AN INQUIRY INTO THE OBSTACLES HINDERING EFFICIENT PROFESSIONAL COLLABORATION WITHIN THE HEALTHCARE SYSTEM IN NIGERIA

CHAPTER ONE

INTRODUCTION

1.1 Background of the study

In the present dynamic environment, the divisions between academic fields are becoming more permeable (Majid, 2018: Shakur, 2021). The conventional divisions of knowledge that previously isolated disciplines such as physics, humanities, and social sciences are being replaced by a new era of interdisciplinary inquiry. Interdisciplinary study, characterised by collaboration and the integration of findings from other disciplines, is becoming increasingly important as scholars acknowledge the necessity of tackling intricate and varied challenges that cannot be easily classified. Interdisciplinary study has significant potential for enhancing our comprehension of the world, although it also presents distinct difficulties and advantages (Shakur, 2021).

Prior to the COVID-19 pandemic, professional teamwork was widely recognised as a highly effective approach in healthcare. However, in the midst of the epidemic, it became absolutely necessary. Amidst a nationwide shortage of hospital staff, it was necessary for all elements of the healthcare system to work together in order to ensure the safety of both patients and doctors. Currently, health systems across the country are striving to create new structures that guarantee the advantages of interprofessional collaboration persist, despite the fluctuating nature of the epidemic (Shakur, 2021). Interprofessional collaboration refers to the cooperative efforts of many healthcare professionals from diverse backgrounds, working with patients, families, carers, and communities, to provide the utmost level of care across various healthcare settings. This definition is provided by the World Health Organisation (WHO, 2020). Effective collaboration among healthcare professionals, including nurses, physicians, chemists, social workers, and other disciplines, is crucial for enhancing workplace environments, health systems, and patient care in the increasingly interconnected healthcare delivery landscape (Shakur, 2021).

Interprofessional collaboration facilitates the training of many disciplines to develop the ability to cooperate and appreciate the importance of diverse skillsets, hence improving the work environment (Sunny et al., 2017). A study discovered that a collaborative work atmosphere enhances conflict management, confidence, and innovation, while reducing emotional weariness. This has a positive impact on healthcare personnel by decreasing their workload and enhancing their job satisfaction. Interprofessional collaboration enhances communication among healthcare professionals, hence expediting decision-making in high-pressure clinical settings. This partnership promotes reverence for the contributions of all fields of study (Jones et al., 2020). Effective professional teamwork in healthcare is crucial for delivering superior patient care. The concept entails the smooth interaction and collaboration of diverse healthcare professionals, such as physicians, nurses, chemists, and allied health workers, who must collaborate to guarantee that patients receive complete and well-coordinated care (Ethan et al., 2023).

 In 2017, the World Health Organisation (WHO) reported a worldwide scarcity of healthcare professionals, prompting governments to actively seek innovative strategies for formulating policies and implementing programs. Interdisciplinary team collaboration is essential in the medical industry to promote the progress of healthcare professions that prioritise teamwork (Park et al., 2021). Interprofessional treatment refers to the methods used to provide the best possible medical care that not only benefits patients but also accomplishes desired results and patient satisfaction (Anders et al., 2019). An interdisciplinary approach is essential for assessing collaborative strategies in medical care. 

Pulisic (2018) stated that extensive research demonstrates that patient outcomes, quality of care, and cost of care delivery are all maximised when different professions collaborate towards a common objective centred around the patient. Interprofessional teamwork enhances patient outcomes by mitigating adverse drug reactions, averting emergency hospitalisations, reducing morbidity and death rates, and optimising prescription dosages. Collaboration among healthcare team members enhances patient outcomes by reducing medical errors and avoidable problems. Pulisic (2018) stated that by adopting an interdisciplinary approach, we may effectively minimise inefficiencies in patient care. "This implies that evaluations and therapies are conducted in conjunction, with an emphasis on the patient as a complete entity rather than a particular diagnosis or treatment." (Pulisic, 2018). 

Effective collaboration among specialists in healthcare systems, including Nigeria, is hindered by substantial hurdles, which can have a detrimental influence on patient outcomes and the overall efficiency of the healthcare system. The healthcare system in Nigeria is intricate and diverse, with a combination of both public and private healthcare providers, a vast array of healthcare facilities, and a varied workforce. Nevertheless, the system encounters various obstacles, including insufficient funding, shortcomings in infrastructure, and a scarcity of proficient healthcare workers. These obstacles are further complicated by problems associated with professional teamwork, which is crucial for efficiently addressing the healthcare requirements of the people. Gaining a comprehensive understanding of these barriers is crucial for enhancing the provision of healthcare and maintaining optimal collaboration among healthcare practitioners. Therefore, the necessity for doing this investigation arises.

