The Executive Secretary of Lagos State health agency, Health Facilities Monitoring and Accreditation Agency (HEFAMAA), Dr. Abiola Idowu, has said between one to three trillion dollars is lost every year, globally, due to unsafe healthcare.
In her words, global annual loss due to unsafe healthcare is a staggering one to three trillion US dollars.
Dr.Idowu explains. “Every year, people die; people get harmful effects from accessing healthcare and it leaves them sometimes disabled. On a yearly basis, we have at least one hundred and thirty four million adverse effects, all over the world, most especially in low-income and middle-income countries. Nigeria belongs to that category.”
The World Patient Safety Day is one of the World Health Organization’s global public health days earmarked to raise awareness and understanding about health issues and mobilize support for action. The World Patient Safety Day was established in 2019 by the 72nd World Health Assembly, to increase public awareness and engagement, enhance global understanding and work towards global solidarity and action by member states, to enhance patient safety and reduce patient harm.
This year’s event, which was kicked off with an awareness walk around the wards and visits to patients in Gbagada General Hospital, was witnessed by many dignitaries, scholars and professionals in the health sector, including special guest of honour and wife of the Lagos State governor, Dr. Mrs. Ibijoke Sanwo-Olu, who was represented by Dr. (Mrs.) Onomoare Juliana Olunuga, Medical Director and MD/CEO of Ebute-Metta General Hospital, Yaba, Lagos.
Others included Dr. Rotimi Agbolagorite, Director, Disease Control at the Lagos State Ministry of Health, who represented the Permanent Secretary, Lagos State Ministry of Health, Dr. Olusegun Ogboye; the Chairman of the Board at HEFAMAA, Dr. Yemisi Solanke-Koya; the keynote speaker, Dr. Adesola Oluwafunmilayo Olalekan, who is a senior lecturer and researcher at the Department of Medical Laboratory Sciences, College of Medicine, University of Lagos (CMUL), Idi-Araba; Dr. Olusegun Joseph Babafemi, Medical Director and MD/CEO of Gbagada General Hospital; Mrs. Toyin Lolu-Ogunmade, fertility and family-building consultant and founder/owner of Precious Conceptions Limited.
In his opening remarks, the Permanent Secretary said this year’s theme, Engaging Patients for Patient Safety, “emphasizes the crucial role patients play in their own healthcare journey and the pivotal role, we as healthcare professionals play in…their active engagement.”
According to him, in the global healthcare landscape, healthcare-associated infections continue to be a concern and affect millions of patients annually.
“unsafe surgical care continues to contribute to surgical complications, thereby impacting patients’ health. Adverse drug effects remain a leading cause of patient’s death, emphasizing the urgency for our efforts to improve medication safety. In Lagos State, we have made significant strides in patient safety. However, challenges persist, reminding us of the work that lies ahead of us, even as our commitment to patient safety must be made, unwavering.”
While stressing that attention to patient safety and engagement with patients should be a continuous activity by caregivers, Dr. Yemisi Solanke-Koya, the Chairman of the Board of HEFAMAA said, “Patients must be engaged through the totality of the healthcare terrain. This encourages deeper appreciation of what is ailing the patient and fosters their compliance. A well-informed and well-engaged patient is more inclined to adhere to protocol for care. Thus, it is a win-win situation for the field of medicine, if patients comply and understand why, for this will translate into better outcomes of health indices.”
Engaging patients as an action plan for patient safety
In her overview of World Patient Safety Day and its significance, Dr. Abiola Idowu shed more light on the annual event and its importance in global healthcare.
According to her, Patient Safety is “a framework of organized activities that create conscious processes, procedures, behaviours, technologies and environments in the healthcare space that cause steadily and sustainably lower risks, reduce the occurrence of avoidable harm, make errors less likely and reduce the impact of harm, when it does occur.
“Every year, there is a large number of patients that are harmed or that die, because of unsafe healthcare and it creates a large burden of death and disability, worldwide, especially in low and middle income countries. It is estimated that one in ten patients has adverse effect when they access care in healthcare facilities. That’s a staggering statistic. Data suggests that 134 million adverse effects occur in hospitals, due to unsafe care and about 2.6 million deaths arise from unsafe care on an annual basis.”
In order to eliminate avoidable harm in healthcare, Dr. Idowu proposed an action plan.
“So, what does the action plan strive to achieve? It strives to eliminate avoidable harm in healthcare, with a vision of a world in which no one is harmed in healthcare and every patient receives safe and respectful care, every time, everywhere and at any time. So, who are the key delivery partners? Government, Ministry of Health and all other agencies in the Health Sector and quality spaces (for example, HEFAMAA), the health care facilities and anywhere patients can receive healthcare services. Others are stakeholders, such as professional associations (in the health sector), NGOs, Civil Service Organizations and the World Health Organization (WHO). What is the guiding principle of the action plan? It is engaging patients and their families.”
In her keynote address, Dr. Adesola Olalekan dwelled on hospital care-associated infection safety.
She expressed her concerns: “how do we reduce the harm that is caused in the hospital? When patients come into our hospitals with particular diseases, do we make addition or do we make subtraction? We need to know about some actions that can lead to patient harm.
“I want to say that Lagos State is unique in a way that they have a system in place and that system has made it easy, for even us, as researchers, to map (and thereby) making infection control to be easy. When the system is not well organized, then you have problem with harm.”
Apart from errors which might arise from the system and undermine patient safety, Dr. Olalekan cited other errors in healthcare as human factors and behavior, education errors, surgical errors, healthcare-associated infections, diagnostic errors, unsafe transfusion practices, unsafe injection practices and patient faults, among others.
