Department Of Obstetrics & Gynaecology

DEPARTMENT OF OBSTETRICS AND GYNAECOLOGY

NATIONAL HOSPITAL ABUJA

QUALITY OF CARE POLICY AND OPERATIONAL GUIDELINES

NHA/CD/QOCP/O&G/001

Dr. Liman Idris

HEAD OF DEPARTMENT

1.0    INTRODUCTION

The department of Obstetrics and Gynecology is one of the founding departments of the hospital established in 1999 with its original mandate to cater for the needs of women and children of Nigeria as well as West African sub region with the view of reducing morbidity and mortality.

There are 4 units in the Department namely; Uro-gynaecolgy/Endoscopy, Maternal-Fetal Medicine (MFM), Reproductive Medicine/Endocrinology and Gynae-oncology being manned by specialists.

The department is one among the pioneering centres that introduced Assisted Reproductive Technology (ART) services within government tertiary hospital setting in 2006.

It has full accreditation for training of resident doctors in Obstetrics and Gynecology for both the West African College of Surgeons and National Post Graduate Medical College of Nigeria.

1.1 Vision Statement

To be the topnotch O &G department of international repute

1.2       Mission Statement

Our mission is to improve women’s health through innovative and compassionate care, equity, education, advocacy, discovery and technological advancement.

2.0       QUALITY ASSURANCE POLICY

• High standard of care is assured for our patients as the Department of Obstetrics and Gynecology NHA through;
• Regular accreditation by both the West African College of Surgeons and National Postgraduate Medical College of Nigeria.
• Regular certification of our midwives by the Nursing and Midwifery Council of Nigeria.
• Audits of case management using daily morning reviews. 
• Regular maintenance and calibration of our equipment.
  • Our practices are in line with international standard operating procedures (SOPs).

3.0    STRENGTH OF THE DEPARTMENT

• Subspecialities and multidisciplinary team work – The Department has a full complement of skilled and experienced subspecialists in Reproductive Medicine and Endocrinology (REM), Maternal-Fetal Medicine (MFM), Gynaecology Oncology (GO) and Uro-Gynaecology (UG) units.
• We have mmultidisciplinary support promoting holistic management of high-risk pregnancies.

Services provide include;

1. Clinical services
   1. Gynaecological Services
      1. Oncology services – pap smear, colposcopy
      2. Family planning services
   2. Reproductive endocrinology including assisted reproductive technology (ART) – Detailed evaluation of the infertile couple (IVF Clinics), Intrauterine Insemination (IUI), In-vitro Fertilization (IVF), Intracytoplasmic Sperm Injection (ICSI), Surgical Sperm Retrieval, Cryopreservation and Assisted Hatching using laser.
2. Obstetrics Services
   1. Prenatal –
   2. biomedical, behavioural and social health interventions to women and couples before conception occurs.
   3. evaluation of women with history of adverse pregnancy outcomes and bad obstetric history by taking detailed history
   4. Antenatal – counselling, routine/high risk care including specialised obstetric scanning.
   5. Delivery and Postnatal services.
   6. Outreach programmes to create awareness on cervical cancer and O&G issues.
3. Specialised services/procedures
   1. Laparoscopy
   2. Hysterosocpy
   3. Management of urogenital conditions e.g. fistulas, incontinence and prolapse. 
4. Training and research
   1. the training and education of resident doctors
   2. training of medical students
   3. training of nursing/midwifery students 
5. active research ongoing in the department including a number of local and international collaborations.

4.0 Operational Guidelines:

Before the commencement of physician-patient interaction health talks are presented to patients by clinic staff.

