AND LABORATORY SCIENCE IN NIGERIA: A REVIEW OF RESPONSES TO COVID-19

The COVID-19 pandemic has spotlighted the criticality of an integrated approach between public health policy and laboratory science, especially in countries like Nigeria, with unique healthcare challenges. This study aimed to comprehensively analyze the synergy between these two domains, focusing on their collaborative potential and implications for pandemic response in Nigeria. Adopting a mixed-methods approach, the research combined qualitative and quantitative data to provide a holistic perspective. The study delved into Nigeria's pre-COVID-19 public health landscape, the historical context of health policy and laboratory collaboration, and this synergy's economic, social, regulatory, and ethical facets. Key findings revealed that Nigeria's public health policies during the pandemic were adaptive, with laboratory science showcasing innovations in diagnostic tools, techniques, and infrastructure enhancements. Mutual feedback mechanisms and international engagements marked the collaboration between policymakers and laboratories. The study concludes that fostering a robust synergy between health policy and laboratory science is paramount for future pandemic preparedness. Recommendations include the need for continuous training, infrastructure development, and international collaborations to bolster Nigeria's healthcare system. This research offers valuable insights for policymakers, healthcare professionals, and researchers, emphasizing the importance of a collaborative approach in health crises.
 Keywords: Public Health Policy, Laboratory Science, COVID-19, Nigeria, Pandemic Response.

The Effects of Traditional Medical Practices on Health Care Delivery System in Nigeria. Quantitative Case Study of Ibiaku Issiet Community of Akwa Ibom State, Nigeria

This research investigates the factors influencing the persistent use of traditional medicine and its implications for the acceptance and utilization of modern healthcare in the urban local government area of Ibiaku Issiet, Akwa Ibom State, Nigeria. Sociologists and medical sociologists have expressed concerns about the continued reliance on traditional healers, which often disregards modern scientific methods and facilities. A sample of 150 respondents was randomly selected, and data was collected using a structured questionnaire. The study reveals that the high cost of modern healthcare is a significant challenge rural dwellers face, leading them to seek more affordable traditional medicine. Traditional remedies have effectively catered to the sociocultural preferences and aspirations associated with modern medical care. Nigeria's socio-economic and sociocultural context, characterized by beliefs in witchcraft, spirits, and gods as causes of diseases, make eradicating this deeply rooted cultural heritage futile. Consequently, individuals are more likely to prefer modern medicine to traditional treatment methods. Based on the findings, it is recommended that traditional medicine be granted legal recognition and co-recognition as an official healthcare system in Nigeria. There is a pressing need to enhance the status, funding, and facilities of traditional medical clinics and practitioners and develop comprehensive training programs.

Synergy between Skilled and Traditional Birth Attendants on Quality of Maternal and Newborn Care in Nigeria

Maternal and newborn health remains a critical challenge in Nigeria, with high maternal and neonatal mortality rates persisting in many regions. The coexistence of formal healthcare systems with traditional birth practices provides a unique opportunity for synergy between Skilled Birth Attendants (SBAs) and Traditional Birth Attendants (TBAs) to improve the quality of maternal and newborn care. This study explores the potential benefits of collaboration between SBAs and TBAs in Nigeria and investigates the barriers and facilitators to such cooperation. The findings highlight the complementary strengths of SBAs and TBAs. SBAs bring formal medical training, evidence-based practices, and access to medical resources, while TBAs possess cultural knowledge, community trust, and local birthing expertise. Through joint training and capacity building initiatives, TBAs can be equipped with updated medical knowledge, improving their ability to identify high-risk pregnancies and refer cases to skilled healthcare providers effectively. Effective referral systems play a pivotal role in ensuring timely access to emergency obstetric care. Challenges to collaboration include cultural and traditional beliefs, language barriers, limited access to resources, and legal and regulatory obstacles. Addressing these barriers requires a comprehensive approach that promotes cultural sensitivity, mutual respect, and inclusiveness within the healthcare system. The study concludes that harnessing the synergy between SBAs and TBAs can lead to a more integrated and effective maternal and newborn healthcare system in Nigeria. By leveraging the strengths of both groups and creating an enabling environment for collaboration, Nigeria can make significant strides towards reducing maternal and neonatal mortality, improving the quality of care, and achieving better health outcomes for mothers and newborns. Continued research and collaborative efforts are essential to capitalize on this synergy and drive positive change in maternal and newborn healthcare across the country.

