Preventive maintenance is a prerequisite to keep installed machines running with minimal or no hitches that may result to downtime.
This is a service support component delivered after sales of a hardware keeping it routinely checked to reduce chances they may suddenly break down. It is a safety approach to ensure installed hardware performs optimally thereby avoiding expensive tangible and intangible costs due to instrument failure. When such service is implemented, the instrument tends to have a prolonged life span, improved reliability, and sustainability.
Unfortunately, Nigeria’s attitude towards maintenance has not changed for better in decades. Poor maintenance culture and sometimes total disregard to its relevance has resulted to heavy costs to our taxpayer’s money.
There is need to turn over a new leaf in our approach to maintenance culture. All hands should be on deck to ensure a proper protocol is established and followed to the letter.
Looking at Nigeria Healthcare system today, there are uncountable challenges facing it that emanate from diverse factors. The list of problems besetting efficient healthcare delivery in Nigeria has continued to emerge in addition to an already well know political, economic, and natural angles to the subject.
Government funding of healthcare infrastructure has remained inadequate, and the gap has continued to widen between the expectation and the actual implementation.
Most public healthcare institutions are struggling with countless needs to strengthen existing infrastructure and establish new projects based on current trend. The teaming clients attending most public health institutions for their healthcare needs are underserved due to these obvious reasons. Despite these growing huge demands in our healthcare system for both physical and physiological reliefs, the Nigeria fiscal input has not kept with the pace, hence worsening the healthcare outcomes of the citizens.
The situation is not so different from what is happening at the private sector. Funding has remained a unified challenge to both categories of healthcare contributors to our Nation. Most private health establishments have adapted flexibilities in their quest for capital inputs to their projects. Some have attracted foreign direct investment, equities from venture capitalists, local and international financial institutions, and sometimes angel investors. Investments in healthcare sector beside the government budgetary allocations have benefited private sector healthcare institutions most times. The flow of these capitals appeared to be fuelled by the way the pioneers of such institutions innovate, show commitment to sustainability and financial discipline.
When such investments are made, fundamental requirements are properly stipulated and agreed upon which include but not limited to employing highly professional vendors to deliver on the infrastructure, after sales service needs for the infrastructure with attendant warranty obligations and preventive maintenance. Nothing is left out in the discussion to acquire new infrastructure to avoid wastage, downtimes, and service disruption, hence long-term goal is guaranteed and return on investment is realized.
Due to some of the meaningful investments and innovations found in our private sector healthcare segment, a lot has improved in their practices, and they have come to the rescue when they are called upon by the state. The services at these private healthcare segments are sourced by mostly the elites, the middle class etc. those that can afford out of pocket healthcare needs.
Another lesson may be learnt from the NGOs that have sustained some healthcare delivery projects in Nigeria. Most of these NGOs deliver on their milestones engaging in more robust procurement and maintenance arrangements as relates to the instruments used for patients’ care. Through a proper structured procurement and maintenance services on their diagnostic devices, some of their instruments have been sustained beyond 10 years and a few are currently utilized after they were donated to the states. This way, huge savings are made, and extra resources deployed for expansion and advancements.
Public hospitals’ situations may be different from the two encouraging scenarios above but with proper policy drive, Nigeria shall begin to see gains accruing from having a proper maintenance culture. The monies spent annually to procure replacement for failed diagnostic equipment can be channelled into better needs and this way healthcare services shall improve and continue to handle myriads of diseases conditions plaguing the populace. Cost of healthcare services may become better as necessary steps towards sustainability are applied.
Providing a policy framework on equipment maintenance through MOH shall help a great deal in reducing government spending on healthcare infrastructure and at same time improving culture of good and uninterrupted practice while driving down cost of cares in the long run.
Proposals
- Policy on equipment maintenance through MOH to all the public healthcare institutions.
- Procurement policy on diagnostic equipment including unit cost and extended warranty for at least five (5) years.
Others
- Policy to manage or put a sealing on level of credit exposures at public hospital.
- Establishing Informal Health Insurance at hospital levels
- Integrated Malaria Testing and treatment Algorithm to avert dangers of drug abuse and drug resistance
- There is need to avert prevalent sickle disease Policy by use of standardized/automated Haemoglobin electrophoresis assay as a requirement to have court weddings.
- Due to some unknown issues in our environment, children are born with some genetic, metabolic, and other forms of deformities, hence need to have Newborn Screening Centres across the country.
- Enacting and strengthening policy in favour of localized IVD productions to save our currency and to reduce too much dependence on imported medical devices for our local needs.