THE JOURNEY TO HRI GLOBAL  

MISSION AND VISION: (since 1991)  

HEALTH SECTOR & SYSTEM STRENGTHENING IN NIGERIA

Photo 1: HRI GLOBAL’s quality healthcare journey 1991-2022     Photo 2: Great Hall, Nigeria High Commission, Northumberland Avenue, City of Westminister, London SW1A. where The NMF UK & Ireland was launched in 1991.

THE BEGINNING:

*Joseph Ana rounding up posting in Oldchurch Hospital, Romford, Essex, London- 1990 *Nigerian Medical Forum UK & Ireland  (NMF UK ) registered Charity - 1991                                                                         

*BMJ West Africa Local Edition1995-2018 – ( plus established many firsts: Health Information Resource Centre (HIRC-2003), Business Centre, Cybercafe, Internet Service Provider)                                                         

*Homegrown 12-Pillar Clinical Governance Programme in Nigeria -2004

*Homegrown PACK Nigeria programme specific for PHC – 2016/2017

GUIDING ENDURING PRINCIPLE 

‘‘No matter how beautiful the buildings in health facilities, No matter how sophisticated the equipment, the critical factor in delivering quality and safe care, preventing and reducing mortality and morbidity is: the ATTITUDE AND BEHAVIOR of the Health Care Providers, their KNOWLEDGE,SKILLS, EXPERTISE AND CPD.’’ (Ana, J. Leader, BMJ-NMF Delegation to Lagos, Nigeria,1995)

The Policies, Procedures and Practices that enable human personnel for health optimize the equipment, medicines, tests and their use to deliver quality and safe care in the unique context of their own facility, narrated in BOOK Reference: Ana, J. ‘Whole System Change of  Failing Health Systems’. 2009. 

DETAILS -

THE NMF UK, AND THEN, HEALTH RESOURCES  INTERNATIONAL  WA  Ltd

Publisher BMJ West Africa Edition

Since 1995 - 2018 

Health information to influence---Best Practice

HEALTH RESOURCES INTERNATIONAL WEST AFRICA (HRIWA) was focused on the health sector in Nigeria and West Africa subregion, with commitment to health improvement through clinical governance, multisectoral and multidisciplinary team working: basic and post basic training, population health, health information and dissemination, project conceptualization, design, implementation and results-based monitoring. Its non profit subsidiary is the BMJ West Africa Edition, a local edition of the BMJ.

ORIGINS:

• Sept 1991 NIGERIAN MEDICAL FORUM UK & IRELAND (NMF) :

Dr Joseph Ana, Dr Mike Eshiett, Dr Ini Smith, Dr Mike Nkwam, Dr Ik.  Azuonye, Dr Baba M. Gana and over 100 other Nigerian doctors resident in the UK and Ireland formed the NMF with a view to supporting the revitalization of the failing Health  System in Nigeria mainly through collection of Health Information  materials to health facilities in Nigeria, including Back-issues of medical journals, books and periodicals. The NMF is registered with the UK Charity Commission (No. 1028197). 

• 1995  BMJ LOCAL EDITORS AND PUBLISHERS (LEAP) CONFERENCE IN ATHENS, GREECE

Dr Joseph Ana as Secretary General & Trustee of The NMF attended a conference at the BMA House on  ‘Health Information to Developing Countries ‘, organized by The BMJ, and met Dr Richard Smith and Mr Geoffrey Burn, Editor and Executive Director  of BMJ, respectively, in 1994. Dr Ana became aware that The BMJ had local editions in different parts of the world (the India local edition was already 12 years old at that time), and he expressed the interest of NMF in taking BMJ to Nigeria / West Africa. Richard Smith and Geoffrey Burns invited him to attend the 1995 BMJ Local Editors And Publishers (LEAP) Conference in Athens, Greece as an Observer.

The NMF was represented in Athens by Dr Joseph Ana and Dr Baba M. Gana.

• September 1995  JOINT ‘BMJ- NMF’  EXPLORATORY TRIP TO LAGOS, NIGERIA
• 1996  BMJ NIGERIA EDITION LAUNCHED 2ND JULY  - QUARTERLY Print 
• 1997  BMJ NIGERIA BECAME BMJ WEST AFRICA EDITION – QUARTERLY Print

BMJ WEST AFRICA LOCAL EDITION - VISION:

To be the most widely cited and the most influential provider of health information in west africa, assisting health professionals to deliver the best patient care, and to provide technical assistance and research support for policies, programmes, and health facility management that promote effective medical and health development in the sub-region.

