By Tunji Adetunji
A consultant neurologist, Dr. Temitope Farombi, has warned that Nigeria’s fragmented healthcare system, weak regulatory enforcement and widespread quackery are putting patients at risk and undermining treatment outcomes.
Farombi, founder of the Brain Centre for Neurocritical and Rehabilitation Services, said the challenges facing the health sector go beyond inadequate infrastructure and manpower, stressing that poor coordination among primary, secondary and tertiary facilities was compromising continuity of care.
Speaking with journalists, she described Nigeria’s healthcare system as “highly fragmented”, noting that vital patient information was often lost as patients moved from one level of care to another.
“What happens in the Primary Care Centre is not known to what happened in the secondary care, as well as what happened in the tertiary care.
“There is not so much policy monitoring. When you give out guidelines, there is not enough monitoring of those guidelines.”
Farombi said policies and guidelines would have little impact without effective implementation and monitoring, calling for stronger links between the three tiers of care.
“If a patient is moving from primary care to secondary care and then to tertiary care, there should be continuity. The information about that patient should follow the patient.”
She also identified weak enforcement of healthcare regulations as a major factor enabling unprofessional practices to persist.
“We have regulations, but the issue is enforcement. When people know that there is no monitoring and there are no consequences for violating the rules, they are more likely to operate outside the standards,” she said.
The neurologist described quackery as another major threat to patient safety, particularly when practitioners treat conditions beyond their competence instead of referring patients to specialists.
“There are situations where people manage patients beyond their competence instead of referring them to the appropriate specialist. That is dangerous because the patient may not get the right treatment at the right time.”
She stressed that timely referral should be regarded as an essential part of good medical practice.
“Referral is part of good healthcare practice. You do not have to know everything. If something is beyond your area of competence, the right thing is to refer the patient,” she said.
Farombi further warned against indiscriminate medicine use, particularly antibiotics, saying self-medication and inappropriate dispensing were contributing to antimicrobial resistance.
“I have seen people who are not adequately trained dispensing drugs simply because somebody tells them, ‘I have a headache’ or ‘I have a fever’, and they give them medication without proper assessment,” she said.
She urged Nigerians to avoid self-diagnosis and the tendency to attribute every fever or headache to malaria or typhoid.
“You cannot assume that every headache is malaria or every fever is typhoid. Symptoms can have different causes, and proper investigation is important,” Farombi said.
On the migration of Nigerian health professionals, she attributed brain drain largely to the search for better working conditions, career opportunities and access to modern equipment.
“People naturally want to work in an environment where they can grow professionally, where they have the tools to do their jobs and where their efforts are properly rewarded,” she said.
Farombi called for increased health funding, better working conditions and modern equipment to make the country’s health system more attractive to professionals.
“Doctors cannot perform miracles when they do not have the equipment, facilities and support systems required to provide modern healthcare,” she said.
She also advocated a government-backed digital health platform to connect Nigerian specialists in the diaspora with patients and healthcare workers at home, particularly in underserved communities.
“If somebody is in a remote community and needs to speak to a neurologist, that person should not necessarily have to travel several hours to a major city before getting specialist advice,” she said.
“Technology can connect that patient or the healthcare worker managing the patient to a specialist who may be somewhere else.”
Farombi also called for greater investment in brain health, describing it as a human capital and economic development issue.
“Brain health is not just a medical issue. It is a human capital issue,” she said.
“If we have a population whose brains are healthy and functioning optimally, we have a population that can learn, work, innovate and contribute more effectively to the economy.”
She urged governments to integrate brain health into national development policies, while calling for greater emphasis on analytical, logical, quantitative and verbal reasoning in schools.
“Education should not only be about memorising information. We need to train young people to think, analyse problems, reason logically and communicate effectively,” she said.
According to her, good nutrition, physical activity, green spaces, recreation and healthy social interaction should also form part of efforts to promote brain health from childhood through old age.
“We should not wait until somebody develops a neurological problem before we start talking about brain health. Prevention and healthy brain development must begin early and continue throughout life,” Farombi said.
