Hostname: page-component-586b7cd67f-rcrh6 Total loading time: 0 Render date: 2024-11-24T15:46:27.609Z Has data issue: false hasContentIssue false
  • English
  • Français

Establishing a sustainable open heart surgery programme in Nigeria, a low-income country: which is the best model?

Published online by Cambridge University Press:  21 November 2019

Ikechukwu A. Nwafor Open the ORCID record for Ikechukwu A. Nwafor [Opens in a new window] ,
John C. Eze ,
Maureen N. Nwafor  and
National Cardiothoracic Center of Excellence (NCTCE), University of Nigeria Teaching Hospital (UNTH), Ituku-Ozalla, Enugu, Nigeria
Ikechukwu A. Nwafor*
Affiliation:
Faculty of Medical Science, University of Nigeria, Ituku-Ozalla Campus, Enugu, Nigeria
John C. Eze
Affiliation:
Faculty of Medical Science, University of Nigeria, Ituku-Ozalla Campus, Enugu, Nigeria
Maureen N. Nwafor
Affiliation:
Intensive Care Pharmacy, University of Nigeria Teaching Hospital, Ituku-Ozalla, Enugu, Nigeria
*
Author for correspondence: Dr Nwafor, IA. Department of Surgery, University of Nigeria Teaching Hospital, Ituku-Ozalla, Enugu, Nigeria. Tel: +2348037784860; E-mail: [email protected]
Get access Rights & Permissions [Opens in a new window]

Abstract

Background:

In any country, the development of open heart surgery programme parallels stable political climate, economic growth, good leadership, and prudent fiscal management. This is lacking in a country like Nigeria without a functional cardiac hospital.

Objective:

To review and compare the various models being adopted towards establishing a sustainable open heart surgery programme in Nigeria.

Materials and Methods:

For ethnic and cultural reasons, Nigeria is divided into six geopolitical regions. Each region has one or more Federal Teaching Hospitals including medical centres. The hospitals have trained cardiothoracic surgeons and cardiologists as well as other auxiliary staff. After attainment of democratic rule in 1999, individual hospitals have devised various models to establish sustainable open heart surgery programme. The number of hospitals in each region, the models devised, and the limitations including the outcome were studied and analysed.

Results:

Each geopolitical zone has about three to four centres, either public or private, trying to establish the programme. There are six different models. Each centre has been trying the different models since the year 2000. The oldest of the model is cardiac mission and the newest is employment of highly skilled retired expatriate consultant cardiac surgeon to help develop the local team. Inadequate funds, lack of governmental support, and brain drain syndrome have largely affected the programme.