           ‘’The West Africa edition is a local edition of the BMJ, published bi-monthly 

           By HRI Ltd. It contains materials selected from issues of the weekly BMJ.  

           The correct reference to the original BMJ article is given   

           within every article and this is the citation that should be

           used whenever that article is referenced.

            BMJ West Africa ed. which was first published in July 1996

            also contains local articles, editorials and commentaries which

            are either submitted or commissioned. The edition brings to

            health professionals in West Africa, first-rate, peer-reviewed

            current information, and offers local authors exposure to the       

            international audience on health.                Copyright ©.’’

• 1998   CLINICAL GOVERNANCE CONCEPT INTRODUCED IN THE UK BY PROFESSOR (Sir) LIAM DONALDSON ( Dr Ana was one of the pioneer Clinical Governance Leads) AND WAS INSTRUMENTAL TO THE ADOPTION OF CLINICAL GOVERNANCE BY BMJ WEST AFRICA EDITION. 
• 2000  HEALTH WRITING WORKSHOPS INTRODUCED  TO INCREASE THE LOCAL CONTENT OF BMJ WEST AFRICA – the aim being to build capacity of local researchers in West Africa to publish their work in peer reviewed international journals like the BMJ:

 - HOW TO READ, WRITE & PUBLISH- APPLYING RESEARCH RESULTS TO CARE

 - CLINICAL GOVERNANCE, QUALITY & SAFETY (ABUJA /LAGOS . ACCRA /KUMASI. CALABAR)

• 2003  ACCESS TO CURRENT ON-LINE  INFORMATION –‘ HEALTH INFORMATION RESOURCE CENTRES (HIRC)’ WAS INTRODUCED. A MODEL HIRC ESTABLISHED IN CALABAR, NIGERIA. BMJWA HEALTH PORTALS WAS DEVELOPED (OVER 1,000 WEB SITES ACCESSIBLE) BRINGING PAPER & ELECTRONIC HEALTH INFORMATION IN ONE PLACE AT LOCAL RATES. ACYBER CAFÉ WAS OPENED FOR DOCTORS AND UNIVERSITY STUDENTS. plus Cybercafe & Internet Service Provider 

(The HIRC received a one-off Grant IN 2003 from BMJ to set it up)

• 2004   CLINICAL GOVERNANCE PILOT COMMENCED IN CROSS RIVER STATE, NIGERIA IN COLLABORATION WITH THE STATE MINISTRY OF HEALTH. 
• 2006 (JALINGO, TARABA STATE) 2007 (ABUJA, FCT) CLINICAL GOVERNANCE MEMOs FROM CRS DELEGATION ADOPTED BY THE NIGERIA NATIONAL COUNCIL ON HEALTH (HCH) AS A MAJOR DRIVER OF QUALITY AND SAFE HEALTH CARE IN NIGERIA. 
• 2007 THE RESULT OF THE PILOT LED TO THE ESTABLSIHMENT OF THE FIRST DEPARTMENT OF ‘CLINICAL GOVERNANCE, SERVICOM & e-HEALTH’ ESTABLISHED IN - CROSS RIVER STATE MINISTRY OF HEALTH.
• 2008   CLINICAL GOVERNANCE SCALED UP TO BAUCHI STATE IN THE NORTHERN PART OF NIGERIA (MALAM ISA YUGUDA WAS GOVERNOR OF THE STATE) - CORE OF HEALTH POLICY IN BAUCHI STATE FOR QUALITY CARE DELIVERY. DR BABA GANA AND DR JOSEPH ANA AS Co-CHAIRMEN OF THE COMMITTEE.
• 2008 BMJ WEST AFRICA LOCAL EDITION – BECAME BI-MONTHLY PUBLICATION.
• 2009 EFFORTS MADE TO REVAMP THE WEBSITE www.bmjwestafrica.com  AND GO ON-LINE. PLANNED AND EXECUTED SEVERAL CAPACITY BUILDING AND SKILLS ACQUISITION WORKSHOPS ACROSS NIGERIA.
• COMPILATION ISSUE OF BMJWA ISSUES FROM 1996 – 2010 PUBLISHED
• 2011 ONLINE www.bmjwestafrica.com  as main outlet for the Local Edition, to stay afloat. Because Pharmaceutical Adverts dried up for medical journals in Nigeria ( a fallout from the deepening disharmony between doctors and pharmacists ).  Subscription has historically been very low.
• In addition to ONLINE presence, we planned to publish Special Issues whenever commissioned; and two six-monthly non-commissioned issues per year as ‘compilation issues’ for the previous six-months. 
• 2011 OPENED THE COMPUTER TRAINING SCHOOL (TO REPLACE REVENUE LOST TO ADVERTS) 2011 GAINED ACCREDITATION OF THE MEDICAL & DENTAL COUNCIL OF NIGERIA A AS A CPD / CME PROVIDER IN NIGER
• URL Metrics of www.bmjwestafrica.com shows the following: monthly page visits 11,340 and monthly visits of 11,340 in the last six months.
• Setting Up and maintenance of the website and all publications and other recurrent and capital expenses have been funded from activities in capacity building / training / conferences and seminars : 

