02867nas a2200205   4500000000100000008004100001260004400042653002600086653002300112653002600135653001900161653002400180100001400204700001400218700001400232700001700246245016200263520221100425022002502636       2024                            d  bSpringer Science and Business Media LLC10aHealth system factors10aMedical Negligence10aHealth Care Providers10aPatient Safety10aQqualitative survey1 aOgueji IA1 aMotajo OO1 aOduola AB1 aRodrigues EM00a"Unequipped health facilities offering services”: understanding the health system factors driving medical negligence among health care providers in Nigeria3 a<p>Medical negligence is a well-documented issue in the Nigerian health system literature. However, there is no in-depth information on the health system factors driving the problem among health care providers in the country. Drawing on the World Health Organization’s framework of health system building blocks, this qualitative survey contributes to addressing the gap. The study employed purposive sampling to select a wide range of 51 health care providers between October and November 2023. Six open-ended questions were used to gather perspectives, and thematic analysis was performed. Findings reveal gaps/problems in the six health system building blocks driving medical negligence. These include the long waiting time experienced by patients in health facilities, inadequate history-taking, nonexistent and/or poor protocols for procedures and work processes, unequipped health facilities offering services, underdeveloped patient safety systems, shortage of health care providers, training gaps among health care providers, poorly stated job descriptions and organograms in health facilities, inadequate remuneration for health care providers, communication gaps among health care providers involved in the multidisciplinary management of patients, the lack of data sharing between health care providers, the documentation of patient data on paper or non-easily retrievable forms, and poor monitoring of the health information system. The gaps/problems also include the use of prototype medical products and devices in health care, the lack of essential medicines, inadequate regulation and monitoring of the quality of medical products, poor healthcare financing, embezzlement of monetary allocations meant for the procurement of medical devices, weak policies and legal interventions to address medical negligence by the government, hospital protocols that delay patients’ access to health care, and health service managers’ inattentiveness to the complaints of health care providers. The study suggests that diverse health system factors drive medical negligence. Interventions to tackle the issue may be more effective if they take a systemic, rather than an individual, approach.</p>
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