…..Sets care level 3 minimum
The Guild of Medical Directors (GMD), Lagos Branch, has resolved to make participation in quality improvement programmes mandatory for all its members, with Care Level Three set as the minimum standard for healthcare facilities after a period of grace.
Chairman of the Guild, Dr Omoniyi Fagbemi, disclosed this at the 2026 Scientific Conference of the GMD, Lagos Branch, themed, “Emergency Preparedness for Emerging and Re-emerging Diseases.”
Fagbemi said the decision was necessary as private healthcare facilities remained critical points of care and would be among the first facilities expected to identify and respond to emerging disease outbreaks.
He said the Guild had also identified infection prevention and control (IPC), the role of private healthcare services, and systems, strategy and leadership for scalable healthcare enterprises as key areas requiring urgent attention.
“We have resolved that all members must be enrolled in a quality improvement programme. We see Care Level Three as the minimum standard after a period of grace,” he said.
According to him, members would eventually be expected to participate in quality improvement as a matter of policy.
Fagbemi said the focus on emergency preparedness was particularly important given the recurrence of diseases previously thought to have been brought under control.
He cited the recent diphtheria outbreaks in parts of Nigeria, including Lagos State, as evidence that diseases considered controlled could re-emerge when surveillance, vaccination and other preventive measures weakened.
“The lesson is clear: emerging and re-emerging diseases are at our doorstep. As frontline healthcare practitioners, we must be abreast of them,” he said.
He added that healthcare practitioners must not only be able to diagnose and treat patients but must also know how to protect themselves, their staff and their facilities during outbreaks.
The chairman recalled Nigeria’s 2014 Ebola outbreak, particularly the role played by late Dr Ameyo Adadevoh and other health workers at First Consultant Hospital, Lagos, saying the episode demonstrated the importance of preparedness, professional judgment and adherence to protocols during public health emergencies.
He also stressed the need for private healthcare businesses to develop systems that could survive beyond individual medical directors.
“Growth is not enough; it must scale,” Fagbemi said, stressing that healthcare enterprises must combine clinical excellence with sound systems, strategy and leadership.
Speaking on “Emergency Preparedness for Emerging and Re-emerging Diseases,” infectious disease expert, Dr Adefolarin Opawoye, warned that outbreaks could quickly overwhelm healthcare systems if private facilities failed to establish effective triage, surveillance, isolation and referral systems.
Opawoye said diseases such as Ebola, mpox, COVID-19, cholera, diphtheria and Lassa fever had demonstrated the continuing threat posed by infectious diseases.
He said the COVID-19 pandemic also showed the importance of private healthcare providers, particularly when restrictions on international travel forced Nigerians who ordinarily sought treatment abroad to depend on local facilities.
According to him, Lagos is particularly vulnerable because of its high population density and mobility, while many residents seek care first from private hospitals.
He therefore urged private hospitals to establish systems for screening patients, isolating suspected infectious cases, notifying health authorities and transferring patients when necessary.
“You must have a surveillance system. You must have a triage system. Patients should not be able to walk straight into your facility without appropriate protocols,” Opawoye said.
He also urged private hospitals to identify their Disease Surveillance and Notification Officers (DSNOs), maintain their contact details and establish internal notification systems so staff can quickly report suspected cases.
He said facilities should be prepared to act before laboratory confirmation where clinical suspicion is strong, particularly because testing may not always be immediately available.
Opawoye said the basic response should be to “screen, isolate, notify and transfer” suspected cases, while ensuring that patients receive appropriate supportive care and are not moved unnecessarily between hospitals.
He also warned medical directors against allowing influential patients or VIPs to override infection-control protocols, saying professional decisions must be guided by patient and public safety.
On infection prevention and control, Lagos-based doctor, Dr Olayemi Daudu, said private healthcare providers had a major role to play in protecting Nigeria against future outbreaks because they provide a substantial proportion of healthcare services.
Daudu said an assessment of 415 health facilities in Lagos using the World Health Organisation’s Infection Prevention and Control Assessment Framework (IPCAF) found that 48.8 per cent scored in the inadequate category.
He said private facilities performed better than public facilities in the assessment but none reached the advanced level of IPC preparedness.
According to him, 214 private and 201 public primary and secondary healthcare facilities were assessed between July and October 2023.
Daudu called for a 90-day IPC compact across GMD member hospitals, including facility assessment, auditing, laboratory linkages, hand-hygiene programmes, surgical-site infection surveillance, facility antibiograms and outbreak-readiness plans.
He said healthcare-associated infections remained a major but often under-recognised problem, adding that antimicrobial resistance was making infections increasingly difficult to treat.
Daudu urged private hospitals to establish dedicated IPC programmes, appoint responsible personnel, provide budgets for infection prevention, train staff regularly and strengthen surveillance and laboratory capacity.
He said private hospitals should also have designated isolation areas, adequate personal protective equipment, running water, hand hygiene facilities and clear referral pathways for suspected infectious diseases.
The doctor said the Nigeria Centre for Disease Control and Prevention’s Orange Network had demonstrated that structured IPC programmes could substantially improve hospital preparedness, but noted that private facilities were not currently included in the network.
He called for greater participation of private hospitals in structured national IPC programmes.
Also speaking on “Systems, Strategy and Leadership for a Healthcare Enterprise Built to Last,” Dr Ayobami Koyoro urged medical directors to reduce their organisations’ dependence on individual leaders by building systems and developing independent decision-makers.
Koyoro said hospitals could not achieve sustainable growth if every major decision depended on the medical director.
He urged directors to examine what would happen to their hospitals if they were absent for six months or a year, saying a sustainable healthcare enterprise should continue to deliver quality care, retain patients and make decisions without constant intervention from its founder.
“Growth is not scale,” he said, explaining that scale meant increasing value without increasing organisational complexity at the same rate.
He urged medical directors to understand their revenue streams, costs, profitability, capacity utilisation, patient retention and payer mix, stressing that increased revenue did not necessarily translate into profitability.
Koyoro also cautioned hospitals against adopting technology simply because other facilities were doing so, saying healthcare organisations should first identify the problem, redesign the process and then select technology capable of solving it.
He said the ultimate test of leadership was whether an organisation could maintain its quality and operations without its founder.
The GMD conference brought together medical directors and other healthcare stakeholders to discuss preparedness for emerging and re-emerging diseases, infection prevention and control, private-sector healthcare delivery and the development of sustainable healthcare enterprises.