Dr. Christian Inya Oko is a renowned healthcare expert and researcher, who recently made waves with his insightful publication titled ‘Relationship between patients and medical professionals: expectations towards healthcare services in Nigeria’. In this exclusive interview with PAUL OKAH, he sheds light on the core findings of his research and the practical implications for Nigeria’s healthcare landscape.
What should people know about you?
I am Dr Christian Inya Oko, a public health researcher and health economist. I have a background in medicine from the University of Nigeria and a masters in public health from Birmingham City University United Kingdom. I also hold a certificate in health economics and policy form University of Lancaster, and a masters in health economics and policy from University of Birmingham. I have attended several professional certificate courses including the Global Surgery Course at the University of Oxford. I have worked with several academic and health organizations/institutions including the London School of Economics, Oxford University United Kingdom, Bayelsa State Ministry of Health, Nigerian Economic Summit Group and the United Nations Economic Commission for Africa. I have been a leader in various capacity and have won the United Kingdom Chevening Scholarship award for global leaders as well as the Bayelsa Governor’s NYSC Award and the NYSC President’s Honours Award.
What’s the overview of your recent publication?
My recent publication examines the relationship between patients and medical professionals in Nigeria. It was inspired by the significant gaps in expectations that I observed during my clinical and research experiences. After years working within the Nigerian healthcare system, I observed the frustration many patients feel due to the gap between their expectations and what they actually experience. Patients often come into the healthcare system with certain expectations that may not align with what the medical professionals perceive or can provide, leading to dissatisfaction and strained trust. These challenges often extend beyond the walls of hospitals and clinics, impacting overall trust in the system. My motivation with this publication was to explore this dynamic and propose pathways to bridge these gaps, improving the patients’ experiences for better healthcare outcomes.
What are some of the key findings from the study?
First, we observed that patients seek knowledge as well as they seek action. They desire to see their doctor’s adeptness in providing accurate diagnoses and appropriate treatments. They also want to know about the causes, diagnosis, tests and treatment plan in lay-man terms. Patients do anticipate that physicians will demonstrate a high level of expertise, competence and knowledge with regards to contemporary medical advancements. Another critical factor influencing patients’ expectations in healthcare are availability and accessibility. Patients appreciate doctors who are accessible, which includes geographical proximity and the availability of appointments with extended durations of interaction. Extended waiting periods, limited accessibility to healthcare facilities, tests, treatment options and difficulties in reaching physicians can foster frustration and dissatisfaction among patients.
What are some of the main factors contributing to this gap between expectations and reality
One major insight was the role of social and economic factors in shaping patient expectations. Patients from more affluent backgrounds, for example, had higher expectations for service quality and shorter wait times, whereas those from less privileged backgrounds were more focused on affordability and access. The trust that patients place in the healthcare system can vary significantly. There is a notable disparity in individual perspectives concerning the trustworthiness of healthcare providers and the healthcare system as a whole. Some individuals harbour a high degree of confidence in their doctors and the overarching healthcare framework, often based on positive past experiences or a belief in the competence of their providers. Conversely, there is a segment of the population that harbours mistrust towards their doctors, a sentiment often rooted in previous unsatisfactory experiences or perceived inadequacies within the system. This might also originate from a lack of familiarity with doctors and other healthcare professionals, potentially leading to hesitance in establishing trust.
Cultural factors also play a significant role in shaping patients’ attitudes and behaviours towards healthcare delivery. The influence of traditional medicine and spiritual beliefs on patient decision-making and attitudes towards healthcare is noteworthy. For example, the prevalent belief that mental illness is caused by spiritual possession or curses led to the use of alternative treatments such as traditional healing homes and faith-based institutions. Also ignorance plays a major role as patients may not understand their problem if oral or written information is given. On the other hand, the role of the internet is very significant as patients may get information with medical jargons about their symptoms. Thus, they come to the hospital expecting to do the different tests, scans and treatment plan they see online. This is irrespective of the appropriateness of their diagnosis or availability of the investigations or treatment plan they browsed. Most of the diagnosis they get online about their symptoms are wrong and ends up in confusion and inappropriate self-medication.
Do you believe your findings can impact current practices within the Nigerian healthcare system?
My hope is that this research encourages more training in patient-centered communication for medical staff and promotes policies that prioritize building trust. If healthcare professionals understand the expectations of their patients better, they can tailor their approach accordingly, which could lead to higher satisfaction rates. Moreover, government and healthcare administrators should invest in equipping healthcare centres with the world-class facilities for investigations and treatments. There should also be increased medical workforce to reduce the workload, allowing them more time for each patient.
What challenges do you foresee in implementing these changes across the healthcare system?
The biggest challenge is the resource constraint. Many healthcare facilities in Nigeria are underfunded and lack the personnel and infrastructure to take care of diagnosis made. This leads to medical tourism. Another challenge is lack of communication skills, Most medical professionals give little time discussing with patients to address their concern. They only just focus on the disease. This leaves the patient confused about their own disease and treatment plan. Overcoming these barriers will require both policy reforms and grassroots advocacy for a cultural shift within healthcare institutions. Education is crucial. Patients often form their expectations based on what they see in the media or online, which may not reflect the realities in Nigeria. By enhancing public health education, we can help patients understand better the prevailing medical conditions around the country and to know both the strengths and limitations of their local healthcare system. This could include media, community engagements and workshops on prevention, primary care, when to go to the hospital and what to expect in a medical setting. Educated patients are empowered to learn more about their conditions and work more collaboratively with their providers, improving overall healthcare outcomes.
What advice do you have for patients and medical professionals?
To patients I would say, ask questions, engage actively in your care and communicate your expectations. To medical professionals, it is important to balance clinical duties with effective patient communication. This could be as active management of the patient of referral to more robust centres. I believe that with mutual effort and systemic support, we can foster a healthcare environment where trust, understanding, and shared expectations thrive. I’m optimistic about the future of our healthcare system and how the research will help shape the future of healthcare in Nigeria.
