Quality care at district hospitals (4)

7 August, 2021

We found Indira Narayanan's post very informative, particularly her ending sentence, that ''Another expected challenge is the continuation of these activities when external facilitation activities need to be discontinued; but that is a story for another day!'', because that has been our experience too, as local resource mobilisation is very low in LMICs. Many useful projects like the one she describes often end with no residual institutional capacity to continue after the development partner has gone at the end of the project. The losses that come from this lack of local buy-in and commitment to sustaining successful projects, are threefold: the patients and community who have embraced the project are left confused and frustrated; the health system; and practitioners; both lose out and with time all that they learnt is lost (waste of donor money and local counterpart fund). There are times when the development partner also contributes to the problem by running a totally non integrated parallel project, sidelining the local desire for vertical and horizontal integration to existing plans.LMICs need to understand the preventable losses they suffer from the current situation and work to prevent it by increasing local system strengthening measures, including more health financing and capacity training and retraining.

Joseph Ana.  

AFRICA CENTRE FOR CLINICAL GOVERNANCE RESEARCH& PATIENT SAFETY

@Health Resources International (HRI) WA.

National Implementing Organisation: 12-PillarClinical Governance

National Healthcare Standards and Quality Monitor andAssessor

National ImplementingOrganisation: PACK Nigeria Programme for PHC

Publisher:Medical and Health Journals; Books and Periodicals.

Nigeria:  8 Amaku Street, StateHousing & 20 Eta Agbor Road, Calabar.

Tel: +234 (0) 8063600642

Website: www.hriwestafrica.org     email: jneana@yahoo.co.uk ;  hriwestafrica@gmail.com

CHIFA Profile: Joseph Ana is the Lead Consultant and Trainer at the Africa Centre for Clinical Governance Research and Patient Safety in Calabar, Nigeria. In 2015 he won the NMA Award of Excellence for establishing 12-Pillar Clinical Governance, Quality and Safety initiative in Nigeria. He has been the pioneer Chairman of the Nigerian Medical Association (NMA) National Committee on Clinical Governance and Research since 2012. He is also Chairman of the Quality & Performance subcommittee of the Technical Working Group for the implementation of the Nigeria Health Act. He is a pioneer Trustee-Director of the NMF (Nigerian Medical Forum) which took the BMJ to West Africa in 1995. He is particularly interested in strengthening health systems for quality and safety in LMICs. He has written Five books on the 12-Pillar Clinical Governance for LMICs, including a TOOLS for Implementation. He established the Department of Clinical Governance, Servicom & e-health in the Cross River State Ministry of Health, Nigeria in 2007. Joseph is a member of the HIFA Steering Group. Website: https://eur03.safelinks.protection.outlook.com/?url=http%3A%2F%2Fwww.hri...

jneana AT yahoo.co.uk