General Gynaecology Clinic

• The gynaecology clinic runs in the afternoon from 12.00 pm to 4.00 pm on Mondays, Tuesdays, Wednesdays and Thursdays under the leadership of the consultants.
• The patients are usually referred from the general out-patients clinic of the hospital. Others come from the private hospitals, general hospitals and tertiary hospitals from all over the country.
• The patients are evaluated and clinical findings, diagnosis, and management options are discussed with them, after which an agreed management option is subsequently implemented.
• Those for surgical intervention are registered electively into the team’s diary and adequate pre-operative care is offered to the patients prior to surgery. These patients are often admitted 24-48 hours before surgery into the gynaecological ward, especially in cases with medical co-morbidities to enable review by co-managing teams prior to surgery.

Preconception care clinic

• The clinic runs in the morning from 10.00 am to 12.00 pm on Wednesdays and under the leadership of the consultants.
• The patients are usually referred from other clinics of the hospital or self-referral.
• The patients are evaluated and an agreed management option is subsequently implemented.

Obstetric clinic

• The obstetric clinic runs in the morning from 8.00 am to 12.00 pm on Monday to Friday with Booking of new cases on Friday.
• A patient is considered “booked” if she has had at least one visit after the booking clinic. Patients receiving antenatal care elsewhere who are referred to the hospital due to complications of pregnancy or labour are considered ‘Unbooked’ at the National Hospital Abuja.
• The patients are usually referred from other clinics and as self-referrals. 
• The patients are evaluated and clinical findings, diagnosis, and management options are discussed with them, after which an agreed management option is subsequently implemented.
• A multidisciplinary approach is mandated, involving obstetricians, midwives, physicians, social services and other indicated healthcare service providers.  Treatment is instituted based on underlying ethology and they are closely followed up from the first pregnancy test at 4-5 weeks. Early second trimester ultrasound scan is done to assess cervical length and anomaly scan is done at 20-22 weeks. These patients are subsequently reviewed at scheduled antenatal clinic visits until delivery, to prevent recurrent adverse outcomes.

Reproductive Endocrinology Clinic

• Patients for this clinic are those referred from sources mentioned above, and evaluation is done based on clinical assessment.
• In addition to evaluation of patient’s male partner, ultrasonography, hysterosalpingography (HSG) or sonohysterosalpingogram (sono-HSG), laparoscopy and dye tests, and endometrial biopsy are available for cases of infertility.
• Hormonal assays in endocrine disorders are carried out with assistance of specialised laboratories in the hospital.
• Male partners of infertile couples are referred to the urology clinic when necessary.

Assisted Reproductive Technology Centre

• Cases requiring assisted conception are referred to IVF unit.

Family Planning Clinic

• Family planning advice is offered free to patients in this clinic, during antenatal care, after delivery and in the postnatal wards.
• The different methods of contraception and their side effects are discussed with the clients to assist them in making an independent choice of the method most suitable to them.
• Client’s relevant data are obtained and a thorough physical examination to determine the type of contraceptive method to be advised is done.
• Registers for the various methods are kept and follow up schedules depend on the methods chosen.

Cervical Cytology Clinic

• This clinic is run by the gynaecology-oncology unit of the department.
• Patients seen in this clinic are referrals from outpatient gynaecology clinics, family planning clinics, postnatal clinics and other sources earlier mentioned.
• Papanicolaou smear, colposcopy, and colposcopically-directed biopsies are done when indicated as office procedures.
• Cystoscopy, sigmoidoscopy and proctoscopy are carried out in liaison with the surgical department when required in the theatre and endoscopy room.
• Management of most of these cases is in conjunction with the Oncology/Radiotherapy unit of the hospital.

Gynaecological Emergency Unit

• Emergency services are provided on a twenty-four-hour basis.
• Patients are evaluated and management instituted as appropriate. Patients who do not require admission are managed and allowed home.
• Those who require emergency operations are prepared and sent directly to the theatre.