Keywords

Open heart surgeryindependencelocal teammedical mission
Type
Original Article
Information
Cardiology in the Young , Volume 29 , Issue 12 , December 2019 , pp. 1489 - 1493
Copyright
© Cambridge University Press 2019 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Edwin, F, Tettey, M, Aniteye, E, et al. Development of cardiac surgery in West Africa. Pan Afr Med J 2011; 9: 15.CrossRefGoogle ScholarPubMed
Adebonojo, SA. Development of open heart surgery in West Africa: a historical perspective: Guest lecture, 48th Annual Scientific Conference, West African College of Surgeons, Freetown, Sierra Leone, 2002.Google Scholar
Anyanwu, CH, Ihenacho, HNC,Okoroma, EO, et al. Initial experience with open heart surgery in Nigeria. Trop Cardiol 1982; 8: 123–127.Google Scholar
Nwafor, IA, Eze, JC, Anyanwu, CH, et al. The scope of cardiac surgeryat National Cardiothoracic Center of Excellence(NCTCE) in Nigeria: A 3-year review. J Vasc Med Surg 2017; 5: 308, doi: 10.4172/2329-6925.1000308.Google Scholar
Ogbeidi, MM. Political leadership and corruption in Nigeria since 1960. A socioeconomic analysis. J Niger Stud 2012; 1: 1–25 Google Scholar
Akokuwebe, ME, Adekumbi, DM. Corruption in the health sector and implications for service delivery in Oyo State Public Hospitals. Ilorin J Sociol 2017; 9: 200–217.Google Scholar
Ogundiya, IS. Democracy and good governance: Nigeria’s dilemma. Afr J Pol Sci Int Relat 2010; 4: 201–208.Google Scholar
Nguyenu, N, Leon-Wyss, J, Iyer, KS, Pezzella, T. Peadiatric cardiac surgery in low and middle income countries: a continuing challenge. Arch Dis Child 2015; 100: 1156–1159.CrossRefGoogle Scholar
Tchantchaleishvili, V, Mokashi, SA, Rajab, TK, Bolman, RM III, Chen, FY, Schmitto, JD. Comparison of cardiothoracic surgery training in USA and Germany. J Cardiothorac Surg 2010; 5: 118–123.CrossRefGoogle ScholarPubMed
Yanka, C, Fynn-Thompson, F, Antune, M, et al. Cardiac surgery in Sub-Saharan Africa. Quo Vadis. Thorac Cardiovasc Surg 2014; 62: 393–401.Google Scholar
Maluf, MA, Franzoni, M, Melgar, F, Hernandez, A, Perez, R. The pediatric cardiac Surgery as a philanthropic activity in the country and humanitarian mission abroad. Rev Bras Circ cardiovasc 2009; 24: VII–IX.Google ScholarPubMed
Corno, AF. Pediatric and congenital cardiac surgery in emerging economies: surgical safari vs educational program. Interact Cardiovasc Thorac Surg 2016; 23: 163–167.CrossRefGoogle Scholar
Pezzella, AT. Volunteerism and humanitarian efforts in surgery. Current Probl Surg 2006; 430: 848–929.CrossRefGoogle Scholar
Velebit, V, Montessuit, M, BednarkKiewicz, M, Khatchatourian, G, Mueller, X, Neidhart, P. The development of cardiac surgery in an emerging country: complete project. Tex heart Inst J 2008; 35: 301–306.Google Scholar
Nwafor, IA, Eze, JC. The status of congenital heart defects in Nigeria: the role of cardiac surgery. World J Cardiovasc Surg 2019; 9: 63–72.CrossRefGoogle Scholar
Nwiloh, J, Smith, F, Mestress, C. Challenges to providing open heart surgery to 186 million Nigerians. Niger J Cardiovasc Thorac Surg 2018; 3: 8–13.CrossRefGoogle Scholar
Bode, CO, Nwawolo, CC, Giwa-Osagie, OF. Surgical education at the West African College of Surgeons. World J Surg 2008; 32: 2162–2166.CrossRefGoogle ScholarPubMed
Kwabena, F-B. Deep Down My Heart, A history of Cardiothoracic Surgery in Ghana. Prof K. Frimpong-Boateng, P.O. Box CT 366 Cantonments Accra, Ghana. ISBN 978-9988-0-9773-5.Google Scholar
Bode, F, Michael, S, Adetinuwe, M, Ifeoluwa, A, Ariyo, I, David, O. The cost of open heart surgery in Nigeria. Pan Afri Med J 2013; 14: 61. doi: 11604/Pamj.213.14.61.2162 Google Scholar
Leon-Wyss, JR, Veshti, A, Veras, O, et al. Pediatric cardiac surgery: challenge and outcome analysis of the Guatemala effort. SeminThorac Cardiovasc Surg Pediatr Card Surg Annu 2009; 12: 8–11.CrossRefGoogle Scholar
Turina, MI. European association for cardio-thoracic surgery: carrying the torch. Eur J Cardiothorac Surg 2002; 22: 857–863 CrossRefGoogle ScholarPubMed
Nwafor, IA, Arua, AO, Eze, JC, Ezemba, N. Utilization of blood and blood product during open heart surgery in low income country: our local experience in 3 years. Cardiol Young 2018; 28: 1–6.CrossRefGoogle Scholar
Falase, B, Sanusi, M, Majekondunmi, A, Ajose, I, Idowu, A, Oke, D. Cost of open heart surgery in Nigeria. Pan Afr Med J 2013; 14: 61–70.Google ScholarPubMed