Perceived Health Impacts, Sources of Information and Individual Actions to Address Air Quality in Two Cities in Nigeria

Poor air quality (PAQ) has serious effects on the environment, climate change, and human health. This study investigated the perceived health impacts of PAQ in two cities in Nigeria (Abuja and Enugu), including whether PAQ may have an interaction with COVID-19 infection and intensity. A recent report published in the Lancet has pointed to the complexity of the health care system in Nigeria and a lack of data on disease burden, so the research in this paper took a self-reporting (perceptual) approach to exploring the health impacts of PAQ. The research also sought to explore the main sources of information used by people to inform them about air quality (AQ) and the actions they are likely to take to address PAQ. The results imply that many of the respondents in the two cities perceived their health to be adversely affected by PAQ and that PAQ worsens both the chances of infection and the intensity of COVID-19. Unsurprisingly, older people were found to be more vulnerable to the health impacts of PAQ. Most respondents, especially younger ones, obtained their information on AQ via electronic media (internet, social media) rather than printed media. Respondents considered that the primary action to address PAQ is proper waste management. Paying the government to address PAQ was regarded as the least likely action, although the government was acknowledged as having a key responsibility.

Physician-Suggested Innovative Methods for Health System Resilience amidst Workforce Emigration and Sociopolitical Unrest in Nigeria: A Survey-Based Study.

Physician emigration (the brain drain) and sociopolitical unrest significantly contribute to the instability of many low- and middle-income countries' healthcare systems. However, limited literature captures the locally driven and context specific suggestions to promote and sustain these health systems' resilience. Thus, the purpose of this study is to 1) understand the effects of physician emigration and sociopolitical unrest on Nigeria's healthcare system, and to 2) synthesize solutions suggested by Nigeria-trained physicians in the form of a resilience framework. An anonymous online survey was conducted among Nigeria-trained physicians. Respondents were recruited using convenience and snowball sampling methods via a WhatsApp group for Nigeria-trained doctors. Quantitative data were analyzed using Stata 17 and qualitative themes were coded by two independent researchers. The final sample included 49 Nigeria-trained physicians-35 physicians practicing in Nigeria and 14 emigrated physicians. All of the physicians currently practicing in Nigeria have considered emigrating, with 79% of them having concrete plans to emigrate in the next five years. Among emigrated physicians, factors such as remuneration (92%) and socioeconomic state of the country (92%) contributed to their decision to emigrate. Suggestions to enhance health system resilience fell into six broad themes: 1) policy and politics, 2) funding and resources, 3) organization and structure, 4) training and education, 5) research and primary health, and 6) health for peace initiatives. The healthcare system is currently unstable and vulnerable due to physician emigration and sociopolitical unrest. To develop and implement solutions to mitigate these issues, capturing the locally trained physicians' perspectives are critical. While each country's healthcare system is unique, countries with similar strains can adapt this model for resilience building. Future studies should focus on adapting the model in different countries with policy-level action points.

Appraisal of the Liability of Health Care Practitioners and Facilities for Medical Negligence in Nigeria: A Case Study of Plateau State, Nigeria.

The healthcare system in Nigeria has recorded unimaginable and unsatisfactory performance in quality health care delivery. There is need to promote the awareness of medical negligence due to the fact that at some point in life, one has fallen victim of medical negligence, but as a result of ignorance it was swept under the carpet. Medical negligence is not synonymous with doctors only but extends to nurses, laboratory scientists, laboratory technicians and other paramedics and the health care institutions in general. This research therefore, examined the level of awareness of the legal remedies for medical negligence against healthcare practitioners and facilities in Plateau State, Nigeria; the extent to which the residents of Plateau State are aware and willing to prosecute legal actions for medical negligence where committed by health care practitioners and also investigate the factors which hinder persons from enforcing their rights through legal means. The survey research method was employed. A sample size of 384 respondents was drawn from the population of study using the Wimmer and Dominick on-line sample size calculator using a confidence level of 95% and precision level of 5%. Findings showed that most of the sampled respondents are not aware of the remedies available to patients in the event of medical negligence caused by healthcare practitioners and facilities. The study therefore recommended among others that, the government and other agencies in the private sector should be proactive in educating the populace on their rights to quality health care services and the availability of legal redress for medical negligence.