Establishing in-hospital geriatrics services in Africa: Insights from the University of Benin Teaching Hospital geriatrics project

Abstract

Background:Unawareness of the peculiar healthcare needs of the elderly and resource constraints may be some reasons why until recently, Nigerian hospitals have not been equipped with the human and infrastructural resources required to meet older adults’ special healthcare needs. There is paucity of specialized health services for the elderly in Africa. Nigeria, with a population of over 170 million, did not have any healthcare facility with dedicated services for the elderly until 2012. The University of Benin Teaching Hospital (UBTH) in Nigeria was established in 1973 and created its geriatrics unit in October 2013. A prepared environment and trained interdisciplinary teams are pivotal in providing effective healthcare services for the elderly. The ongoing UBTH geriatrics project aims to provide specialized interdisciplinary health services to older adults and to provide training and continuing professional development in geriatrics for healthcare staff. In developing our inpatient services, we adopted the acute care for elders (ACE) model and worked in tandem with the “ABCs” of implementing ACE units.Results:In the face of limited resources, it was possible to establish a functional geriatrics unit with a trained interdisciplinary team. Family participation is central in our practice. Since October 2013, residents and house officers in internal medicine have been undertaking 4- and 12-weekly rotations, respectively. There is also a robust academic program, which includes once-weekly geriatric pharmacotherapy seminars, once-weekly interdisciplinary seminars, and 2-weekly journal club meetings alternating with seminars on geriatric assessment tools.Conclusions:It is possible to establish geriatric services and achieve best practices in resource-limited settings by investing on improving available human resources and infrastructure. We also make recommendations for setting up similar services in other parts of Africa.

A Quality Assessment of Clinical Service Utilization in a Geriatrics Unit in West Africa: 2014-2018

“…The Geriatrics Unit in University of Benin Teaching Hospital (UBTH) in Nigeria was established in an effort to provide quality healthcare to older persons with co-morbidities, using the Acute Care for Elders (ACE) model [5] . The service review reported in this paper is formative and was designed to assess the extent to which the initiative of setting up the unit had achieved the purpose; to disseminate lessons learned and make adjustments to the structures and processes, with a few to improving clinical outcomes [7] .…”

“…Admissions were capped at a maximum in-patient number of 15 because of challenges with increasing the nursing and supporting the workforce. Criteria for admission included age equal to, or greater than 60 years and multiple medical (and other) conditions [5] . Documentation of regarding bed occupancy and bed stays, transfers in and out, discharges and deaths are routinely done by the geriatric nursing staff.…”

“…Retention of competent, motivated staff is the key to maintaining quality healthcare. The interdisciplinary workforce was mostly comprised of healthcare professionals who had had prior team training in geriatrics [5] . Apart from this cohesive team, patients in the ward also received care from several consultants from several other disciplines in the hospital.…”

“…The geriatrics unit in University of Benin Teaching Hospital (UBTH) was set up in October 2013 to provide specialized, quality care to older persons with medical and other co-morbidities, in an environment that fosters a pleasant healthcare experience [5] .…”

Nigerian healthcare workers’ perception of transdisciplinary approach to older adults’ care: A qualitative case study

“…15 This rapid increase in the elderly population is also accompanied by a preponderance of non-communicable diseases in Nigeria 16 ; hence, the gaining momentum of geriatric/ gerontological practice in Nigeria is timely. 13,14 With the growing awareness of specialist care for older people in Nigeria, and recent interest by the Nigerian government to establish regional geriatric centres for clinical care, understanding the collaborative disciplinary experiences of HCPs working in a geriatric unit in a tertiary health institution is warranted. Due to resource constraints and other factors, we decided to explore the HCPs' perspective of the transdisciplinary approach in one centre in Nigeria, for several reasons.…”