Gastro-intestinal endoscopy capacity in Nigeria: strengths and challenges

Prof Olusegun Alatise - Obafemi Awolowo University, Ife, Nigeria

What has motivated us to look at the capacity of gastrointestinal endoscopy in Nigeria is because we have recently found out that the incidence of colorectal cancer is on the rise. Because the incidence is rising we need to develop infrastructure to be able to do early detection of colorectal cancer. Whatever method you are using, colonoscopy capacity is key in the early detection of colorectal cancer.

So we did a survey, trying to analyse what is the infrastructure that we have and how can we build it up. Currently in Nigeria we have about 200 endoscopy facilities and almost about half of them are providing good colonoscopy services. Unfortunately, almost half of these centres are located in Lagos, Lagos State, where we have just one or two in other states. So currently most of our endoscopy facility is still skewed to Lagos State and one of the things that we need to do quickly is to see how we can build capacity, both human capacity and also build capacity in terms of equipment that people can use. Subsequently we can now start working on ensuring the quality of the services that are being provided for people in all the centres.

We are far behind so both have to be done in tandem. We need to continue to build human capacity, build infrastructure capacity and also continue to build a structure to ensure that whatever services are provided by all our endoscopists are quality. The Society of Gastroenterology and Hepatology in Nigeria is championing the aspects of building quality along these lines. They have come up with the guidelines for our accreditation of centres. This is not published yet but effort is ongoing along these lines because most of the endoscopists in Nigeria actually belong to the society. We are hoping that in the next few years we will be able to develop guidelines for which endoscopy facilities should be established in Nigeria and then what are the ways, how should those facilities be run so that quality can be maintained. That quality will meet international standards.