1.2 Statement of the problem

This study aims to examine the barriers that impede effective professional collaboration within the healthcare system in Nigeria. Although the significance of teamwork and collaboration in healthcare is acknowledged, several problems still impede the efficient operation of multidisciplinary teams in Nigeria. The elements that can contribute to this issue encompass hierarchical structures, communication difficulties, resource limitations, professional rivalries, and a dearth of standardised protocols for inter-professional collaboration (Abiola et al., 2022).

Nigeria's healthcare system frequently experiences resource deficiencies, such as a scarcity of medical equipment, inadequate finance, and a dearth of healthcare experts (Omonete, 2022). These limitations might result in excessive workloads and stress, which can have a detrimental impact on joint endeavours. According to Marcus (2023), a lack of sufficient healthcare infrastructure and facilities can hinder the ability of healthcare personnel to communicate and coordinate effectively. Inadequate infrastructure may encompass obsolete technology, absence of integrated health information systems, and restricted availability of electronic health records. The healthcare system in Nigeria is fragmented, with differing degrees of service quality and accessibility in both the public and private sectors. The presence of fragmentation can hinder the smooth collaboration between healthcare professionals that operate in separate institutions or locations (Abiola et al., 2022).

In addition, Balogun (2022) argues that the presence of traditional hierarchical structures in Nigerian healthcare organisations can impede the flow of free communication and limit collaboration. The presence of inflexible hierarchies can lead to the formation of obstacles between various staff levels and hinder a cooperative approach to patient care. This, in turn, can result in professionals assuming overlapping tasks and responsibilities (Tunde, 2023). Unclear or overlapping roles and responsibilities within the healthcare profession can result in confusion and conflict among professionals. In the absence of clearly defined roles, team members may encounter difficulties in successfully coordinating their activities (Balogun, 2022). A significant number of healthcare practitioners in Nigeria may have insufficient training in collaborative practices and team-based treatment. Lack of adequate knowledge regarding interdisciplinary teamwork can impede their capacity to function efficiently in a collaborative setting (Akanimoh et al., 2020).

Efficient teamwork necessitates unambiguous and uniform communication. Obstacles such as linguistic difficulties, disparities in culture, and inadequate communication abilities might impede collaboration and the provision of quality patient care. Mensah et al. (2020). Mensah (2020) asserts that rivalries and conflicts among healthcare workers might have a detrimental effect on teamwork. Interpersonal conflicts can stem from factors such as competition, divergent professional viewpoints, or personal disagreements. Insufficient motivation and support from leaders and colleagues can diminish the passion and dedication of healthcare professionals to engage in collaborative practices (Balogun, 2022).

It is essential to overcome these challenges in order to enhance professional cooperation within the healthcare system in Nigeria. The study intends to gain insights into the impact of these barriers on collaboration and provide solutions to improve teamwork among healthcare workers through identification and analysis. Enhancing professional collaboration can result in enhanced patient outcomes, more efficiency in healthcare delivery, and a more integrated healthcare system in Nigeria.

Objectives of the study

The primary objective of this study is to critically investigate the obstacles hindering efficient professional collaboration within the healthcare sector in Nigeria. Specific objectives of this study are to:

To determine the primary barriers that hinder efficient collaboration among healthcare professionals in Nigeria.

To assess the Impact of Resource Constraints on Collaboration among healthcare professionals in Nigeria

To identify Communication Challenges and their impact on professional collaboration within the healthcare system

To assess the Impact of Training and Education on Collaborative Practices within the healthcare system

To develop recommendations to address the identified obstacles and improve the efficiency of professional collaboration in Nigeria’s healthcare system

1.4 Research Questions

The following research questions which are in line with the objectives of this study will be answered in this study:

What are the primary barriers that hinder efficient collaboration among healthcare professionals in Nigeria?

What is the Impact of Resource Constraints on Collaboration among healthcare professionals in Nigeria?

What is the Impact of Communication Challenges on professional collaboration within the healthcare system?

What is the Impact of Training and Education on Collaborative Practices within the healthcare system?

What are the recommendations to address the identified obstacles and improve the efficiency of professional collaboration in Nigeria’s healthcare system?

