CHSD faculty fellow leads effort to modernize Nigerian health care

A new world-class system aimed at modernizing the delivery of health care in the Nigerian state of Akwa Ibon was developed with leadership from the Ustawi Research Institute, headed by Macharia Waruingi, a faculty research fellow at Texas A&M’s [Center for Health Systems & Design] (http://chsd.arch.tamu.edu/) .

URI facilitates the creation of products for health and human development with a focus on emerging economies and developing nations in Africa.

“Health services in Akwa Ibom are unsafe, low quality, and inaccessible to a majority of the people,” said Waruingi, URI's chief executive officer and board of directors president.

A wealthy, oil producing state located in southeastern Nigeria on the Gulf of Guinea, Akwa Ibom is part of the resource-rich central African equatorial rain forest.

“Despite the state’s wealth and resources, its healthcare system leaves a lot to be desired,” said Waruingi. “Akwa Ibom’s people, afraid to use local health services, seek medical care in other countries such as India, South Africa, Germany, England and the United States.”

However, Waruingi said, Nigeria's rapidly growing middle class is demanding high-quality healthcare service closer to home.

“Healthcare consumers in Akwa Ibom,” he said, “are willing to pay more for better care, an improved supply of drugs, better technical quality, better maintained health facilities and shorter wait times.”

In January 2012, Thomas & Grace Investments Limited, a Nigerian service company in the oil and gas sector, asked URI to research health care needs in Akwa Ibom and provide recommendations for upgrading the state's healthcare system.

To tackle the project, URI developed a wiki, or website facilitating online collaboration between health care experts from around the world. Participants also met online in weekly webinars to compile a health care assessment that ultimately identified needs for diagnostic, imaging and therapeutic services; enhanced delivery and payment systems, and for linking medical education and training to the health network.

Plans developed from those recommendations include a 700-bed medical center on a 100 acre-site in the centrally located city of Afaha Obon, with a series of affiliated primary and secondary care centers throughout the state.

The plan also calls for establishing a health care cooperative to facilitate community engagement with the health care system.

“Community involvement and collaboration is the cornerstone for community health improvement through sharing the burden of health promotion and disease prevention,” said Waruingi. “Community engagement in a world-class healthcare system is a process of the system’s working collaboratively with Nigeria’s farmers, small business owners, employed people, parents, and the unemployed.”

The Center for Health Systems & Design at the Texas A&M College of Architecture promotes research, teaching, and communication in an interdisciplinary program that focuses on health facility planning and design. Research interests of faculty associates range from the effects of environmental stress on patients’ well-being and health to evidence-based design of hospitals, nursing homes, neighborhood clinics, healing gardens, accessible communities, and healthy cities.