A national survey of hospital readiness during the COVID-19 pandemic in Nigeria

Abstract

Introduction The COVID-19 pandemic continues to overwhelm health systems across the globe. We aimed to assess the readiness of hospitals in Nigeria to respond to the COVID-19 outbreak. Method Between April and October 2020, hospital representatives completed a modified World Health Organisation (WHO) COVID-19 hospital readiness checklist consisting of 13 components and 124 indicators. Readiness scores were classified as adequate (score ≥80%), moderate (score 50–79.9%) and not ready (score <50%). Results Among 20 (17 tertiary and three secondary) hospitals from all six geopolitical zones of Nigeria, readiness score ranged from 28.2% to 88.7% (median 68.4%), and only three (15%) hospitals had adequate readiness. There was a median of 15 isolation beds, four ICU beds and four ventilators per hospital, but over 45% of hospitals established isolation facilities and procured ventilators after the onset of COVID-19. Of the 13 readiness components, the lowest readiness scores were reported for surge capacity (61.1%), human resources (59.1%), staff welfare (50%) and availability of critical items (47.7%). Conclusion Most hospitals in Nigeria were not adequately prepared to respond to the COVID-19 outbreak. Current efforts to strengthen hospital preparedness should prioritize challenges related to surge capacity, critical care for COVID-19 patients, and staff welfare and protection.

Challenges in Implementing the WHO Hospital Readiness Checklist for the COVID-19 Pandemic in Indonesian Hospitals: A Qualitative Study

“… 20 Usually, just like in other country, a designated hospital representative was in charge of filling out the checklist. 5 Coordination among hospital units is also difficult due to a lack of technical instruction. Furthermore, because there was no requirement to upload supporting evidence when filling out the checklist, it is feared that the officers will only fill in based on their respective perceptions, potentially resulting in a biased outcome.…”

“…This supported the findings of previous research in which the results of completing assessments in Nigeria were not independently verified, potentially leading to response bias. 5 …”

“…The checklist has been used in numerous countries. [4][5][6][7][8][9] Nepal, Nigeria, and Lesotho, for example, have already conducted centralized assessments. [4][5][6] In the meantime, other countries conduct provincial assessments and hospital self-assessment.…”

“…[4][5][6][7][8][9] Nepal, Nigeria, and Lesotho, for example, have already conducted centralized assessments. [4][5][6] In the meantime, other countries conduct provincial assessments and hospital self-assessment. [7][8][9] Indonesia has also implemented this checklist based on the decision of the Director-General of Health Services, 10 whereby the hospital performs the checklist on its own every 3 months.…”

A Pathfinding Algorithm for Lowering Infection Exposure of Healthcare Personnel Working in Makeshift Hospitals

“…Many hospitals were not adequately prepared for COVID-19, which is why it was able to spread so quickly and put so much strain on global healthcare systems. A study carried out in Nigeria found that only 15% of the hospitals they surveyed would have been adequately prepared for COVID-19 [ 12 ]. Another study found that hospitals on average in the United States only had around 0.8 beds per 1000 people on a normal day, meaning there were very few beds for COVID-19 patients [ 13 ].…”