The challenge of Non Communicable diseases (NCDs) such as Stroke in LMICs are many especially the lack of effective referral from one practitioner to the other and from one facility to the other. Where some referral occurs there is hardly a two-system such that the specialists communicate his intervention to the referring colleagues after the patient has been treated. Apart from lack of continuity of care that results from the ineffective system and poor communication there is the loss of educating and learning that should flow from specialists to primary health care level of care. There is also the One-Stop Centres / Clinics of care for NCDs which not only facilitates Patient Centred Care such as reducing multiple visits to hospital to see different health experts on different days, at huge out of pocket cost to the patient and risks from repeated travel on very bad roads. The situation is compounded by the chronic shortage of experts in supportive / rehabilitative care including speech therapists, physiotherapists, Dietitians and Nutritionist, etc etc.
LMICs must find ways to think out of the box to retain their local experts and not continue to lose them in drives to Western Countries. They need to be innovative in designing care models especially with the on-going realities of COVID-19 pandemic.
HIFA profile: Joseph Ana is the Lead Consultant and Trainer at the Africa Centre for Clinical Governance Research and Patient Safety in Calabar, Nigeria. In 2015 he won the NMA Award of Excellence for establishing 12-Pillar Clinical Governance, Quality and Safety initiative in Nigeria. He has been the pioneer Chairman of the Nigerian Medical Association (NMA) National Committee on Clinical Governance and Research since 2012. He is also Chairman of the Quality & Performance subcommittee of the Technical Working Group for the implementation of the Nigeria Health Act. He is a pioneer Trustee-Director of the NMF (Nigerian Medical Forum) which took the BMJ to West Africa in 1995. He is particularly interested in strengthening health systems for quality and safety in LMICs. He has written Five books on the 12-Pillar Clinical Governance for LMICs, including a TOOLS for Implementation. He established the Department of Clinical Governance, Servicom & e-health in the Cross River State Ministry of Health, Nigeria in 2007. Website: www.hriwestafrica.com Joseph is a member of the HIFA Steering Group and the HIFA working group on Community Health Workers.
Email: jneana AT yahoo.co.uk