Dr. Farid Fezoua is the President, CEO of General Electric Healthcare Africa. In this interview with Martins Ifijeh, he talks about the need for Nigerian healthcare system to have a sustainability and maintenance plan towards its medical technologies, his organisation’s role in upgrading 255 PHCs and 23 General Hospitals in Kaduna State and other sundry issues
Photo Caption: Dr. Fezoua
On how maintenance culture can sustain effective use of medical equipment
The first thing that struck me when I took the job of CEO for General Electric Healthcare was that the various Ministries of Health of some African countries were procuring their ultra sound, X-ray, MRI and other medical machines without putting into consideration servicing and maintenance plans for the machines. No matter how good these machines are, if there are no maintenance and service plans in place, there is a likelihood that such machines will pack up within two years. And this is what has been happening in various countries, mostly in Africa. There is no way any country can optimally give service to patients this way.
Secondly, there are hardly provisions for training of users of purchased equipment. Why can’t radiographers, laboratory scientists, and other health personnel trained on how to maintain or service machines they are directly using. Sometimes, countries or establishments buy the machines for millions of dollars, and they will end up becoming idle and unusable because there are no maintenance system from either the supplier or the institutions’s health workers using the machines.
But with the culture of purchasing equipment with an embedded maintenance agreement in place, there is a high possibility that such healthcare equipment will serve its patients and the health facilities optimally.
That is why as a technology company partnering in different countries, we are talking to both the public and private partners to see the need to embed service maintenance into the healthcare machines they are getting. For instance, in Kenya, we are upgrading 98 PHCs and it is our responsibility to provide maintenance for e-technologies in these centres. If any of the equipment is not working up to 90 per cent of its capacity, it is our responsibility to send engineers to fix it.
So we can reasonably say the equipment supplied to these areas will be functioning optimally for the next seven years, which is the duration of our partnership with the Kenyan government. Also for the seven years, all the users of the machines will be continuously trained. We also try to go beyond training users because we know people change jobs all the time. We might end up training someone who within two years, leave the job, thereby creating a vacuum. So, we always ensure the next person coming in to take over is also trained. That is why we have the continuous training model for all users of our equipment.
This same model is what we are replicating in the Kaduna State partnership, and in the next three years, we are optimistic about optimal productivity in the health facilities in the state for the benefit of Kaduna residents.
Saving millions of lives through effective primary healthcare system
If you look at most structures of many countries, especially in Africa, you will discover that about 70 per cent of their population live in rural and sub urban areas, and if one want to genuinely address healthcare challenges on a larger scale in such areas, the best thing to do is bring healthcare to the people, which is through the primary healthcare system. That way, it can reach the rural dwellers, which are more in terms of population.
We are proud that the Nigerian government is spearheading healthcare interventions on a larger scale through the ‘Saving One Million Lives’ launched by the Federal Ministry of Health. The best way to making this achievable is by making the primary healthcare level system effective. And this is where we have decided to come in, to help build the country’s primary healthcare system for maximum impact. This makes healthcare affordable and accessible to the larger population.
GE healthcare role in upgrading PHCs
Having identified that making the primary healthcare level effective will help in improving the healthcare system of the larger population, we have decided, in partnership with Kaduna State Ministry of Health and some other Non Governmental Organisations (NGOs) to help in modernising and upgrading 255 PHCs and 23 General Hospitals in the state, such that these centres and hospitals will be very effective with affordable technologies like the Ultra-sound, ECG, Cardiac diagnostic and monitoring machines, anaesthesia, among others, to enable for safe delivery and other primary healthcare needs. Each PHCs will have all the required technologies to give effective treatments to people at the primary healthcare level in Kaduna State.
Assuming you take one of the Ultra sound machines, the V-scan, which is very portable and go to communities to screen pregnant women, and then you eventually discover there is a pregnancy at risk, all you need do is take such a woman to a PHC with these facilities for surgery or other emergency treatments. When all these healthcare systems are put in place in PHCs, you will discover that people will access the centres for one form of treatment or the other.
The planning has been ongoing for over a year now, and we appreciate the Governor of Kaduna State, Malam Nasir el-Rufai for his commitment to bringing this to reality, as this will go a long way in saving several members of the Kaduna population.
As we are supplying the technologies to these centres, we are also training the users, which are the nurses and the health workers on how to use and maintain them. There is a whole programme geared towards making them know how to use and maintain the technologies. There is also a system of funding, which is very convenient for the state to adopt, as it does not put a burden on them. For Kaduna State, the partnership to bringing all the 255 PHCs and 23 General Hospitals to life will span into a three year period, but with the possibility of extension when the model achieves desired result. And we know it will work because same intervention is ongoing in Kenya at the moment and it’s already achieving results by reducing number of deaths and increasing access to healthcare.
On solving maternal and child health issues in Nigeria
Just like I said earlier, you can’t solve healthcare issues relating to the grassroots without the inputs of the PHCs, and that is why we have signed a memorandum of understanding with the Federal Ministry of Health, and we have launched an initiative around PHCs, which is specifically aimed at reducing maternal and infant deaths targeted during the Millennium Development Goal era. The initiative is still on, but it’s now geared towards the Sustainable Development Goals three (SDG3).
This partnership entails monitoring very early stage pregnancy, the woman and the neonate, as well as post delivery condition, and this will ensure that any preventable death can be saved. This is a five year programme that is currently on going.
Another way of solving maternal and child issues in Nigeria is the need to train midwives and other health workers on the use and maintenance of diagnostic machines even in rural areas. We have identified this, and it is part of our partnership with the Federal Ministry of Health.
Impact of the partnership with the Federal Government
We expect that this programme will benefit not less than 20,000 expectant mothers and it will have an impact in terms of curbing maternal and child mortality in the country. This is a result we are sure of because we have done a pilot study in Tanzania. We believe if these combined solutions are implemented till the end and allowed to run on a continuous basis, they will increase tremendously the number of antenatal care, and by extension, save maternal and new born lives in the country.
On lack of inaccurate diagnosis in the country
We can say one of the major reasons why this happen is because of malfunctioning medical equipments. This is one of the reasons we are challenging healthcare service providers to put systems in place to be able to maintain their equipment. This would help curb malfunctioning of machines like inaccurate diagnosis, among others.