Nearly half of Lagos health facilities lack adequate infection control — GMDs

… Warn hospitals without IPC systems could amplify outbreaks

By Chioma Obinna

Nearly half of 415 healthcare facilities assessed in Lagos have inadequate infection prevention and control, IPC, systems, raising concerns over the preparedness of health facilities to contain emerging and re-emerging disease outbreaks.
The finding was disclosed by Dr Olayemi Daudu while speaking at the 2026 Scientific Conference of the Guild of Medical Directors, GMDs, Lagos Branch, held in Lagos with the theme, “Emergency Preparedness for Emerging and Re-emerging Diseases.”
Daudu said 48.8 per cent of the 415 facilities assessed under the World Health Organisation, WHO, Infection Prevention and Control Assessment Framework, IPCAF, scored within the inadequate range, underscoring gaps that could compromise patient and healthcare worker safety during outbreaks.
She said the assessment covered 214 private and 201 public primary and secondary healthcare facilities between July and October 2023.
According to her, although private facilities performed better than public facilities in the assessment, neither sector had facilities that reached the advanced level of IPC preparedness.
She said: “Infection prevention is not a department or a department of activity, but a standard of care that is driven by governance, and we as directors are charged with that responsibility.”
Daudu stressed that quality healthcare goes beyond treatment to include patient safety, warning that facilities without effective infection prevention systems could become amplifiers of disease outbreaks.
“Every major outbreak has shown the same thing. The hospital without an infection prevention and control system becomes an amplifier,” she said.
She urged private healthcare providers to strengthen outbreak preparedness through effective triage and screening, designated isolation areas, referral pathways, surveillance, hand hygiene, surgical-site infection monitoring and antimicrobial stewardship.
She also called for stronger laboratory capacity, describing the laboratory as “the engine of infection control” because it enables healthcare providers to turn specimens into evidence-based clinical decisions.
Earlier, Chairman of GMDs Lagos Branch, Dr Omoniyi Fagbemi, said the choice of the conference theme was informed by the growing threat posed by emerging and re-emerging diseases.
Fagbemi recalled Nigeria’s experience with Ebola in 2014, including the role played by the late Dr Ameyo Adadevoh and First Consultant Hospital, as well as the more recent re-emergence of diseases such as diphtheria.
“The lesson is clear: emerging and re-emerging diseases are at our doorstep. As frontline healthcare practitioners, we must be abreast of them,” he said.
He added: “We must know not only how to diagnose and treat our patients properly, but also how to protect ourselves, our staff and our facilities.”
Fagbemi said the GMDs had also resolved that members should be enrolled in quality improvement programmes, with facilities expected to attain at least Care Level Three after the agreed grace period.
Beyond clinical preparedness, he said the conference was designed to strengthen the capacity of medical directors to build sustainable healthcare enterprises, stressing that “growth is not enough; it must scale.”
Also speaking, Dr Ayobami Koyoro, who addressed participants on “Systems, Strategy and Leadership for a Healthcare Enterprise Built to Last,” challenged medical directors to examine whether their hospitals could function effectively without their constant personal intervention.
He asked: “If we actually leave the hospital tomorrow, what will happen?”
Koyoro explained that growth in patient numbers, staff, services and revenue could also increase complexity and dependence on the founder, whereas genuine scale requires systems that allow an organisation to increase value without increasing complexity at the same rate.
“Growth is not scale,” he said.
According to him, sustainable healthcare organisations must have systems that reduce dependence on one individual, empower staff to make decisions, use data to guide decisions and maintain financial discipline.
He warned medical directors against confusing revenue with profitability, urging them to understand costs, wages, overheads, power expenses, capacity utilisation, patient retention, payer mix, contribution margins and cash flow.
Koyoro also cautioned against adopting technology without first fixing underlying processes.
“The digital version of a broken system is still a broken system,” he said, urging healthcare leaders to identify problems, redesign processes and determine the required outcomes before introducing technology.
He also stressed succession planning, saying healthcare institutions should be built to survive beyond their founders.
Answering questions from journalists, Dr. Adefolarin Opawoye, who presented “Emergency preparedness for emergency and re-emerging diseases” explained that the WHO IPCAF tool provides healthcare facilities with a structured means of assessing their IPC systems and identifying areas requiring improvement.
She highlighted key components including IPC programmes, evidence-based guidelines and standard operating procedures, education and training, healthcare-associated infection surveillance, multimodal strategies, monitoring and feedback, staffing and workload, as well as the availability of appropriate infrastructure and running water.
She also noted the importance of protecting healthcare workers through appropriate adult vaccination and other preventive measures, particularly during outbreaks.
On disease surveillance, Dr Olayemi urged healthcare facilities to maintain a high index of suspicion and promptly report unusual disease patterns.
She said increased surveillance was particularly important because of movement across borders and the occurrence of outbreaks in neighbouring countries.
She advised private healthcare facilities to establish functional relationships with their local Disease Surveillance and Notification Officers, DSNOs, and make use of available public health reporting channels.
“If you do not actively look for a disease, you will not find it,” she stressed, urging facilities to monitor unusual increases in cases and promptly alert the relevant authorities.
On sustainability and succession, Dr Kuyoro urged medical directors to build systems and develop the next generation of leaders rather than allowing their organisations to depend entirely on one individual.
He said a healthcare practice should remain viable even after its founder or current owner retires.
The conference also focused on the broader role of private healthcare providers in Nigeria, with speakers noting that the sector provides a substantial proportion of healthcare services and therefore has a critical role to play in national outbreak preparedness.
Daudu said private providers must move beyond viewing infection prevention as an expense and recognise it as central to the survival and credibility of healthcare facilities.
“Infection prevention is not a cost centre. It’s a licence to operate,” she said.
She urged the GMDs to establish a private-sector IPC network, strengthen collaboration with the Nigeria Centre for Disease Control and Prevention, NCDC, develop common IPC standards, promote peer mentoring and improve access to trained IPC personnel.
The speakers agreed that preparedness must extend beyond responding to outbreaks after they occur, stressing the need for healthcare facilities to establish systems that enable early detection, safe patient care, effective reporting, staff protection, and continuity of services.
They insisted that preparedness, quality improvement, strong leadership and sustainable systems must become part of routine healthcare delivery rather than measures activated only when an outbreak occurs.