5.0    DEPARTMENTAL ACTIVITIES

Clinic/Academic schedule

Days	Activities/Time
8:30am – 9:00am	9:00am – 12:00pm	12:00pm – 4:00pm
Mon	Post-Call/Morning Review	Urogynaecology unit  Antenatal/Postnatal Clinic	Reproductive/ endocrinology unit Gynecological Clinic
Maternal–fetal medicine unit theatre
Gynae oncology unit Consultant ward round/ Reproductive/ endocrinology unit ward round
Tue	Post-Call/Morning Review	Maternal–fetal medicine unit Antenatal/Postnatal Clinic	Urogynaecology unit  Gynecological Clinic
Gynae oncology unit theatre/ Reproductive/ endocrinology unit theatre
Urogynaecology unit  Consultants ward round
Wed	Post-Call/Morning Review	Reproductive/ endocrinology unit Antenatal/Postnatal Clinic	Gynae oncology unit Gynecological Clinic
Preconception clinic
Unit academic activities/Research
Thu	Post-Call/Morning Review	Gynae oncology unit Antenatal/Postnatal Clinic	Maternal–fetal medicine unit Gynecological Clinic
Urogynaecology unit  theatre
Maternal–fetal medicine unit Consultants ward round
Fri	Post-Call/Morning Review	Clinical Presentation 9:00am – 10:00am	Booking 10:00am – 1:00pm
Family planning and cytology services can be assessed daily

UNITS

1. UROGYNAECOLOGY UNIT  – Dr. I.M. Liman
2. MATERNAL–FETAL MEDICINE UNIT Dr. D.A. Katagum, Dr. S. Bello
3. REPRODUCTIVE/ ENDOCRINOLOGY UNIT- Dr. C.O. Agboghoroma, Dr. E.R. Efetie, Dr. SMR Ibraheem, Dr. Durojaiye, Dr. JS Abubakar
4. GYNAE ONCOLOGY UNIT – Dr. F.Z. Mairami, Dr. M.U. Umemmuo

• Call hours are covered by Consultant led team

6.0 ORGANOGRAM

7.0 HEALTH AND SAFETY POLICY

The Department of Obstetrics and Gynecology is committed to ensuring the health, safety and welfare of its patients and staff, visitors and any other persons affected by our workplace practices. This is achieved by having policies and management structures in place to identify and manage risks. All staff are also trained to eliminate and take appropriate action to avert accidents, injuries and losses to the department.

These measures include but are not limited to:

1. Providing safe means of entry to and exit from all work areas of the department.
2. Maintaining a safe and healthy working environmental conditions with adequate facilities for staff welfare.
3. Safe handling, transportation and storage of appliances, instruments and equipment.
4. Ensuring all equipment are carefully maintained after use, replaced where need be, and disposed of safely where necessary, in accordance with current health, safety and environmental legislation.
5. Provision of suitable and sufficient information, instructions, training and supervision to enable all employees identify hazards and to work safely without risk to themselves or others.
6. Regular preventive vaccination.
7. Proper waste disposal by use of kick-about, appropriately labelled and colour-coded bins.
8. Universal basic precaution including use of protective personal equipment (PPE) on the wards, clinics, labour ward, theatres and emergency outlets.

Holding area is available for suspected cases of transmissible infectious diseases, such as COVID-19 and Lassa fever.

