Human Capital Development on Healthcare Delivery in Nigeria

Assignment Task

Background Of The Study

Every organization faces the challenge of survival: how it will stay in business as long as possible. This issue breeds another challenge; which is the effectiveness of its activities or operations or its general service delivery that will ensure its longevity. These challenges pre-occupy all the strategies developed by the management in order to tackle these problems. One of the most important strategies managements throw up revolve around human capital. It is widely accepted by most experts that human capital is an indispensable factor of production (Dae-bong, 2009; Imole, 2013;Odoh, 2016). The human capital or resources are the champion, manager or the mover of all activities and strategies geared towards profitability or otherwise of any organization and consequently its survival. Human capital are the men and women who have the requisite capacity, skills, knowledge and attitudes which are needed in the production of goods and rendering of services as well as the general development of a nation (Marimuthu et al, 2009; Davenport, 2018). They help organisations to realize their objectives with overall intention of promoting national growth and development (Oluwatobi & Ogunrinola, 2011). Human capital is the knowledge, skills, competencies and attributes inherent in people that facilitate the creation of personal, social and economic well-being (OECD, 2001). It makes up the human part of the two critical out of the four (4 )factors of production: labour and entrepneurship which are the most important of them all. Lutz & Samir (2011) give their perspective by stating that human capital is the capability and the efficacy of people in the transformation of capital and raw materials into services and goods and the agreement that it is only through the education system that these skills can be learned. Therefore, organisations devote so much resources in ensuring that their human capital remains effective and efficient in its quest for quality service delivery and the means in achieving this is through human capital development.

Human capital development is the processes or activities implemented by a firm which are aimed at improving the output or productivity of employees and consequently the overall performance of the firm in order to sustain its competitive advantage. These processes include training, education and other professional initiatives in order to increase the level of knowledge, skills, abilities, values, and social assets of an employee which will lead to the employee’s satisfaction and performance, and eventually a firm’s performance. Human capital is the most essential part of the factors of production. Therefore, its development is essential in achieving optimum productivity in any organization. To this end, organizations have to invest so much in training, seminars, apprenticeship and e-learning equipment. The absence of human capital development scheme in any organization will be evident in the low level of productivity, incompetent workforce, high production cost, poor service delivery, mismanagement of resources, indiscipline, resistance to change and corruption to mention but a few. The problem of incompetence in public service delivery and lack of drive among a great number of workers in Nigeria public organizations has been attributed to lack of human capital development and the situation was worsened by the drift of our trained personnel to foreign land in the quest for greener pasture, all resulting in brain drain. Thus foreign experts are having a field day in most sectors of our economy. For Nigeria to overcome its myriad of developmental challenges, its human resource needs to be developed up to the global standard (Enefiok & Ibanga, 2014).

Nigeria has declined in Human Development Index, HDI ranking (which is a measure of human development in 3 basic areas: a decent standard of living, access to knowledge and a long and healthy life) from 158 in 2018 to 161 among 189 countries according to the United Nation Development Programme, UNDP 2020 report. The report showed that the HDI value for 2019 was 0.539 which placed the country in the low human development category. This points to the fact that human capital development is not given the needed attention in our nation and the consequence is reflected in the quality of service delivery in both our public and private sectors. According to Onodugo (2012), “an analysis of most nations that moved up fast in the ladder of development shows that they were able to do that on the basis of human resources strategy”. Countries like Singapore with little natural resources and shared the same developing nations’ tag with Nigeria years ago have joined the league of developed countries due to its investment in developing its human resources (Atoyebi, Iyayi, Odusola and Inyang,2013). South-Korea has followed the same footstep as Singapore by investing 12% of its GDP in education and is ranked among world’s emerging economies (Bergheim, 2005).

Many organizations in Nigeria pay lip service to the issue of human capital development. This is because they consider it as a waste of resources or a drain in their income. Little wonder most of them always stipulate in their recruitment requirements that any applicant must have a given number of years of experience in order to be eligible for a job. The question will be ‘where can a fresh graduate get such experience?’ It is a fact that most organizations in the developed climes have training institutions for new and old employees. Therefore, it is not surprising that their productivity and service delivery are excellent and cannot be matched with what is obtained among their counterparts in developing countries like Nigeria. This position is supported by Bakare (2016) where he opined that poor investment in human capital has led to incompetence in public service delivery and subsequently low economic growth rate.

It is a common knowledge that most organization in Nigeria including our tertiary health institutions contract their staff, units or departments to other organisations in the name of outsourcing due to inefficiency or inability to perform. For instance, some radiology departments in our hospitals are managed by different organisations due to the inability of the former management of the unit to offer the desired services to the patients. This arrangement might not be the best for the hospital as it makes it vulnerable to intruders whose motive will be to make profit at all cost at the expense of the overall welfare of the patients. The management of our health institutions could have avoided this situation if they had invested adequately in human capital development which is more effective and less expensive in the long run than embracing the outsourcing arrangement.