Saying every one of ten patients is harmed, due to associated infections, she maintained that the global burden of healthcare-associated infections is high, because it is responsible for so many deaths. Dr. Olalekan advised that the only way to curb incidences of healthcare-related infections is by preventing them, especially by putting patients at the centre of healthcare and by engaging with the patients every time.
Turning point: from adversity to narratives for change
Perhaps a dramatic high spot in the event was the speech made by Mrs.Toyin Lolu-Ogunmade, who said she was once a victim of unsafe healthcare, because of an error in surgery.
Now founder and owner of Precious Conceptions Nigeria Limited, a fertility and family-building consultancy, With high hopes of success, Mrs. Toyin Lolu-Ogunmade had gone for surgery sometime in 2006, because of a condition. Unfortunately, the surgery went wrong, due to an error. This made her unable to bear children.
She narrated her story. “I went in for a surgery that should cure a disease and I came out, unable to have children and, so, I went through several corrective surgeries again and the diagnosis was I could never be able to carry children.”
However, after thirteen years of heartbreak and pain, she made important decisions. First, she decided to have children by surrogacy. Second, she took a bold step, not only to become an advocate, but also to help others who might have challenges with child-bearing.
Pointing to two children in the audience, Mrs. Lolu-Ogunmade said, “but today, I’m a mum. My twins are here. They are sitting right there in the audience and I thank God for medical breakthrough, because I became a mum through surrogacy and a generous, fantastic Indian woman carried my children for me. They know how they were born, so I’m very public about it. They know their surrogate mother and it took me thirteen years to have these beautiful children.
“My journey took me to India. I lived in India, for two years. It was while I was in India that I decided I was going to do something and I had gone through another surgery and I was crying, because the doctor told me nothing could be done again. I said in my heart, ‘there are people in Nigeria who are going through the same difficulty I was facing’ and a lot of women are committing suicide and a lot of women are helpless; they are labeling them witches and calling them barren and I’m in a position to help and I decided I was going to speak out.”
She advised caregivers to be empathetic towards patients.
“Realize that that person sitting in front of you is a human being and you need to take critical decisions concerning them. So, whatever it is you are going to do, please, the first thing you should know is, these are human beings and that their lives are in your hands. Please handle with care.”
Mrs.Lolu-Ogunmade also advised people who might be going through health challenges to share information with their doctors, rather than keep such challenges to themselves.
“Please, don’t keep quiet. If your body starts to misbehave in funny ways, please let your doctor know. A lot of the issues we see and that doctors face for secondary referrals and all, can be easily reversed, managed, treated and cured, if patients can learn to speak up on time.”
Health is at the heart of development in Lagos State
In her goodwill message, the special guest of honour and wife of the state governor,, Dr. (Mrs.) Ibijoke Sanwo-Olu, emphasised the important role of Health in the developmental agenda of the present Lagos State government, under the leadership of His Excellency, Governor Babajide Sanwo-Oku.
Encouraging HEFAMAA to sustain its role in ensuring that health facilities in the state continue to adhere to best practices and standard operating procedures, she said, “as a critical agency of government that is charged with the responsibility to set and enforce standards in the health sector, it is commendable that HEFAMAA is using the opportunity of this global celebration to pay premium attention to the safety of patients in our health facilities, both private and public.
“As a medical practitioner, it is gratifying for me personally, that the world is thinking and doing something about the safety of patients. For us in Lagos State, Health occupies a pivotal spot in the developmental agenda of the present administration, for a greater Lagos, otherwise known as the THEMES PLUS developmental agenda.
“It is important to note that since assumption of office, Mr. Governor has put measures in place, to revamp, rejuvenate and reposition the health sector for efficient and effective service delivery. The state government, through the health insurance scheme, has been providing affordable and comprehensive healthcare services for all residents, irrespective of age grade, ensuring financial protection and reducing exorbitant expenditures. As I speak, our pregnant women are getting free medical care in our government-owned hospitals.
“The gesture is part of the government’s health palliative which covers the cost of normal pregnancy delivery, caesarian sections and antenatal care. I am glad that HEFAMAA is taking the lead to protect patients in line with the mandate to monitor both public and private health facilities, by ensuring the registration and accreditation of all health facilities in the state,”
Other goodwill messages were delivered at the event by representatives of professional bodies and civil society. These included speeches by Abioye Omoyeni Akanji, Chairman, Association of Medical Laboratory Scientists of Nigeria, Lagos State Branch; Julius Abimbola Adekoya, Chairman, Guild of Medical Laboratory Directors, Lagos State Branch; Mrs. Opeoluwa Oduwole, Chairman, Association of Radiographers of Nigeria (ARN), Lagos State Branch; Pharmacist Abiola Paul Ozieh, Chairman, Healthcare Providers Association of Nigeria, Lagos State Branch and Reverend Adebola Nuga, Head of Monitoring & Evaluation at the Lagos Civil Society Participation for Development (LACSOP).
The World Patient Safety Day 2023 event was concluded with awards and a presentation.
Special recognition awards were given to some members of the board of HEFAMAA, for their support and contributions towards making the event a success. Also, two hospitals got awards, for excellence in healthcare delivery and patient safety. Ikorodu General Hospital got the award in the public hospital category, while Evercare Hospital was awarded in the private hospital category.
Dr. Olorunfemi Olonire who heads the Research and Statistics department at HEFAMAA made a presentation of the findings of a survey of health facilities in Lagos State and the quality of their responsiveness in healthcare. The survey, which was conducted by HEFAMAA, provides insights into aspects which might require some improvement in healthcare delivery.