CPD / CME TRACK RECORD 

(For doctors, pharmacists, nurses, midwives, community health practitioners, non clinical staff )

RECORD ON ‘WHOLE SYSTEM CHANGE OF FAILING HEALTH SYSTEMS’ (Private & Public FACILITIES):

1. Lecturer on Clinical Governance, ARD AGM, ABUTH Zaria, 11, Dec 2014.
2. Resource Person – United Nations International Development Organisation (UNIDO) Abuja – 3, DEC. 2014
3. Resource person at the Presidential Summit on Universal Health Coverage (UHC), Abuja, Nigeria.  March 2014
4. Hosting a workshop in Calabar for doctors and other health practitioners: Relationship of Health Practitioners with their Regulatory bodies & How to avoid summons. Dec 6th 2013 
5. Consultant to Sir Ahmadu Bello Medical Foundation building doctors & health worker capacity in managing mass casualty from blast injuries in North Central zone, Nigeria. November 2013
6. Writing & Evidence Based Practice Workshop, Lily Hospital Warri, July 2013
7. Consultant to the Sir Ahmadu Bello Medical Foundation to build health workers emergency skills and capacity in Northeast and Northwest Zones, Nigeria – May 2013
8. BMJWA is accredited by the Medical & Dental Council of Nigeria to award CPD credits
9. Health System Consultants to Bauchi State Government from 2007 to date 
10. Health Logistics Consultants to World Bank Malaria Booster Programme in Bauchi State
11. Accredited as CPD Provider by the Medical & Dental Council of Nigeria that introduced mandatory Continuing Professional Development for Nigerian doctors and dentists with effect from January 2011.
12. Advisor of the fastest growing Private Hospital in the South-South geo-political zone of Nigeria – Lily Hospitals Limited on its stabilization and expansion.
13. BMJWA Lead Consultant is former Commissioner for Health Cross River State 2004-2008,  Dr Joseph Ana FRSPH, FRCSED, DUrology, AMRCGP-UK, DFFP, BM BCH(Nig) 

CPD TRACK RECORD ON CLINICAL GOVERNANCE, QUALITY AND SAFETY IN HEALTH TRAINING SINCE 1996 (for doctors, pharmacists, nurses, midwives, comm. health practitioners, non clinical staff )

1. Started Publishing the Bi-monthly peer review BMJ West Africa edition since July 1996.
2. Published the ‘Compilation of Clinical Governance Editorials in BMJWA 1996-2006
3. Consultants to the Bauchi state government in conducting a comprehensive needs assessment of the Bauchi State Health Service and prepared a Blue Print for the health sector June 2007
4. Ran the Capacity Building workshop on Clinical Governance  and Training  for hospital Consultants and other Health practitioners on behalf  of Bauchi State MOH August 2008
5.  Ran in Collaboration with The Lagos State University Teaching Hospital, Ikeja the Fifth BMJ West Africa Masterclass Lecture on the Role of Information in modern Healthcare delivery, by Professor. Dora Akunyili, Director General of NAFDAC, September 2008
6.  Clinical Governance introductory lecture to management of UBTH Benin City. Oct 2008
7. Clinical Governance introd lecture to Edo State MOH/Central Hosp Benin city. Oct2008
8. Clinical Gov lecture to management of Braithwaite Hosp Port Harcourt. Nov. 2008
9. Ran the Emergency Skills  Acquisition (BLS & ACLS) Workshops in November 2008
10. Ran the Capacity Building workshop on Clinical Governance  and Training  for primary health care practitioners (Community Health Workers) on behalf  of  Bauchi State Primary  Health Care Development Agency (BPHCDA)  November 2008
11. Ran a 3-Day Workshop on Clinical Governance, Quality and Safety: Evidence Based Health Care (How to read, write and get published) for senior doctors and other health practitioners at the Braithwaite Memorial Hospital (BMH), Port Harcourt, Rivers State, Nigeria. March 2009
12. Part sponsor Dr Joseph Ana to attend and present his paper titled ‘whole system change of cross river state of Nigeria health service 2004-2008 pilot’, at the 2009 International Forum on Quality and Safety in Health, ICC Berlin, Germany. March 17-20, 2009 
13.  In collaboration with University of Maiduguri Teaching Hospital (UMTH) held seminar on Clinical Governance, Quality and safety: Attitudinal Change for members of the Medical Advisory Committee (MAC). 5 MAY 2009
14. Medical Adviser to Calabar Women & Children Hospital, Calabar 2009-2013