Lack of human capital development in Nigeria public organizations especially our tertiary health institutions located in the South-South has affected the quality of service delivery in these institutions. Without serious and sustained attention on human capital development in tertiary health institutions in South-South States in Nigeria, employees’ performance might continue to deteriorate.

From the foregoing, this research is conducted to unravel the issues concerning human capital development and service delivery using the tertiary health institutions located in south-south Nigeria as a case study.

Statement Of The Problem

Over the years, the federal government has initiated various policies and made serious efforts towards improving the quality of services rendered by government ministries, departments, parastatals, agencies and healthcare institutions. One of the initiatives in recent times that readily comes to mind is SERVICOM (Service compact with all Nigerians). Also the recently inaugurated National Council on Productivity in 2022 after 10 years it was created is another attempt to improve productivity and by extension service delivery. However, all these efforts have not yielded the desired result as Nigeria is seriously lagging behind in all development indices including our healthcare. For instance, in the report, published by Nigerian Economic Recovery and Growth Plan (2017-2020), it showed that the average life expectancy in Nigeria is 52 years which is below that of Ghana (at 61 years) and South Africa (at 57 years). It also stated that Nigeria ranks poorly on the prevalence of HIV (123 ^rd out 138 countries) and tuberculosis (128 ^th out of 138). Furthermore, Nigeria’s under-five child mortality stood at 89 deaths per 1000, a level far above the target of 64 deaths per 1000 live births set in UN Sustainable Development Goals (SDG). The report went further to state that Nigeria spent US$1 billion annually on outbound medical tourism with poor patient-to-doctor ratio of 2500:1 which is more than 4 times higher than the WHO’s recommendation of 600:1. The question one will ask is ‘why is the government not getting it right?’ The answer is not far-fetched since it is in public domain that our human capital development strategy is nothing to write home about.

The competence of most of healthcare providers are below par when compared with others in developed climes; no thanks to poor HCD policies of healthcare organizations. The collaboration with international healthcare organizations in training of staff in recent advancement in medical science is almost non-existent in most tertiary healthcare facility in Nigeria especially in the south-south zone.

 Therefore, this study will seek to unravel the reason behind this. The constant advancement in technology has left many of our healthcare employees almost redundant because they are not trained and therefore lack the skill to cope which such innovations. Therefore, consultants are sometimes invited to save the situation with its attendant high cost. The question that flows from this is whether the issue of training needs assessment are given adequate attention when formulating HCD plans? Also why is it that the opportunities which e-learning and mentoring offers to healthcare providers towards improving their competence in their field of practice are not utilized adequately? All these have resulted in poor healthcare delivery with its offshoot of medical errors in treatment of patients in tertiary healthcare institutions in Nigeria especially the South-south. The issue of medical errors have not been given adequate research attention in our nation maybe due to its sensitive nature yet it is a cancer that is eating deep in the healthcare delivery of our hospitals leading to harm and sometimes death of patients.

 The search in literature on this issue only showed works conducted in the developed nations with very few in Africa and almost none in Nigeria. Many studies have examined among other issues the dependence of economic growth on HCD (Awe & Ajayi, 2010; Agunyai, 2015; Bamidele &Olayinka, 2018) and HCD challenges in Nigeria (Ugal & Betiang, 2003). However, very few have considered service delivery issues in the health sector or our health institutions as it relates to HCD and by extension, none has considered the geographical location of south-south Nigeria. For instance, Kayumba. (2015) conducted a study on the importance of employee training and retention strategies of healthcare professionals for effective service delivery: a case study of Manama mission hospital in Zimbabawe. As a result of this, this study is designed to fill in this gap. Consequently, this study is going to investigate the issues surrounding Human Capital Development (HCD) and Service Delivery in tertiary health institutions located in South-South, Nigeria.

Objectives Of The Study

 This study investigates the impact of human capital development on the service delivery of tertiary health institutions in the south-south region. The specific objectives of this study are to :

1. Assess the effect of the number of qualified specialists in a particular field and the number of post-treatment mortality of patients.
2. Determine the effect of in-house training on the incidence of prescription errors by medical resident officers of tertiary hospitals.

• Ascertain the relationship between working with visiting medical experts on foreign missions and the proficiency of performing complex medical procedures.

1. Examine the impact of e-training of health professional on the quality of services rendered to patients in tertiary health institutions in South-south, Nigeria.
2. Investigate the effect of continuing professional development on service delivery of doctors working in tertiary hospitals in south-south, Nigeria.

