Q1. What is unsafe care and what is its local and global impact?
Unsafe care occurs when patients are exposed to preventable harm through errors, delays, misdiagnosis, inappropriate treatment, poor communication, medication errors, infection risks, inadequate referral, or failures in follow-up. Globally, patient harm is a major public-health problem, particularly in low- and middle-income countries. In West Africa, the consequences are amplified by weak health infrastructure, shortages of skilled personnel, fragmented services and financial barriers. For people living with NCDs — such as hypertension, diabetes, cardiovascular disease, > cancer and chronic respiratory diseases — unsafe care can result in avoidable complications, disability, premature death, catastrophic household
expenditure and loss of confidence in health services.
Q2. What are the main causes of unsafe care for people living with NCDs? To what extent is access to reliable healthcare information a determinant of patient safety?
Major causes include late diagnosis, inadequate screening, medicine stock-outs, polypharmacy, poor continuity of care, weak referral systems, limited diagnostic capacity, insufficiently trained health workers, overcrowded facilities and poor patient-provider communication. Reliable health information is a fundamental determinant of safety. Patients need understandable information about symptoms, medicines, warning signs, appointments, lifestyle changes and when to seek urgent care. Health workers likewise need accurate, current clinical guidance, patient records and reliable diagnostic information. Misinformation, fragmented records and low health literacy can directly increase unsafe decisions.
Q3. What can be done to better understand and improve health systems for safer NCD care?
Countries should establish stronger patient-safety surveillance and incident-reporting systems, conduct routine quality-of-care audits, map NCD care pathways, strengthen referral and counter-referral, and use patient and community feedback. Primary healthcare should be strengthened as the foundation for prevention, early detection, treatment and long-term follow-up. Digital health records, decision-support tools and interoperable information systems can improve continuity and reduce errors.
Q4. How can we better support patients and health workers?
Patients should be empowered through health-literacy programmes, culturally appropriate information, self-management education and meaningful participation in care decisions. Health workers need continuous training, practical guidelines, adequate staffing, essential medicines and diagnostics, supportive supervision and safe working environments. Ultimately, safer NCD care requires a whole-system approach in which informed patients, competent health workers, reliable information and accountable institutions work together to prevent avoidable harm.
HIFA profile: Dr. Uzodinma Adirieje is a leading voice in health education, community health, and advocacy, with decades of experience advancing people-centered development across Africa and beyond. His approach to health education emphasizes participatory learning, knowledge transfer, and behavior change communication, ensuring that individuals and communities gain the skills and awareness to make informed decisions about their health. He develops and delivers innovative health promotion strategies tailored to local realities, particularly in resource-limited settings. In community health, Dr. Adirieje has championed integrated primary health care, preventive medicine, and grassroots health initiatives. Through Afrihealth Optonet Association (AHOA), which he leads, he connects civil society, community groups, and health institutions to strengthen healthcare delivery, tackle health inequities, and improve access to essential services for vulnerable populations. His work addresses infectious diseases, maternal and child health, nutrition, climate and health, environmental health, and emerging public health challenges. As a passionate advocate, Dr. Adirieje works with governments, NGOs, and international organizations to influence health policy, mobilize resources, and promote sustainable development goals (SDGs). He amplifies community voices, ensuring that health systems are inclusive, accountable, and responsive. His advocacy extends beyond health to governance, environment, and social justice, positioning him as a multidisciplinary leader shaping healthier and more equitable societies. afrepton AT gmail.com