UNIVERSITY COLLEGE HOSPITAL, IBADAN

Celebrating 65 years of service to humanity

By ELLY OKUTOYI

University College Hospital, Ibadan won the best public health institution award in Nigeria on September 2021 in a ceremony graced by the Country’s Head of State, General President Muhammadu Buhari. The receipt of the prestigious award was a testament to the hospital's unwavering commitment to providing excellent healthcare services to its patients over the years.

Behind the hospital’s success is Chief Medical Director, Professor Jesse Abiodun Otegbayo, and his team of 6,887, who are spread across its 80 departments and 9 Units. The well-schooled Professor of Medicine was appointed to the position by President Buhari in January 2019 and has since strived to steer the institution to even greater heights.

Prior to that, Prof. Otegbayo who is also a Consultant Gastroenterologist & Hepatologist had enjoyed a long illustrious career in academia where he taught and served as an undergraduate and postgraduate examiner in universities and hospitals in Nigeria, Cameroon, and Ghana.

In an interview with Healthcare Middle East and Africa (HCMEA) magazine Prof. Otegbayo gives a detailed insight into the hospital’s past and its preparation to restore its position as one of the top hospitals in the Commonwealth.

“The University College Hospital was established by an Act of Parliament in November 1952 in response to the need for training of medical personnel and other healthcare professionals for the country and the West African sub-region. The physical development of the hospital commenced in 1953 in its present site and was formally commissioned after completion on 20th November 1957. The hospital was initially commissioned with 500-bed spaces but presently the Hospital has about 1,000 beds. The current bed occupancy ranges from 70% - 80%. In addition, the hospital also provides facilities for postgraduate residency training programs in all specialties of Internal Medicine, Surgery, Obstetrics and Gynecology, and Pediatrics,” explains Prof. Otegbayo.

Organizational Structure And Governance

The University College Hospital – Ibadan, is largely run by a Board of Management under the Chairmanship of Mr. Alhaji I. B.B Shettima. The Federal Ministry of Health has one representative, while the public interest is taken care of by Honorable B.S Oluruntoba and Dr. Michael Somoye.

The Nigerian Medical Association is represented by Professor Titus Ibekwe, while Dr. A.O Adeyanju sits in for the Oyo State Government, while the other Health Professionals are ably represented by Professor Grace T. Fadupin. Other members of the board include Dr. A.M Adeoye who doubles as a representative of MAC, and Mr. S.O Oladejo, who is the Director of Administration and Secretary to the Board.

As Chief Medical Director, Professor Otegbayo’s role largely revolves around Managing the Hospital’s Clinical and Non-Clinical operations. He oversees the hospital budgets and ensures that all staff adheres to safety standards and precautions. It is also the duty of the Chief Medical Director (CMD) to ensure that patients are comfortable and staff welfare is given the highest consideration.

Meanwhile, the institution has a Medical Advisory Committee (MAC) Chaired by Dr. Abiodun Moshood Adeoye, which oversees clinical services and ensures that patients visiting the Hospital are given adequate, prompt, and proper attention. The MAC is also charged with the responsibility of reviewing and recommending clinical governance that includes policies, guidelines, standard operating procedures, and clinical compliance framework for approval by the Board.

Administration matters at the facility have been placed on the shoulders of Mr. Stephen Olubusayo Oladejo, who doubles as the Secretary to the Hospital’s Management Board. Mr. Oladejo’s role involves supervising and coordinating activities and performance of all departments, and training of clinical and non-clinical staff members. His other roles include helping in the recruitment of staff and work performance evaluation, besides ensuring the Hospital complies with all applicable laws and regulations.

RESTORING HOSPITAL’S FORMER GLORY

Professor Otegbayo intimates that when he came into office as CMD, he discovered most of the structures were in a gory state of despair due to long use and negligence. To live up to its promise as one of the largest public hospitals in the West African region, the facility has significant infrastructure upgrades. Before new equipment arrived, a change in mindset for the entire staff had to be achieved. The Professor adopted “A Vision for Excellence” as his Mantra, while he adopted “Staff Welfare and Patient comfort” as the catchphrase for the administration.

These are the guiding principles of the UCH today. Professor Otegbayo holds monthly consultative meetings with all members of staff just to keep every team member aligned with the mission of rebuilding and revitalizing the institution.

The journey of revamping the Hospital began in earnest in June 2019, when 48 three-seater stainless steel chairs were procured for use by patients who hitherto had to sit on bare floors and staircases outside the accident and emergency unit and wards in the hospital. A further focus on patient comfort saw UCH’s central toilets on six floors given a facelift courtesy of Eco Bank Plc Nigeria. Fifty new hospital beds were also donated by the office of the Senior Special Assistant to the President on Sustainable Development Goals, on September 5th, 2021 just to ensure patients seeking care at the hospital receive the utmost level of comfort.

