Nigerian government formally avoids auxiliary nurses which are already trusted by citizens. What’s the way forward?
This week, the government of Oyo state expressed its displeasure with the training of auxiliary nurses in private health facilities in the state. According to the government, such practice will not be tolerated.
Read more: Nigerian nurses oppose potential paths to legality for auxiliary nurses
According to the state government, the training of auxiliary nurses is against the ethics that guides the profession for training of nurses in private facilities which lead to quackery. The state government added that the state has 12 qualified institutions that train nursing students in tandem with best practices across the globe.
Also in Ogun state, the state government has banned auxiliary nurses from operating in the state.
Health Commissioner, Doctor Babatundee Ipaye, announced this while monitoring the level of compliance with the registration and re-validation exercise of private health facilities in the Abeokuta South and Odeda Local Government Areas of the State. Ipaye says the decision aims at checking quackery and Unprofessionalism in the State Health Sector, which has placed the lives of residents in the state at risk.
However, HealthNews.NG‘s review of foreign medical systems revealed auxiliary nurses are integral parts of the health systems of several other developed and developing countries including the United Kingdom and South Africa.
In UK, auxiliary nurses are employed through the National Health Service (NHS) or through private health care institutions. Ideally, the role of an auxiliary nurse is to assist qualified nursing practitioners in administering care to patients. Auxiliary nurses are often referred to as health assistants.
But in Ibadan and across Nigeria, the line that separates auxiliary nurses from nurses can be very blurred thus creating confusion among unsuspecting members of the society who only seeks treatment and not professional designations.
HealthNews.NG gathered that several private hospitals in Ibadan are actively engaging the services of auxiliary nurses and are using them as nurses to administer treatment and patient management because they cannot afford to employ real trained nurses – a development that had resulted in several bad medical outcomes designated as quackery.
“It is unfortunate that in Nigeria, most people put on the uniform and parade themselves as Nurses and are even encouraged by some health care providers to lie to us because they are cheaper to employ and sack,” an online commenter said on Nairaland.
In an argument over the legality of auxiliary nurses, several Nigerians pointed to the fact that Nigeria is not the only country where auxiliary nurses are operating. However, it has been able to regulate auxiliary nursing pratice and practitioner conduct.
“South Africa had standardised and modified how nurse assistants should practice and the level of education needed. Same also is applicable in other developed and developing countries but can’t be equated with the sort of quackery we are witnessing here in Nigeria. In other countries, there are boards to regulate this workers even in Ghana they have nursing assistant schools which gave it the much needed legal backing.
Do we have it here? No. Everything about us, even health is a classical cut and join,” DuroDe said.
The auxiliary nursing education system
HealthNews.NG spoke to 5 auxiliary nurses and they said they decided to seek training in private hospitals after failing to secure admission to any of the schools of nursing or were unable to afford the fees.
“I applied for 4 years to about 8 schools of nursing. Someone then told me that I could get trained as a nurse at the major private hospital in our area. They thought us a lot including how to give injection, make provisional diagnosis and give drugs. When things are getting out of hand, we can call the matron who will call the doctor if she cannot handle it,” Toyin Adeola, an auxiliary nurse in Ibadan told HealthNews.NG
Different hospitals that are training auxiliary nurses in Nigeria have their own training modules but the best perk is practical exposure which the auxiliary nurses said they have more than student nurses.
“Within one week that I started my training, I was already helping with patient management. This is not possible at the school of nursing,” Taibat Ibukun added.
But the major shortcoming of the current unregulated training for auxiliary nurses is the shallow scientific knowledge depth of the graduates and the inability of the sick members of the public to separate real nurses from auxiliary nurses thus making it extremely hard to stem quackery in the health system when the patients already trust the auxiliary nurses.
Opportunity to improve healthcare assess
While Oyo state government is unrealistically striving to end auxiliary nursing in the state, the fact that they are already providing healthcare services in unreached areas present an opportunity to improve healthcare access across the country.
Justifying the need to shut down auxiliary nursing in Ibadan, the State Commissioner for Health, Dr Azeez Adeduntan, said anybody who is interested in going to medical school to become a qualified nurse should go to a nursing school established and identified by the State Government.
During an exercise to shut down illegal health centers in the state, the state government reported that eight out of eleven facilities visited were closed for quackery practices, illegal operations, unqualified medical personnel, and failure to maintain the minimum standard of practice, noting that they were not also registered with the government.
The big picture
If 8 out 11 health facilities are found wanting, this could be a good reflection of the state of healthcare quality in the state. With the government losing the identified facilities down, the goal of achieving universal health coverage becomes almost impossible to achieve in the state and across the country.
“Looking at the figures, it doesn’t make sense to just close the hospitals down. First of all, you cannot close down all substandard hospitals in Nigeria and you cannot end auxiliary nursing training either. What ought to be done is to offer the auxiliary nursing students a path to formal education so that they can know what they are doing and they might help in bridging the country’s wide health access gap. Whether the government likes it or not, auxiliary nurses are here to stay. They’ve been around for decades and they will continue to be around for years to come,” said Dr Victoria Adepoju, Director of HealthNews.NG’s Report+Impact Foundation.