Descriptive analysis of cardiac services provision in urban Nigeria

Cardiovascular diseases (CVD) in several African Countries are becoming a major health concern, affecting workers at the prime of their working life with significant societal impact. This study is a descriptive analysis of cardiac services provision in urban Nigeria. Surveys were administered to 66 physicians and 108 prospective patients, supplemented by interviews with selected cardiologists, policymakers and academics. 80% of physicians (GPs/Internists) indicated that the incidence of CVD in their practices was increasing – particularly hypertension. This is attributed to lifestyle changes e.g. obesity and stress. Other CVDs in declining order were Valvular Disease, Rheumatic Disease and Ischemic Disease. 60% of patients who are referred by GPs/internists are sent to cardiologists while 40% are referred to cardio-thoracic surgeons. Over 50% of cardiac patients are referred to teaching hospitals while 13% are referred to private practices and the remaining to government clinics. More than 75% of cardiologists and cardio-thoracic surgeons refer cardiac patients to other countries: India 41% South Africa 10% United Kingdom 14% United States 5% Nigeria has about 100 trained cardiologists. It estimated that Nigerians spend at least $1 billion dollars on health tourism and there are about 50 cardiologists of Nigerian origin in the US alone. Thus, Nigerian policy makers may wish to engage with diaspora physicians to provide in-service training to physicians in-country or other innovative approaches to service provision e.g. telemedicine. Moreover, Nigerian policymakers may wish to consider public health interventions (e.g., diet, hypertension screening) to prevent continued acceleration of the CVD burden.