Certificate of Standards: FG begins quality assessment of tertiary health institutions

University of Maiduguri Teaching Hospital (UMTH)
university of maiduguri teaching hospital

The federal government has launched a checklist for assessing the quality of services in federal tertiary health institutions in Nigeria ahead of awarding them the Certificate of Standards.

The development is part of the government’s effort to improve the operational standards of the health institutions under its control.

The assessment manual was put together by the National Tertiary Health Institutions Standard Committee (NTSC).

The committee is mandated by the National Health Act, 2014, to ensure standardisation of tertiary health institutions in Nigeria.

This is to ensure that Nigerians get quality healthcare services at the institutions.

The manual was launched alongside a National Surgical Obstetrics, Anaesthesia and Nursing plan for Nigeria on Tuesday in Abuja by the Minister of Health, Isaac Adewole.

At the event, Mr Adewole, a professor of gynaecology and obstetrics, said ascertaining the operational standards of the health institutions had become necessary because of the bad news about their operations.

He said quality health is a fundamental human right, which every Nigeria must enjoy.

He said the tertiary health institutions were under pressure because the secondary and primary health care systems of the country are underperforming.

Mr Adewole urged the committee to be impartial in the evaluation of the facilities.

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Certificate of Standards

According to the National Health Act 2014, an health institution must have the Certificate of Standards before it can offer health services to Nigerians.

Section 13 of the NHA states:

(1) Without being in possession of a Certificate of Standards, a person, entity, government or organization shall not:-

(a) establish, construct, modify or acquire a health establishment, health agency or health technology;

(b) increase the number of beds in, or acquire prescribed health technology at a health establishment or health agency;

(c) provide prescribed health services; or

(d) continue to operate a health establishment, health agency or health technology after the expiration of 24 months from the date this Bill took effect.

(2) The Certificate of Standards referred to in subsection (1) of this section may be obtained by application in the prescribed manner from the appropriate body of government where the facility is located. In the case of tertiary institutions, the appropriate authority shall be the National Tertiary Health Institutions Standards Committee, acting through the Federal Ministry of Health.

Illegal operation

Based on these criteria, tertiary health institutions in Nigeria are operating illegally, as the government is yet to begin the issuance of the certificate.

A former president Nigeria Medical Association (NMA), Mike Ogirima, in an interview with PREMIUM TIMES last year said the Certificate of Standards is for every health institution in the country.

“A clinic needs to have some basic requirement. Can the government tell us one clinic they have visited? Can the committees tell if they have formed any committee on Certificate of Standards? That committee they formed is supposed to go round and register all clinics, hospitals and even teaching hospitals and private hospitals,” he said.

The NHA stipulation on the Offences and Penalties in respect of Certificate of Standards under section 14 states that : Any person, entity, government or organisation who performs any act stated under section 13(1) without a Certificate of Standards required by that section is guilty of an offence and shall be liable on conviction to a fine of not less than N500,000.00 or in the case of an individuals to imprisonment for a period not exceeding two years or both.

However, the government has said it is not out to sanction but to put things in proper perspective.

Standards Committee

Speaking at the event, the Chairman, National Tertiary Health Institutions Standards Committee, Abiodun Ilesanmi, said the attitude of health workers is important in achieving a good health care system.

He said no matter the resources committed to the upgrading of health facilities, if the attitude of health workers are bad, then standards cannot be achieved.

“Attitude is key to achieving standards. The idea is to make sure that there are minimum standards in all tertiary health institutions.

“If you look at Nigeria’s budget on health, majority of the budget goes to the tertiary health institutions because of their mandate. Apart from providing clinical services, they are to build health manpower for the nation and they are to conduct researches.”

Mr Ilesanmi said a monitoring committee is important because of the tertiary institution’s mandate.

“The committee is like the commission for the tertiary hospitals and what it is expected to do is to make sure that, from time to time, we are on the same page with the standards with teaching hospitals and other tertiary hospitals. We assure that is the purpose of the checklist. What is going to follow this is the proper implementation of the checklist, training and retraining of those who are in charge of qualities in these various institutions.”

He said this will “ensure that they do not train rubbish and ensure that when patients come there, they have the best”.

Mr Ilesanmi said the committee will go round and rank the hospitals and institutions.

On the issue of sanctions, Mr Ilesanmi said the committee would be encouraging the tertiary institutions to attain the set standard goal and not punish them.

“When you do this, you are indirectly serving the country and helping Nigerians because you and I visit these places. If the situation is substandard, then you get substandard treatment and the consequence is great.

“But with this, we expect that there will be a tremendous improvement in the facilities, in the training and in the research output of the tertiary health institutions.

“We must not forget that we are really underfunded. But no matter the underfunding, our own attitude is important.

“Putting the checklist in place and improving our attitude will definitely improve productivity and health outcome. The checklist, if carried out appropriately, will lead to the reduction of incidence of medical errors and medical negligence,” he said

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