How e-Health Expands Medical Care Beyond Borders – Wada
Dr Ibrahim Wada is the medical director of Nisa Premier Hospital. He was one of the early gynaecologists who recorded successful In Vitro Fertilisation (IVF) in Nigeria. In this interview with NKECHI ISAAC, he highlights milestones recorded in IVF application in Nigeria. He also speaks on the need to adopt e-Health for better efficiency in service delivery in the nation’s health sector.
You were one of the first to record successful IVF in Nigeria in 1998, what are the milestones that’s been recorded in this sector since then?
I am one of the first Nigerians to record the test tube baby, baby Hannatu in 1998. What is good to know was that the baby was presented to the public and they have followed the growth of the baby, she’s currently a medical student overseas and doing very well.
This development has continued to assure Nigerians that we have entered the test tube technology age and since then what has happened is that the knowledge of IVF has spread very wide in the country, north, south, east and west. Many centres, doctors, scientists, nurses, counsellors have benefitted from the knowledge of this programme and there are established centres all across the country and some of these centres are doing very well. The implication for the Nigerian woman is that there is hope near them now, they don’t need to go abroad or even travel to the big cities to access this technology because there are many other sub-centres. That’s a very important milestone which means that accessibility to IVF is improving gradually and very well.
Another milestone is the quality of care, there are close to 60 IVF centres in this country, at least 20/30 percent of them are solid, successful, scientifically run. The other centres also have the potential to come up and be good but it’s just a question of time. The milestone is that the critical mass of centres have been raised to enable us form a self-regulation vehicle, the Association for Fertility and Reproductive Health (AFRH) consisting more than 200 doctors, nurses, scientists in this country who have come together under that umbrella to advance not just the science but the interest of the infertile couples and also reduce quackery, inefficiency and unethical practice to its barest minimum has emerged.
Also the stigma that was associated with infertility has been eroded as a result of the IVF advantage because now babies born by IVF are no longer a big story in Nigeria.
Are there any new milestones in terms of scientific advancement in IVF procedure?
Yes there is because we have advancement beyond the normal test tube baby. Test tube baby simply means the joining of the sperm and eggs of the woman to form embryo seeds which are then planted in the woman’s womb to give her a chance of pregnancy.
So, the scientific advancement involved are one, if a man’s sperm is so low that it cannot fertilise a wife’s eggs by itself, many units in this country can now do advanced assisted fertilisation techniques (AAFT). People who could not normally because of their poor sperms or absence of sperms be expected to become fathers are now fathers based on AAFT. The second part is that we’re now able to freeze sperm, embryo and eggs like the rest of the world. It has allowed us to enter an era called the preservation of fertility. It is important because our society is advancing culturally and educationally where women are delaying marriage to complete career requirements and once you delay marriage and you’re above 35 years your egg quality reduces so the ability to preserve eggs now means that a woman can go to a hospital where they can stimulate and preserve her eggs until she’s ready to give birth thereby preserving her fertility and avoiding the normal egg changes. This is a huge scientific advancement in the health sector. Many centres can freeze eggs in this country now and that has opened up the chance of fertility preservation for both men and women.
Another major scientific advancement is also the technique of screening embryos in pre-implantation genetic diagnosis (PGD) for any kind of genetic disease. We can screen embryos to know if they are affected by any disease such as (AS) or sex selection of a baby after fulfilling the ethical requirements.
We’ve recorded a lot of milestones especially in the health sector, the government has been talking about eHealth. How do you think this can come into play especially in managing data?
Well you’re in a hospital that likes to pride itself as a paperless hospital. The role of eHealth today versus an establishment that does not practice eHealth is to compare those olden days analogue phones and mobile phones. They are two worlds apart. To enable the public understand one civilisation and e-civilisation, today eHealth in terms of patient care means you can register yourself anywhere in the world, log on, put your data and details even before you come to the hospital, you have your number, your doctor and you can even make appointments and even video consult, you don’t have to be there physically. It makes healthcare so convenient. Then majority of the equipment are automated now so human error is cut down to the barest minimum because the machine prints out the result by itself and uploads in a computer and you can assess it wherever you are in the world.
eHealth has recorded unbelievable progress in telemedicine. It means that multiple doctors can give opinions on just one case from different locations in the world. For instance you do an x-ray or MRI or city scan in Abuja but the doctor reading and interpreting the result is in India, London or New York. So, it expands the world of care beyond borders. That is medical care on frontier. Expertise can be drawn beyond doctors.
How will you assess eHealth medical care in Nigeria?
In answer to this I will praise the Nigerian software companies because they are in there producing software that compares with some of the best in the world. eHealth software is not inaccessible in Nigeria but unfortunately, currently, our eHealth landscape is still quite dark.
I think there are dots of light among the darkness. The seabed is dark which means that very few hospitals are in the e-age. If you look at it the key ones are eHealth compliant but many hospitals are still struggling. So, I don’t think we can generalise about the country yet but it is dark, it is non-e, it is analogue because most hospitals are writing papers, missing files, delaying patients and all that but there are spots of light and I think the light will brighten with time because eHealth has demonstrated that it is far more efficient and cost effective than the analogue.
What role can the government play in facilitating the adoption of eHealth for hospitals in Nigeria?
I am aware that there is political will and their role is mainly advocacy, setting the culture change, the goal post. For instance, this has worked efficiently in the banking sector where the former CBN governor, the Emir of Kano, Sanusi, set a date for making some states cashless and it was adopted. There is no better role for the government than to give us such timeframes. It is called advocacy and also creating the enabling environment. I don’t expect the government to wake up and put eHealth in every hospital, we allow the private players to come in and drive it. This is the story of eHealth. It should also be regulated so that charlatans don’t come in and take over the process. There should be a minimum standard. And NITDA is well positioned to define the standards of what the eHealth application should look like. This is the role of government.
By: Nkechi Isaac
The Leadership News
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