1.5 Research Hypotheses

To determine the effectiveness of this study, the following research null hypotheses will be formulated to guide the study and it will be tested at 0.05% levels of significance.:

Ho: There are no significant barriers that hinder efficient collaboration among healthcare professionals in Nigeria.

Ha: There are significant barriers that hinder efficient collaboration among healthcare professionals in Nigeria.

1.6 Significance of the study

The research on "Identifying the Barriers Impeding Effective Professional Collaboration within the Healthcare System in Nigeria" is of great importance to multiple stakeholders in the healthcare industry. Gaining insight into and resolving the barriers to efficient professional collaboration can result in significant enhancements in healthcare provision and results. 

Recognising and resolving obstacles to professional collaboration can enhance the coordination and comprehensiveness of patient treatment, potentially leading to enhanced health outcomes and improved quality of life. Effective collaboration among team members frequently improves the patient's experience by guaranteeing a higher level of comprehensive and consistent treatment, hence potentially boosting patient satisfaction and fostering trust in the healthcare system.

Furthermore, productive teamwork might result in a more optimal utilisation of existing resources, such as medical apparatus, staff, and financial support. Healthcare organisations can enhance resource allocation and minimise inefficiency by successfully surmounting hurdles. Enhanced collaboration among team members can also lead to financial benefits by minimising duplications and preventing unneeded medical interventions or procedures. Tackling collaboration obstacles can enhance the efficiency of healthcare processes and optimise service delivery. Implementing this can optimise the overall efficiency of healthcare facilities and minimise any delays in patient care. Enhanced collaboration among healthcare providers can result in improved care coordination, guaranteeing that patients receive thorough and uninterrupted care across various services and specialities.

Furthermore, the results of the study can offer valuable understanding of systemic problems that impact professional collaboration, so aiding in the formulation of policies and initiatives that enhance the overall healthcare system. The study's evidence can be used to develop rules and regulations that encourage efficient teamwork and tackle obstacles that have been identified.

Furthermore, the identification of deficiencies in training and education pertaining to interdisciplinary teamwork can result in the creation of focused training programs that improve collaborative abilities among healthcare workers. Enhanced collaboration can result in more rewarding professional experiences, more prospects for career advancement, and heightened job contentment for healthcare professionals.

Moreover, this study enhances the existing academic literature on healthcare administration and professional collaboration by offering significant data and insights that may be utilised for future research. It provides a standard for assessing and contrasting collaborative methods and results in healthcare settings, both in Nigeria and globally.

1.7 Scope of the study

Broadly, this study focus is to critically investigate the obstacles hindering efficient professional collaboration within the healthcare sector in Nigeria. Specifically, this study seeks to determine the primary barriers that hinder efficient collaboration among healthcare professionals in Nigeria, assess the Impact of Resource Constraints on Collaboration among healthcare professionals in Nigeria and identify Communication Challenges and their impact on professional collaboration within the healthcare system. 

Further, this study will focus on assessing the Impact of Training and Education on Collaborative Practices within the healthcare system and it also seeks to develop recommendations to address the identified obstacles and improve the efficiency of professional collaboration in Nigeria’s healthcare system.

 The study is carried out in Nigeria. 

1.8 Limitations of the study

As with any human endeavor, the researchers faced many minor constraints during the investigation. The main limitation was the lack of extensive literature on the subject, due to the limited availability of data about an inquiry into the obstacles hindering efficient professional collaboration within the healthcare sector in Nigeria. Hence, a significant allocation of time and exertion was necessary to ascertain the appropriate materials, books, or information and amass data. 

Furthermore, this study is constrained by its small sample size and narrow geographical scope, focusing solely on Nigeria. Therefore, the conclusions of this study cannot be extended to other situations, thus requiring further investigation. 

Moreover, the limits faced by the researcher were primarily due to financial constraints, as they are a student without any source of income to sustain themselves. The exorbitant transportation charges at the research location posed a challenge in meeting the expenses associated with transportation fees.

Furthermore, the researcher faced a time constraint due to the need to do this research while still fulfilling the obligations of attending lectures and participating in other educational activities.

1.9 Definition of terms

Interdisciplinary teamwork: Interdisciplinary teamwork (also known as Professional collaboration) in healthcare refers to the collaborative approach where professionals from different disciplines work together to deliver comprehensive patient care.

Patient outcome: Patient outcomes are the results from care and treatments patients have received whilst in hospital, other clinical or care settings. They focus on meeting the physical, social, and emotional needs of patients from their own perspective to highlight what is important to them.

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