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Advancing Healthcare in Nigeria requires a Redesign of the System

Advancing Healthcare in Nigeria requires a Redesign of the System

16:05 8th November 2019 | Business of Healthcare

Business of Healthcare Practice of Medicine Investor Relations Therapia Health Technology Sustainable Business

A paper presented at the 25th AGM and Scientific Conference of the National Guild of Medical Directors in Abuja, 26 October 2019.

Richardson A Ajayi FRCOG, FWACS

Bridge Clinic, 66 Oduduwa Way, GRA Ikeja, Lagos, Nigeria


On Saturday, 26 October 2019, during the 25th AGM and Scientific Conference of the National Guild of Medical Directors held in Abuja, Dr Richardson Ajayi, a renowned Consultant Gynaecologist and Executive Vice Chairman of Bridge Clinic declared Nigeria a sick nation.


The healthcare sector has observed an increase in investor interest both locally and from an international perspective. However, is investment in the industry the only challenge we face to deliver better quality care? Dr Ajayi questioned whether the healthcare system is ready to transform, and if it was poised to do so, what plausible solutions exist amid the chaos that is Nigeria’s healthcare system. And are these solutions sustainable?

"The first step in working towards answers is to identify the problem. And the problem rests largely in how the Nigerian healthcare system is designed." He highlighted the continuum between the practice of medicine and the profession of healthcare. 

Dr Ajayi stressed the need for a paradigm shift from the independent sole proprietorship model, which makes it difficult to combine the practice of medicine from the business of healthcare. To effectively render a sustainable service that does not put patient lives at risk requires a careful balance of various components. This matrix drives the value chain of primary and support activities.


He motivated that clear lines to be drawn to define these ideals which are critical to the successful outcome within the healthcare system. This model of separation between healthcare-as-service and healthcare-as-business has led to many medical breakthroughs across several hospital groups in the UK and India. 

He challenged doctors to review their practices by separating the functions of medicine as a profession and the operational side of running a sustainable business. Dr Ajayi proposed a number of strategies to effectively accomplish this separation.


There is evidence that the best healthcare systems are those managed by doctors with management experience. By embracing this trend, we create an enabling environment for industry consolidation. Consolidation leads to greater economies of scale, reduced rivalry amongst doctors, and more importantly, increased market power against partners such as HMOs. 

According to Dr Ajayi, this objective can also be achieved by organising the industry through licensing and the enforcement of standards which can be made effectively in a service platform model.

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