15 In collaboration with University of Uyo Teaching Hospital, Uyo (UUTH) ran 1ST Clinical Governance Quality & safety: Attitudinal To Patients seminar   June 2, 2009.

1. Consultants to Rivers State Govt on Introduce  MTSS to the Health Sector – Aug 2009
2. 10th Health Writing Workshop for Doctors & Health Professionals. Abuja. Jan 26, 2010. 
3. 11th Health Writing Workshop for doctors and other health professionals in 4-cities: Abuja, Bauchi, Calabar, Lagos July 2011
4. Inaugural CPD WORKSHOP IN collaboration with AGPMPN September 2011
5. CPD Workshop 2012 for Doctors & other Health Practitioners – Calabar -Jan 2012
6. CPD Workshop 2012 for Doctors & other Health Practitioners – Enugu- April 2012
7. CPD Workshop 2012 for Doctors & other Health Practitioners – Warri venue – Nov. 2012
8. CPD Workshop 2013 for Doctors & other Health Practitioners –  Warri venue - Mar2013
9. Emergency Care after blast injuries Workshop 2013 for Doctors & other Health Practitioners – in Gombe ( North East) and Sokoto (North West)  – May 2013                         

2018 – BMJ proposes new contract for BMJWA local edition in view of changes in BMJ and changes in ICT globally making publication of BMJWA and other local editions no longer consequential or viable. BMJWA rejected the proposed contract and ceased publication! 

THE HRIWA FACULTY (past & present):

 JOSEPH  N. O. ANA 

Lead Consultant in Clinical Governance, Quality & Safety & Editor, BMJ West Africa Edition

Associate  Professor, CRUTECH, Cross River State.

BM BCh (UNN); Diploma of Faculty of Family Planning of RCOG-UK; Diploma of Institute of Urology-UK; Fellow Royal College of Surgeons, Edinburgh; Joint Certificate Royal College of Gen Practice-UK,    Fellow of Royal Society of Public Health.

BABA  M. GANA

Consultant Urologist, NHS Hospital Trust, Carmarthen, Wales, UK

MB BS (ABU); Diploma Institute of Urology, UK; Fellow Royal College of Surgeons, Glasgow; Fellow of European Board of Urology

ARIT J. ANA

Executive Director, BMJ West Africa Edition. Author and Trainer.

RPHNutr, FRSPH (UK), FAfN (UK)

HND Nutrition & Dietetics (KadPoly); MSc Health Promotion (UK); PgD Nutrition(UK); Certificate in Education of Barnfield College, Luton,UK; Fellow Royal Society for Public Health & Accredited trainer in Food Safety and Hygien;; Fellow, Association for Nutrition.

Mr PRINCE O. ANA

General Manager, BMJ West Africa Group

BSc (AUA), MSc in Information Systems Development, Univ of Bedfordshire, UK 

INVITATIONAL  CONSULTANT  /TRAINERS :

A core group of recognized and accredited local and international Trainers in capacity and skills building for health practitioners have been involved over the years since 1996:

Professor Idris Mohammed OON FWACP, FRCP

Emeritus Professor of Medicine & Immunology, FMC, Gombe

Professor Richard Smith CBE

Former Editor, BMJ, and Director, United Health Chronic Disease Initiative

Dr Queeneth Kalu  FWACS

Consultant Anaesthetist, University of Calabar Teaching Hospital, Calabar.

