Messages from - the 8th edition : Pillar on audit in health practice held on Thursday, August 17th, 2023

28 August, 2023

Dear Colleagues and All,


Lecture 1:  Prof Joseph Ana shared the reasons why the pillar on Audit was created in the 12-PCGP in 2004, explaining that where there is no ‘No Audit’, there cannot be ‘Quality Improvement’. He added that Audit involves all Health facility personnel, both clinical and non-clinical: it is multidisciplinary and multispecialty. It must not be seen as an additional chore, because Audit (Reflective practice) is what defines professionalism of health practitioners/ health workers. It is not to victimise staff.

Lecture2: 'Multi-disciplinary AUDIT IN HEALTH PRACTICE' was delivered by Dr. Omatsola Kpiasi. MBBS., M. Sc. FRCS of The Lily Hospitals, Warri, Nigeria. He described in good detail  the structure of and implementation process of Audit in Lily Hospital as an example of how it is done in Nigeria, an LLMIC, despite all the challenges facing health care delivery in the country, as follows:  i) STRUCTURE: Successful implementation and start-up of Clinical Audit requires a coordinated approach with structures and defined Roles and Responsibilities within the Clinical Governance system in the hospital: : Clinical Audit Facilitator, Clinical Audit Resource Office, Unit  Convenors,  Clinical Audit Committee;      ii) Define Audit Tool Elements to be used,  the acceptable level of compliance for each tool., most compliant items,  cumulative audit findings,  compare audits (e.g. Jan-Jun & Jul 2022), note most compliant items; and note the reasons for noncompliance  As an example Dr Kpiasi shared data from the Audit of the  ‘ Use of Partographin Labour Care’ in Lily Hospital. He concluded that  ‘’Improvement is Never Ending’’ hence ‘Auditis  Cyclical’. And that it is essential to note ‘What happens between one Audit and Re-audit?, thereby ensuring Quality Improvement (QI)  e.g. Continuous Improvement Cycles of Deming based on PDSA/SACA in Kaizen.



9TH Edition is on Thursday, 19TH OCTOBER, 2023. 6PM WAT. On Zoom.


Prof Joseph Ana

Lead Senior Fellow/ medicalconsultant.

Center for Clinical Governance Research &

Patient Safety (ACCGR&PS) @ HRI GLOBAL

P: +234 (0) 8063600642


8 Amaku Street, State Housing, Calabar,Nigeria.

HIFA Profile: Joseph Ana is the Lead Senior Fellow/Medical Consultant at the Centre for Clinical Governance Research and Patient Safety (CCGR&PS) with Headquarters in Calabar, Nigeria, established by HRI Global (former HRIWA). He is the Country Coordinator for PACK Nigeria (Practical Approach to Care Kit) which is specifically designed to improve clinical competence (improving accuracy of diagnosis and treatment) in primary health care. He is also a Member of the World Health Organisation’s Technical Advisory Group on Integrated Care in primary, emergency, operative, and critical care (TAG-IC2). As the Cross River State Commissioner for Health (2004-2008), Joseph Ana led the introduction of the evidence based, homegrown quality tool, the 12-Pillar Clinical Governance Programme (12-PCGP) in Nigeria, which also suitable for lower-, low-, and middle income countries (LLMIC) with similar weak health sector and system. To ensure sustainability of 12-PCGP, the ‘Department of Clinical Governance, Servicom & e-health’ was established in Cross River State Ministry of Health in 2007. His main interest is in ‘Whole health sector and system strengthening in LLMICs’. He has written six books on the 12-Pillar Clinical Governance Programme, including the TOOLS manual for its Implementation, currently in its 2nd Edition. He served as Chairman of the Nigerian Medical Association’s Standing Committee on Clinical Governance (2012-2022), and he won the Association’s ‘Award of Excellence’ on three consecutive occasions for the innovation of 12-PCGP in Nigeria. He served as Chairman, Quality & Performance subcommittee of the Technical Working Group for the implementation of the Nigeria Health Act 2014. He was Member, National Tertiary Health Institutions Standards Committee (NTISC) of the Federal Ministry of Health, 2017-2022. He is the pioneer Secretary General/Trustee-Director of the Charity, NMF (Nigerian Medical Forum UK) which took the BMJ to West Africa in 1995. Joseph is a member of the HIFA Steering Group; the HIFA working group on Community Health Workers, and the Working Group on HIFA-WHO Collaboration ( Email: info AT and jneana AT