Mistrust of the Nigerian health system and its practical implications: Qualitative insights from professionals and non-professionals in the Nigerian health system

Ogueji, Ifeanyichukwu Anthony; Ogunsola, Olabanjo Okunlola; Abdalla, Nuha Mohamed; Helmy, Mai

doi:10.1007/s10389-022-01814-z

Cited by 18 publications

(4 citation statements)

References 43 publications

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“…In Nigeria, data is not easily available, and AI requires a large amount of data to train the innovations. This lack of data may be attributed to Nigerians' declining trust in health research and associated activities (Ogueji et al, 2023). Despite the existence of a regulatory framework for the conduct of health research, many use Pfizer's experience as a reason for non-participation in health research and associated activities (Ojewale & Mukumbang, 2023, p.5;Archibong & Annan, 2021).…”

Section: A Bias and Discrimination Implications Of Ai In The Nigerian...mentioning

confidence: 99%

Navigating the Legal and Ethical Terrain of Artificial Intelligence in Enhancing Patient Safety in Nigeria

Akinpelu,

Akintola

2023

JIPIT

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The emergence of Artificial Intelligence (AI) significantly impacts the understanding of medical errors, minimizes their occurrence, and provides contextual solutions for patient safety in Nigeria.Given the country's expanding population and constrained healthcare resources, the potential significance of AI in enhancing patient safety in Nigeria cannot be overstated. There is a rapid trend to integrate AI into Nigeria's healthcare system, however, this raises concerns about algorithm bias and privacy. This study explores the ethical and legal implications of deploying AI for patient safety in Nigeria and assesses how the existing Nigerian legal frameworks address these concerns. This research shows that although bias and discrimination are generally prohibited by the Constitution of the Federal Republic of Nigeria and other legal instruments, algorithmic bias which arises from the use of AI is not catered for by these laws. In addition, despite current privacy and confidentiality safeguards, AI in healthcare presents unique and novel challenges that the legislation does not yet address. Therefore, developing a new legal and governance structure to address both present and prospective challenges of AI in the health sector is extremely useful.

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Section: A Bias and Discrimination Implications Of Ai In The Nigerian...mentioning

confidence: 99%

Navigating the Legal and Ethical Terrain of Artificial Intelligence in Enhancing Patient Safety in Nigeria

Akinpelu,

Akintola

2023

JIPIT

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“…Also, the culturally diverse setting of Nigeria [ 36 ] and the continuous rural-urban migration that occurs in the country [ 37 ] exposes HCPs to regular clinical encounters with patients from cultural, language, and ethnic orientations different from theirs. Moreover, a recent study found that Nigerians mistrust the Nigerian health system due to a lack of patient-centred care [ 38 ]. This finding from this study indeed suggests the need for cultural competence among health care providers in the Nigerian health system since patient-centred care and cultural competence go hand-in-hand.…”

Section: Introductionmentioning

confidence: 99%

Patterns and predictors of cultural competence practice among Nigerian hospital-based healthcare professionals

Ogunlana,

Oyewole,

Aderonmu

et al. 2023

BMC Med Educ

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Background Being culturally competent would enhance the quality of care in multicultural healthcare settings like Nigeria, with over 200 million people, 500 languages, and 250 ethnic groups. This study investigated the levels of training and practice of cultural competence among clinical healthcare professionals in two purposively selected Nigerian tertiary hospitals. Methods The research was a cross-sectional study. A multi-stage sampling technique was used to recruit participants who completed the adapted version of Cultural Competence Assessment Instrument (CCAI-UIC). Data were analysed using descriptive statistics, Pearson’s correlation, ANOVA, and multivariate linear regression. Results The participants were mainly women (66.4%), aged 34.98 ± 10.18 years, with ≤ 5 years of practice (64.6%). Personal competence had a positive weak correlation with age (p < 0.001), practice years (p = 0.01), training (p = 0.001), practice (p < 0.001), and organisational competence (p < 0.001). There were significant professional differences in the level of training (p = 0.005), and differences in training (p = 0.005), and personal competence (p = 0.015) across levels of educational qualifications. Increasing practise years (p = 0.05), medical/dental profession relative to nursing (p = 0.029), higher personal (p = 0.013), and organisational (p < 0.001) cultural competences were significant predictors of the level of training. Male gender (p = 0.005), higher years in practice (p = 0.05), local language ability (p = 0.037), rehabilitation professionals relative to nursing (p = 0.05), high culturally competent practice (p < 0.001), higher training opportunities (p = 0.013), and higher organisational competence (p = 0.001) were significant predictors of higher personal competence. Conclusion About a third of the participants had no formal training in cultural competence. Incorporating cultural competence in the Nigerian healthcare professionals’ education curricula may enhance the quality of care in the multicultural setting.