Prof Asindi  A. Asindi FWACP

Professor of Paediatrics, UCTH, Calabar

Professor Eric Archibong FWACS, FRCOG

Professor of Obstetrics & Gynaecology, UCTH, Calabar.

Professsor Angela Oyo-Ita FWACP

Consultant, Department of Community Medicine, UNICAL.

Professor C. Odigwe FWACP

Professor of Medicine, UCTH, Calabar

Professor Ezedinachi FWACP

Professor of Medicine, UCTH, Calabar.

Professor Dora Akunyili FPSN

Professor of Pharmacy, UNN, former DG, NAFDAC

Dr Emmanuel Nsan FRSPH

Consultant Dept of Community Medicine, UNICAL

Professor Rowland Ndoma-Egba FWACS, FRCS

Consultant, Dept of Surgery, UCTH, Calabar

Professor Uduak Archibong, RN

Professor of Inclusion & Diversity, Univ of Bradford, UK

Professor Carol Baxter RN

National Health Service ( NHS) Executive, UK

Dr Udochukwu O. Asonye, M.D., FAAP

Neonatologist & Clinical Associate Professor of Pediatrics

 Midwest University Medical School, Downers Grove, IL, President, NeoPed Foundation, Oak Brook, IL, Vice President, Business Development & Strategy, Midwest NeoPed Associates, Ltd, Oak Brook, IL, USA

Arvind Shukla, M.D., FAAP

Neonatologist & Associate Professor of Pediatrics

 Rush University Medical School, Chicago, IL, Director, Neonatology Services, Midwest NeoPed Associates, Ltd, Oak Brook, IL, Chicago, USA

Susan Faber, ND, NNP

Neonatal Nurse Practitioner & Director, Neonatal Nurse Practitioner Program

Midwest NeoPed Associates, Ltd, Oak Brook, IL, Chigao, USA

Andrew Shitta, FWACP

Consultant Paediatrician, Jos University Teaching Hospital, Jos, Nigeria

Dr Etim Ayi  Masters in Surgery, Egypt

Consultant Plastic & Burn Surgeon, General Hospital, Calabar, Nigeria

M. Odey, FWACS

Consultant Orthopaedic Surgeon, Jos Univ Teaching Hospital, Jos, Nigeria

Ndu Eke, FWACS

Professor of Urology, Univ of Port Harcourt Teaching Hospital, Port Harcourt.

Prof Francis Uba FWACS

Professor of Paediatric Surgery, UNIJOS

Adamu Onu, FWACP

Family Physician, Garki Hospital, Abuja, Nigeria

Dr Louis Alekwe, FWACS

Consultant Obstetrician & Gynaecologist, Lily Hospital, Warri

OFFICE CONTACT:

20 Eta Agbor Road, Calabar                                       

 website: www.bmjwestafrica.com                  email: bmjwa@yahoo.com 

GSM: Tel: 08063600642;  08033183236

Signed: MANAGEMENT                                                      8TH December, 2014

============================================== 

HEALTH RESOURCES  INTERNATIONAL  WA  Ltd 

Publisher: BMJ West Africa Edition 

PRODUCT PORTFOLIO

• HEALTH INFORMATION

• Health Information Resource Centre (HIRC)(virtual library installation)
• BMJ West Africa Edition
• BMJ Specialist Journals
• Tropical Health CD ROMs
• Medical Books
• BMJWA Health Portals (www.bmjwa.com) 
• Annual Masterclass Lecture Series

• TRAINING, CAPACITY BUILDING & RE-ORIENTATION

• KNOWLEDGE

• Workshops (How to Read a Paper, How to Write a Paper, How to get past editors & get published) ( Demystifying clinical research)
• Workshops (Critical appraisal of papers & Application of research results in local practice)

• SKILLS

• Basic & Advanced Trauma Life Support, Safety in Surgical care/ Surgical Checklist
• Workshop on Management, Needs Assessment, Preparation of action plans, Results-Based Monitoring & Evaluation/ Surgical Checklist
• Accredited Public Health Nutrition & Food Hygiene & Safety of The Royal Society of Public Health (UK) Training
• Consultation & Communication skills in patient care
• Presentation Skills at Scientific Meetings & Workshops

• ATTITUDE TO PATIENTS & BEHAVIOUR

• Professionalism (Continuing Personal/Practice Development Plans- CPPD)
• Punctuality/Empathy/Politeness/Caring/ Consent/Confidentiality
• Duty of Care
• Patient Rights & Responsibilities