The World Health Organization defines integrated service delivery as “the organization and management of health services so that people get the care they need, when they need it, in ways that are user-friendly, achieve the desired results and provide value for money.” The primary focus of integrated service delivery is to provide access to quality healthcare to the intended recipients at a convenient, affordable, and acceptable manner. In most settings in Nigeria, resource availability is perceived to be inadequate and unevenly distributed with most centers lacking full complement of manpower and materials to render effective and comprehensive medical services.
Several efforts have been expended over the years to remedy the situation with varying degrees of success. It has become increasingly glaring that it will be very difficult (if not impossible) to fill all resources gaps for the simple reason that the overall population will keep expanding while the resource availability will remain at current levels. The net effect is a shrinking resource base. Is there a way of creatively making the resources available to stretch out and cover more ground effectively? Can professionals share notes and consult with one another over the care of difficult and novel cases? The answer is yes. Indeed, where there is a will, there is always a way. The benefits provide enough incentive to put as much effort as is required to make it work.
Imagine this:
Mama Fatima takes her daughter to the local Health Center because the child is sick. The health personnel in charge of the facility, a Community Health Extension Worker, receives the sick child. The child’s electronic file is pulled up and the vital signs are checked and recorded. The CHEW asks preliminary questions and puts all the notes into the system. A doctor is available and on duty in the 1Space Healthcare Virtual On-Demand App. The CHEW places the patient on a queue and the doctor is auto prompted. When the doctor is available, the CHEW assists the patient to speak to the doctor by video conference. Questions are asked to elicit history and background of presenting complaints. If required, the doctor asks the CHEW to place a digital stethoscope over the child’s chest to enable doctor to review the condition of the lungs and heart. The doctor reviews the clerking and examination data and may ask for some diagnostic tests to be carried out. The child enters the laboratory where samples are collected, and tests carried out. Results are uploaded to the patient’s file for the doctor to review. The doctor reviews the situation with the mother and the prescription is given for her to get the drugs and administer. Follow up care is carried out through the same platform.
Integrated health services delivery is the guaranteed way of providing premium health care to the largest number of recipients in resource challenged systems. The key ingredient of establishing such system is the determination by the authorities to be convinced of the proven advantages including the ability to provide needed care to people who need it in an effective manner. The requirements for integrating the available system also depends on getting the willful commitment of all health personnel especially doctors, and in establishing a cultural and managerial shift which will foster and reward accountability in service delivery. A successful integrated system requires automation and information system infrastructure. Click here for more informtion.
