DAVID EBOH

BA (Hons) (Health Service Management) PGDipHE, LLB, MBA

Health Management Consultant

President: Nigerian Association of Health Service Managers and Consultants

(NAHSMAC)

Author: Two management books on healthcare

School Governor: St Peter’s R.C. Pri. Sch. London

• The market and competition

• Globalisation and technology

• Corporate failures and successes

• Data management and information research

• Understanding yesterday

• Dealing with today

• Planning for tomorrow (future)

• Public interest and National/State Image

Financial strategy

Business strategy

Human Resource Strategy

Clinical leadership and Medical Research

Staff education, training and development strategy

Branding and Marketing strategy

Estate and facility management

Security

• Over 10 episodes of doctors’ strike in 2 years

• Over 100,000 deaths following the strikes

• Each strike last consistently over 2 – 10 months

• Diversion of public drugs and equipment to private hospitals

• Redirection of patients from public to private hospitals

• Cash deposit overrides Hippocratic oath for saving lives

Uffot, E. (2010) ....They’re still at best consulting clinics Newswatch 50th

Birthday Special Edn. 29 Sept.

• Political rhetoric, no genuine commitment

• Public fund paying for overseas treatment of government

officials

• Foreign medical treatment cost Nigeria N30 billion

annually (Ngozi Okonjo-Iweala)

• Failure to manage the synergy across health related

agencies – food, road/transport, water etc

• Political indecision on interprofessional rivalry

• Subjectivity to external influences – Nigerians used as

guinea pig for clinical trials

(Eboh, D. (2008) The Politics of Healthcare in Nigeria, A Game of Lottery

1 million Nigerian children currently die per year at birth

compare to 9 million globally (WHO)

1,100 children die annually out of 100,000 births

53,000 women die annually from pregnancy related

conditions (WHO, see Uffot 2010)

1 in 5 children die before their 5th birthday in Nigeria

Estimate of 60% of the deaths are preventable

Low life expectancy, 48 years men, 49 years women

• About 80% of preventable deaths are due to clinical

negligence

• In 2007 N400 million health budget mismanaged by then

Minister of Health Prof Adenike Grange

• In 2003, N17.4 billion health loan from IDA, world Bank not

properly accounted for

• In 2009, N13 billion loan from IDA ,World Bank also

unsatisfactorily managed

• Present Health Minister, Prof. Chukwu asserts that N 4.47

trillion ($20 billion) is needed to achieve MDG by 2015 (Uffot

2010)

Patient centred care - clinical and administrative staff

Equality and diversity

Corporate culture and identity; Collective ownership

Absence of learning and development – status barrier

Mutuality in dignity and respect across all boundaries

Every stakeholder matters in healthcare setting

The gradual growth of foreign healthcare providers in

Nigeria – threat and opportunities

Under developed accident & emergency services

Poor primary healthcare system - Non-viable community

healthcare services

Continuing brain drain of medical, other clinical and

healthcare professionals

Dead or isolated prominent Nigerians in healthcare

institutions abroad– why???

Road accidents and other traumatic incidents

Extensive review of the key influencing factors

Proactive PEST analysis

Comprehensive SWOT analysis

Overhaul of institutions and organisational structure

Introduction of corporate leadership

Introduction of Socio - entrepraprenural health management

model

Training, development and mentoring of managers

Taking advantage of IT and modern technology

Establishment of dedicated Health Management Institute

Extensive and sustained investment in medical research

Clear distinction in roles between clinical and management

leadership

Managed and viable primary healthcare system

Universal registration with Community Health Clinics

Functional A&E and Ambulance services

Proactive disease prevention and chronic disease

management

21st Century Healthcare Corporate Boardroom

With Social-Entrepreneural Model for Service Delivery

This model enhances multi-talents approach to corporate priorities and unifies strategic vision for growth,

productivity and profitability. It centres on the public and consumers’ needs © David E. Eboh

Dir. of Allied Medical Services

Director of Nursing & Quality

Chief Med. Director(CMD) (Experienced Doctor)

Director of Finance

Chief Executive Officer (CEO) (Trained and Qualified Strategic Manager)

Director of Pharmacy

Dir. of Strategy, Business & Org. Dev.

Secretary (Legal Practitioner)

Director Corporate Affairs, Communication & IT

Dir. of Public Health (Any Graduate in PH)

Dir. of Human Resources

Director of Procurement

Service Users Representatives: Community and Religious Leaders

Chairman

(Successful Entrepreneur)

©D.E. Eboh

Ancient Historical Healthcare Management Boardroom

With Medical Model for Service Delivery

Chief Med. Dir. Prof. (Doctor)

Rep. of Public Interest (Doctor)

Chairman MAC (Doctor)

Director of Administration

Rep. of University (Doctor) Dir. of Public Health

(Doctor)

Chairman

(Doctor)

Rep. of other professions

Rep. Fed. Min. of Health (Doctor)

Rep. of NMA (Doctor)

Hospital Boardroom

This model obscures fundamental corporate priorities and constricts innovation and creativity in strategic leadership and management

Secretary to Board

Idea projection for innovation and creativity

Training

Mentoring

Project management

Consultancy

Championing specific corporate philosophy/ideology

Hands on in clinical practice & corporate strategic

leadership

Support clinical and management research

Standard and quality

Accountability

Respect for human lives

Dignity and respect for everyone

Value for equality and diversity

Profitability for the respective institutions

Research and Development

Workforce training and development

Policy development and active implementation

Building organisational culture and identity

Universal access to affordable healthcare services

Positive inter-professional relationship, collaboration and co-

operation

Journal development and publication of health specific

articles, news and general information

Maximising satisfaction level for patients / services users,

and other stakeholders

Wake up the law for Patients and public protection

Coroners investigation

Financial and clinical accountabilities

Customer care services

Complaint management and patient / customer satisfaction

Rewarding success for clinicians and other staff

Knowledge, skills and experience of IT use

Knowledge, skills and experience of modern equipment

National Association of Health Service Managers and Consultants (NAHSMAC)

©David Eboh (2011)

Fed

era

l H

ealt

h S

erv

ice

Au

tho

rity

(F

HS

A)

General Hospitals

CEO of Fed Health Service Authority

(FHSA)

Fed. Chief Nursing Officer (FCNO)

Fed. Chief Medical Officer (FCMO)

Corporate Management

/ Leadership

(

Clinical Management

and Leadership

Primary Health Care

(Community Health Centres) Universal Access for Locals

National Dir of Healthcare Procurement

Mental Health Hospital

Teaching Hospitals

National Dir., Allied Health

Professionals Director General, NAFDAC

Political

Corporate strategic and managerial

Clinical

Technical and technological

Federal: Minister of Health for the Government

National Health Flag: Chief Executive for Federal Health

Service Authority (FHSA) (proposed)

State: Commissioner for State Government

State Health Flag: Chief Executive for state Health Service

Authority (SHSA) (proposed)

Health Institutions – CEO for Corporate leadership

Directors for medical, nursing, pharmacy etc, directorates

Directors for Admin, technical & other directorates -

Finance, HR, Estate, Engineering etc

NAHSMAC