8.0 POLICY ON MINIMUM STANDARDS

–        Ensure all working tools are available and functional

–        Always maintain safety precautions

–        Following available SOPs for procedure 

9.0 LIST OF STAFF

S/N	NAME	RANK	QUALIFICATION
CONSULTANTS (10)
1	Dr. Dauda Abubakar Katagum	HOD O&G/Chief Consultant	MBBS, FWACS
2	Dr. C.O Agboghoroma	Chief Consultant	MBBS, FMCOG, FWACS, FICS, MPH, MD, MA, PGA (ART), MNIM
3	Dr. Efetie E.R.	Chief Consultant	MBBS, MRCOG, FWACS, FRCOG
4	Dr. Ibrahim RSM	Chief Consultant	MBBS, FEACS, FCAI, FICS, ACM, PGA-ART, AMNIM, ASS, MRCOG
5	Dr. F.Z. Mairami	Chief Consultant	MBBS, FWACS, FICS
6	Dr. Durojaiye KW	Chief Consultant	MBBS, FWACS, FMCOG
7	Dr. Bello S	Consultant	MBBS, FWACS
8	Dr. Liman IM	Consultant	MBBS, FWACS
9	Dr. J.S. Abubakar	Consultant	MBBS, FWACS
10	Dr. Umemmuo M	Consultant	MBBS, FWACS, FMCOG
MEDICAL OFFICERS/REGISTRARS (40)
11	Dr. U.E. Samuel	PMO 1	MBBS
12	Dr. S.O. Oladepo	PMO 1	MBBS
13	Dr. Lawal Jibia Idris	PMO 1	MBBS
14	Dr. O. Victor Babatunde	PMO 1	MBBS
15	Dr. Elizabeth O.Austin Amadi	Senior Registrar	MBBS
16	Dr. Ezeike A.Chinweokwu	Post part II fellow	MBBS, FWACS, FMCOG
17	Dr. Babandi Rukayya M.	Post part II fellow	MBBS, FWACS, FMCOG
18	Dr. Usman Safiya Faruk	Post part II fellow	MBBS, FWACS, FMCOG
19	Dr. Onyeuche, Osom-Lott	Post part II fellow	MBBS, FWACS, FMCOG
20	Dr. Akinnagbe Akinbola	Post part II fellow	MBBS, FWACS, FMCOG
21	Dr. Rabiah Ahmad MaHmoud	Post part II fellow	MBBS, FWACS, FMCOG
22	Dr. Ifeyinwa Nwokoro	Post part II fellow	MBBS, FWACS, FMCOG
23	Dr. Muddathir M.  Abdulqadir	Senior Registrar	MBBS
24	Dr. Hafsat A Dantata	Supern. Senior Registrar	MBBS
25	Dr. Akinamo Onaolapo Ebong	Senior Registrar	MBBS
26	Dr. Musa Fatima Binta	Senior Registrar	MBBS
27	Dr. Auwal Suraiya Suleiman	Senior Registrar	MBBS
28	Dr. Rukayat Momodu-Lecky	Senior Registrar	MBBS
29	Dr. Oladunni E. Kayode	Senior Registrar	MBBS
30	Dr. Lanre-Aremu Babajide	Senior Registrar	MBBS
31	Dr. Amina O. Ismail-Are	Senior Registrar	MBBS
32	Dr. Ramatu M. Dikko	Senior Registrar	MBBS
33	Dr. Taibat Ajoke Lawal	Senior Registrar	MBBS
34	Dr. Unimke Jeremiah Agim	Senior Registrar	MBBS
35	Dr. Idris Balasa Hafsat	Senior Registrar	MBBS
36	Dr. Okoye Uchenna Elizabeth	Senior Registrar	MBBS
37	Dr. Ubani Felix Ugo	Registrar	MBBS
38	Dr. Dada Ayodele Olanrewaju	Registrar	MBBS
39	Dr. Aniki Emmanuel Ovoro	Registrar	MBBS
40	Dr. Asiya Ahmad Sama	Registrar	MBBS
41	Dr. Prisca Chidimma  Ibe	Registrar	MBBS
42	Dr. Rufaidah Saad Baba	Registrar	MBBS
43	Dr. Ifiok Anthony Edward	Registrar	MBBS
44	Dr. Isah Khadijat Tinuola	Registrar	MBBS
45	Dr. Osuagwu Chiamaka U.	Registrar	MBBS
46	Dr. Nehemiah Mfon	Registrar	MBBS
47	Dr. Akpong Ineba Sandra	Supern. Reg	MBBS
49.	Dr. Edemekong, John Okon	Supern. Reg	MBBS
50.	Dr. Ogbuagu Chinyere	Supern. Reg	MBBS

Contact email: hod.obstetricsgynae@nationalhospital.gov.ng