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“…Communities distrust for the health sector is well documented [60][61][62]. As in our case, community structures may be available to build trust between the community and the health sector, but these may not function well.…”

Section: Why Do Community Structures Not Function?mentioning

confidence: 77%

“…These include communications via email, text messaging, e-chat rooms, and social networking sites such as WhatsApp, Telegram, Facebook, YouTube, and Twitter. There is more reliance on such media of communication for social support, exchange of information and make life impacting decisions in this technological age [60][61]. These virtual communities are now recognised as potential partners for community participatory research [55].…”

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confidence: 99%

Improving Immunization utilization using participatory action research in Nigeria

Akwataghibe

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Background In 2005, Nigeria adopted the Reach Every Ward (REW) strategy to improve vaccination coverage for children, 0–23 months. By 2015, Ogun state had full coverage in 12 of its 20 local government areas but eight had pockets of unimmunized children, with the highest burden (37%) in Remo-North. Since the exact factors responsible for this trend were not known, participatory action research (PAR) was introduced. Through iterative processes of reflection and action, among communities, health workers and local government officials, insights into the relevant problems identified by different groups in the community were discussed and as their realistic, context-specific solutions designed and implemented. However, a knowledge gap was that there was little known about whether and how PAR would lead to improved access to immunization services and change of immunization-seeking behaviour in communities in Nigeria. This thesis aims to gain insight into if and how PAR can be used to develop context-specific strategies to improve access to and utilization of immunization in Nigeria. Methods The PAR intervention took place from 2016 to 2017. It involved two (4-month) cycles of dialogue and action between community members, frontline health workers and local government officials in two wards of Remo North, facilitated by the research team. The PAR involved outcome and process assessments which included four studies (two qualitative and two mixed methods studies). Data was analysed using the Strategic Advisory Group of Experts (SAGE) vaccine hesitancy framework. Results The studies showed that immunization utilization and access are influenced by interlinked community and health services issues. Involving community, health service and policy actors in the PAR is critical to addressing immunization access and utilisation challenges and ensuring that strategies are adjusted to suit the contexts. Integration of evidence into dialogues with stakeholders can lead to change, while leveraging existing government and community structures and resources enhances effectiveness of strategies. The PAR approach enables development of effective partnerships amongst government, health workers and communities to achieve health-related goals and to put the needs of the community at the center in development of solutions, even in the presence of asymmetries in relationships. However, intra-community dynamics and socio-cultural contexts drive exclusion of vulnerable groups. Effectively addressing issues of less privileged community members requires inclusion strategies for proper representation of these groups. Having a valorisation strategy is crucial for encouraging government ownership and enhancing the utilisation of research results to (sustainably) improve immunization issues locally and at state level. Conclusion PAR has the potential to actively involve affected communities in the decision-making processes that impact their health and immunization and to facilitate co-creation of contextualised solutions (with health workers and local governments) to address community needs and enhance sustainable change. At the same time, PAR cannot change major flaws in the system, such as governance arrangements, or solve contextual elements such as turnover of health workers or commitment of policy makers. In addition, inclusion of vulnerable groups requires specific strategies.

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Mistrust of the Nigerian health system and its practical implications: Qualitative insights from professionals and non-professionals in the Nigerian health system

Cited by 18 publications

References 43 publications

Navigating the Legal and Ethical Terrain of Artificial Intelligence in Enhancing Patient Safety in Nigeria

Navigating the Legal and Ethical Terrain of Artificial Intelligence in Enhancing Patient Safety in Nigeria

Patterns and predictors of cultural competence practice among Nigerian hospital-based healthcare professionals

Improving Immunization utilization using participatory action research in Nigeria

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