Research Questions

In order to conduct this study successfully, the following research questions will serve as a guide in eliciting the appropriate data from respondents located in tertiary health institutions of south-south Nigeria:

1. What effect does the number of qualified specialist in a particular field has on the number of post-treatment mortality of patients?
2. Does in-house training have any impact on the incidence of prescription errors by resident medical officers of tertiary hospitals?
3. Is there any relationship between working with visiting medical experts on foreign missions and the proficiency of performing complex medical procedures?
4. Does e-training of health professional have any effect on the quality of services rendered to patients in tertiary health institutions in South-south, Nigeria?
5. What is the effect of continuing professional development on service delivery of doctors working in tertiary hospitals in south-south, Nigeria?

Formulation Of Hypotheses

The following hypotheses are formulated to guide this research effort in these tertiary health institutions located in south-south Nigeria:

1. There is a relationship between the number of qualified specialist in a particular field and the number of post-treatment mortality of patients.
2. In-house training has an effect on the incidence of prescription errors by medical resident officers of tertiary hospitals.
3. There exists a significant relationship between working with visiting medical experts on foreign missions and the proficiency of performing complex medical procedures
4. E-training of health professional has an influence on quality of services rendered to patients in tertiary health institutions in South-south, Nigeria
5. Continuing professional development has a significant effect on the service delivery of doctors working in tertiary hospitals in south-south, Nigeria

Significance Of The Study

This study is very important to the general management of our health system. First, it is beneficial to the policy makers: the government and managers of our healthcare institutions in the formulation of the right policies towards human capital development which has not enjoyed sufficient attention over the years. It will help them to appreciate the need to have adequately trained human resources in our hospitals with the right skills and competence in order to achieve the desired quality service delivery. This study will encourage the policy makers to fine-tune our training schemes and methods so that they will be efficient, effective and result-oriented. The absence of adequate ICT infrastructures in our hospitals is a drawback in our HCD effort and consequently service delivery, as it is the foundation upon which the e-learning is built. Therefore this study will encourage the policy makers to change the narrative so that our healthcare providers will be able to cope with technological advancement in their field of practice. It will also encourage them to take seriously the concept of training needs assessment and incorporate it in their HCD strategy towards quality service delivery. Furthermore the healthcare providers will benefit immensely from this study as it will open their eyes to recognize more the importance of HCD in the daily discharge of their duties especially in the reduction of medical errors. Also they will value the role of ICT in improving their skill set through e-learning and then strive to be ICT compliant. The recommendations of this study will help to enhance the productivity of healthcare providers by encouraging personal development of staff, understanding the concept of consumer satisfaction and also improving their relationship with patients.

Thirdly this research will add to the growing wealth of knowledge on HCD and service delivery. It will also bring to the fur the issue of medical error which has not enjoyed much attention in our clime. There are very few literature and research effort on this issue in Nigeria as the available ones only emanate from the west. Therefore, it will help in filling this gap.

To cap it all, the findings and recommendations of this study will be useful in tackling the myriad of challenges facing HCD and service delivery in Nigeria especially in tertiary health institutions in south-south Nigeria.

Scope Of Study

This study is centered on two variables: human capital development and service delivery. In trying to investigate the issues relating to HCD, this study will limit its scope to these sub-variables such as education, e-learning, training, collaboration between foreign medical missions and Nigerian health institutions, the impact of qualified specialist doctors and continuing professional development. Also, in analyzing the dependent variable: service delivery the study will go no further than issues of medical errors and consumer satisfaction. These sub-variables have direct impact on this study and will help us to understand and analyze adequately the issues of HCD and service delivery.

This study will concentrate on only staff of the selected tertiary health institutions located in the six states of south-south Nigeria. These institutions have been in existence for long and have well-established structures and staff that will be of immense help to this study.

Limitations Of The Study

Definition Of Terms

The following are the definition of some concept as used in this work:

Human Capital Development : This is a concept used in this study to encapsulate all activities used to improve or enhance the knowledge, skill, capacity or competence of an individual to perform on a job. These activities include education, training, mentoring and seminar among others.

Service delivery : This is a term used to describe all activities performed in meeting the demands of consumers or satisfying their needs.

Healthcare delivery : This is the type of service rendered in a healthcare institution which involves the diagnosis and treatment of patients among others.

Tertiary healthcare Institutions : These are hospitals that provide advance and specialized healthcare services most times with referrals from both primary and secondary health institutions. They are owned most times by the federal government and comprises of the teaching hospitals, federal medical centres and specialist institutions (orthopedic and psychiatric hospitals e.t.c)

Public Service : This the service rendered by government-owned institutions, ministries, agencies, parastatals and so on.

Human capital : This comprises of all individuals: employees, managers and administrators, who work in an organization.

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