Harnessing ICT to Model Effective Healthcare in Nigeria

Picture: Dr Osagie, assisted by ward nurses, attends to an infant at the maternity ward at Bwari General Hospital.

Before 2015, Bwari General Hospital, a medical facility in the outskirts of Abuja, was plagued by a myriad of challenges leading to compromised quality of care. It was characterised by low patient visits, lack of proper healthcare infrastructure, poor management of the facility, lack of essential equipment and a shortage of drugs. Patient records were misplaced and poorly archived, thereby causing delays in accessing medical care. The situation was fuelled by a misuse of resources due to lacking transparency and accountability. The centre, meant to serve a population of close to half a million citizens from the Bwari area of Abuja and across the neighbouring Kaduna and Niger states, had collapsed.

Dr Osayande Ehigie Osagie, a former gynaecologist and obstetrician consultant, and an Australia Awards Scholar, graduated with a Master’s of Public Health (specialisation in Epidemiology and Biostatistics) from the University of Melbourne in 2014. His most significant turning point, while in Australia, was seeing how information, communication and technology (ICT) had been harnessed to improve service delivery and provide fast, efficient and adequate medical care. He recognised the ability for ICT to transform healthcare services in his home country Nigeria.

15 months after completing his award, Dr Osagie was appointed the Director at Bwari General Hospital. He used the skills, knowledge and networks gained, including leadership in public health, health resource management and health systems strengthening, to identify and prioritise the needs that required urgent attention in the transformation of the hospital.

Dr Osagie’s transformation of the Bwari Hospital led to the introduction of an electronic medical records (EMR) system. Essentially, EMR is an electronic record of health-related information that facilitates easy access and transmission of patient information. The system integrates all the hospital facilities, from patient registration, through to doctors’ diagnoses and post-consultation services such as laboratory tests and prescriptions, using a patient’s mobile phone number or date of birth. He rolled out the detailed computerised system with the support of the administration of Health and Human Services Secretariat of the Federal Capital Territory Administration, Abuja.

The introduction of the system presented a new way of thinking and working at the hospital; however it faced challenges. At first, there was resistance from staff, mostly due to inadequate knowledge of operating computers. Moreover, there was general hostility to the innovation by some of the staff, as well as an erratic supply of electricity around the country, which inadvertently affected operations at the hospital.

Following the intervention, Dr Osagie has helped to re-write the story of Bwari Hospital. He commented, “I am joyful to see the numbers increasing gradually over the months. When I started, there were about 2,000 patients per month. Now we deal with at least 8,000 patients every month accessing various services in our facility, and I am confident that we serve up to 90% of the needs of the community. This is a sign of confidence in the delivery of services rendered by the hospital.”

Other notable wins for Dr Osagie include an increase in internally generated revenues from AUD 7,600 in April 2015 to an average AUD 83,000 currently. With increased funding, the hospital was able to acquire advanced facilities for patient diagnosis and care as well as train and recruit more healthcare professionals. Delays in accessing medical care at Bwari have decreased significantly, and the array of available services have been up-scaled to include a comprehensive centre for accessing anti-retroviral therapy for persons living with HIV and non-communicable diseases. There is also a geriatric clinic that takes care of the aged, every Monday and Thursday.

The ICT platform has increased transparency and accountability of generated revenues, thereby reducing corruption and under-reporting. In turn, this has increased the goodwill of donor agencies and foreign governments in securing other crucial equipment for the hospital. In 2017, through Dr Osagie’s efforts, Bwari General Hospital received funding through the Australian Government’s Direct Aid Programme to purchase a power generating plant aimed at improving electricity supply in the hospital. In January 2018, the Australian High Commission to Nigeria, in partnership with the Nigeria Australian Alumni Association, donated ophthalmic equipment estimated at AUD 75,000 to the hospital. This transformed Bwari Hospital to a comprehensive eye clinic with facilities for eye operations and other specialised forms of care, previously unavailable in any public health facility in Abuja.

Currently, Bwari is a renowned institution around the country and has been the recipient of various accolades as a leader in providing quality healthcare in an enhanced, efficient and sustainable way. Early in 2018, the Health and Human Services Secretary in Nigeria, Barrister Amanda Pam, described the improved level of cleanliness and other areas of service delivery at Bwari General Hospital, as a model for other hospitals to emulate. As a sign of confidence, the First Lady of Nigeria, Mrs Aisha Buhari, together with a host of other dignitaries, visited Bwari Hospital to celebrate the first baby of the year and congratulate the mothers on admission at the maternity ward.

Dr Osagie has proven that by providing more efficient ways of accessing, communicating, and storing patient information, ICT helps healthcare facilities to bridge the information divide between healthcare providers and the communities they serve. He took on the delivery of his new role with flair and the passion of unmatched commitment and is now making waves as a distinguished administrator-cum-physician through his transformative work at the hospital.