On quality healthcare delivery, the UCH commissioned the High Dependency Unit in July 2019. The unit on the third floor was designed and equipped to serve as an extension of the Intensive Care Unit (ICU).

Two months later, the hospital took receipt of seven new top-range anesthesia machines and two interventional invasive monitoring machines and commissioned the main theatre suites changing room, conveniences. The suit even received a cleaner corridor to enhance its capability to deliver quality care to patients. In September of the same year, several state of art laboratory equipment were procured to bolster the hospital’s capacity in medicine research. The UCH-RAD-AID pictorial archiving communication system (PACS) reporting room in the radiology department was also commissioned at the same time.

The Hospital further managed to procure six brand new vehicles for top management staff in November 2019, while the month of December saw the Hospital acquire anesthetic machines and chairs for adult and children surgery in the ophthalmology surgery unit.

With Covid-19 threatening to paralyze the healthcare system globally, UCH Ibadan made several interventions toward improving its own capabilities in handling complex medical situations. Particular focus was given to the Intensive Care Unit (ICU) and the theatre which both underwent major renovations. Other major investments made during the COVID-19 pandemic include the acquisition of medical equipment such as Braun Nuve nf1200 bench centrifuge and a Jenway 7315 spectrophotometer. Two (nos S70 GE) echocardiographic units under the department of medicine were acquired as well.

One other major developments that the hospital has undertaken under the professor’s leadership include the conversion of the former Multi Drug Resistant (MDR) building (Damien Foundation) located along East Gate road to a 12- bed capacity infectious disease treatment center and the refurbishment of the chemical pathology laboratory which is now equipped to meet global standards. The FRSC RS 11.3 Oyo Sector Command’s Staff Clinic Laboratory was also commissioned by the CMD on April 13th 2021.

In order to safeguard all these resources and investments, the Hospital’s Management Board has set up an Anti-Corruption and Transparency Unit to ensure prudent use of the resources. Alongside this, an independent financial analyst has been contracted by the hospital to assess issues bordering on procurement, breach of contract, and fraud has been put in place. Various committees have also been put in place to help in the wholesome management of the institution. The staff welfare was put in place in June 2019, the ward management committee, the special duties unit inaugurated in June 2019, and the theatre management committee.

SUPPORTING NIGERIA’S FIGHT AGAINST CANCER

At the height of the pandemic, UCH equipped the Department of Radiology with Uninterrupted Power Supply Station to ensure services run smoothly even when the hospital experiences power outages. The Radiology Department at the University College Hospital, Ibadan stands to benefit due to a huge boost it has received through its latest acquisition and installation of a 64-Slice computerized tomography (CT Machine) and a Digital Mammography machine to carry out a variety of radiodiagnosis services. This is an innovative milestone in terms of the hospital’s approach to solving health issues related to CT.

Patients can access the following services at the facility: General Brain CT, Brain CT for Trauma, Brain CT for Stroke, Chest CT, Abdominal CT including 3phase liver scan, Abdominopelvic CT, Peripheral Angiography, Pulmonary Angiography, Cerebral Angiography, General CT Angiography, Paranasal Sinuses CT, CT of the Spine and CT Urography.

According to the World Health Organisation, more than 50 percent of cancer patients require radiotherapy as part of cancer care and it is frequently used to treat the most common types, such as breast, cervical, colorectal, and lung cancer.

Nigeria has an estimated population of 200 million people and experiences approximately 115,000 new cases of cancer and around 70,000 cancer deaths per year. The addition of 64-Slice CT Machine to the hospital’s oncology infrastructure will not only serve to improve the capacity of UCH Ibadan but also bridge the gap that is associated with the dearth of machines of that caliber needed to serve the teeming

Nigerian population where each machine serves an estimated 25.7 million people.

Oncologic imaging, in particular, stands to benefit greatly from the deployment of Digital Mammography with the latest GT Technology in Mammography at the hospital. Among the services the hospital will be able to render include, 2D Digital Mammography, 3D Digital Mammography (Tomosynthesis), and Stereotactic Biopsy for early Breast Cancer detection. The fast-tracked imaging is particularly important in the fight against the scourge of breast cancer and improve the survival rates in lieu of the knowledge that 75% of patients diagnosed with breast cancer at Stage 0 have a close to 100% survival rate, while survival rates drop between 20% and 40% at Stage 4.

The Hospital’s Radiology Department has kicked off an on-site training of its staff on Basic Computed Tomography CT application for the newly installed Sixty-four (64) slice General Electric CT Machine to ensure proper system function. The Head of the Radiology Department, Dr. Ademola Adekanmi stated that the training involves Consultants, Resident Doctors, Radiographers, Bio-Medical Engineers, and Nurses.

A Center Of Academic Excellence

The UCH Ibadan prides itself in taking a leading role in training qualified healthcare professionals. Since its inception, the school’s main thrust in meeting the broad objectives has been the training of middle-level manpower for health industries in different academic courses. The institution recently received a five-year full accreditation from the Health Officers Registration Board of Nigeria with effect from 11th April 2022 in Health Information Management allowing it to enroll more students. Even as that happens, the institution recently celebrated its sixth matriculation ceremony in January when it welcomed 120 students into the institution to undertake academic programs in National

Diploma (ND) and Higher National Diploma. Even more, its Nursing school is reputed as the best school of Nursing in Nigeria and is recognized for quality education.

In his address to the new intakes, Professor Otegbayo said: “The school’s primary mission and core value is to transmit a body of knowledge and a command of adequate technical skills and to produce graduates with sound minds.” He emphasized that as an institution, “We have zero tolerance for any form of misconduct and vices such as cultism, drug abuse, sexual abuse, cheating, falsification of documents, rudeness to authorities, and inducement of staff for undeserved favours.”

A Bumpy Ride Ahead

The progressive journey at UCH Ibadan has however not been without challenges. Inadequate funding, aging infrastructure with huge maintenance costs, negative perception, and high expectations from the public, top the list of barriers standing in UCH Ibadan’s way to excellence.

There is also a myriad of other challenges ranging from healthcare staffing shortage, industrial unrest, and staff laxity (Civil Service Mentality), which the administration of Professor Otegbayo has had to deal with.

Besides, obsolete healthcare infrastructure and unavailable facilities, power problems, and water shortages add to the shortcomings list. “These challenges may appear daunting but not insurmountable. Our Oliver Twist approach gives one the hope that help will always come. As we all know, Rome was not built in a day. We will continue to optimally explore all avenues and resources at our disposal to ensure that these challenges are managed and eventually surmounted in the nearest foreseeable future.

"Mark my words: Patient’s comfort and constructive engagement of staff and all stakeholders will be explored to move the University College Hospital, Ibadan forward to the glory of God and the benefit Nigerian citizens and humanity in general,” adds Professor Otegbayo.

BUILDING A QUATERNARY-LEVEL HOSPITAL

One of the ambitions that Professor Otegbayo is nursing is to transform the University College Hospital, Ibadan into a quaternary-level hospital offering highly specialized and not widely accessed levels of care. The journey to this status has already begun with the Chief Medical Director intimating that his hospital is investing in several facilities including a Cardiac Centre, Sickle Cell Centre, Tuberculosis Centre, and Prostatic and Orthotic Service Centres. Acquiring MRI machines, improvement of special diagnostic services and putting up a Bioequivalence and Bioavailability Centre are some of Professor Otegbayo’s administration plans for the next 5-10 years.

The Molecular Laboratory is currently under construction, and when completed will serve as a high-tech laboratory for the diagnosis of Covid-19, Lassa fever Virus, and Ebola Virus among others. Other new services to be launched in the next five years include Organ banking and transplant Centre, separation of medical and surgical accident emergency services, Enhancement of E-communication as well as Federal equipping of the Hospital Laboratories.

Renovation and putting into use, the Akinkgbe Kidney Care Centre as well as the construction of a Hospital Fire Station also remain key in the Hospital’s 5-year plan. The completion of UCH Schools of Post Basic Nursing funded by the Tertiary Education Trust Fund will be given serious consideration.

Plans to extend the General Out Patient Department (GOPD) building are also underway. Through Public-Private Partnerships (PPPs), the Hospital plans to construct residential quarters for the growing population of workers, whose stay within the precinct of the Hospital is essential.

Professor Otegbayo reveals that more emphasis will also be laid on continuous staff development and training, starting with putting up a Hospice and Palliative Care Centre and commencement of training courses. The Hospital also expects to construct a purposebuilt and dedicated building for the National Health Insurance Scheme (NHIS). Community Health Tutors’ Hostel and Demonstration as well as equipping the mortuary with state-of-theart equipment is part of the future plans of the Hospital.

The renal unit at the Hospital will benefit from a planned development of a Liver Transplantation program. Procurement and installation of 125 Slice CT in the Radiology Department and further equipping of the Hospital’s Laboratories will be given emphasis.

The Professor notes that the future plans he has designed for the institution will lift it back to its former status of being number 4 in the Commonwealth: the Hospital where kings and princes used to come for treatment.

He sums it up by quoting Williams Arthur Ward, one of the famous writers in America who said, “Opportunities are like sunrises. If you wait too long, you miss them. I am prepared to take the opportunity of making UCH great again as swiftly as I can,” he concludes. HCMEA