Dr. Ade-Conde Adetunji James, MBBS, FRCOG, FRCSC, FACOG: A Journey Through Medicine and Insights on Nigeria’s Health Sector

Dr. Ade-Conde Adetunji James, MBBS, FRCOG, FRCSC, FACOG: A Journey Through Medicine and Insights on Nigeria’s Health Sector

Dr. Ade-Conde Adetunji James, a Canada-based medical doctor, recently engaged in an exclusive conversation with select journalists to discuss his career and share his views on the Nigerian healthcare system, its economy, and related societal issues. Dr. Ade-Conde’s journey from a humble background in post-civil war Lagos to becoming an esteemed specialist in Obstetrics, Gynecology and representing endocrinology provides a unique perspective on these topics. Below are excerpts from this insightful discussion.

Beginnings and Career Journey

How did your journey into medicine begin, and what were your early experiences?

“My roots are modest. I grew up in a disciplined household; my father was a teacher who instilled discipline, knowledge, and integrity in us. I was born in Lagos, but we later moved to the outskirts (Alimosho ) towards the end of Shagari era, where we lived at Jakande Estate, Ipaja.

I completed my secondary education at State High School, Alimosho, Lagos, and earned my medical degree from the University of Lagos in 1996. After working as a medical officer with the Lagos State Government, I pursued further training in Ireland in 2002, just after 9/11. 

This period was pivotal, offering a structured path for junior doctors to gain experience under the mentorship of seasoned consultants. I advanced through roles as a Senior House Officer and Registrar, Specialist Registrar and eventually obtaining the Certificate of Completion of Specialist Training (CCST) and completing a fellowship in Human Reproduction and Assisted Conception.”

Scope of Practice

As a specialist in obstetrics and gynecology, what areas do you focus on?

“My practice spans a woman’s reproductive lifespan, providing care from conception to post-reproductive years. My expertise includes:

• Fertility and Reproductive Technology: I perform procedures such as ovarian stimulation, egg retrieval, embryo transfer, and other steps vital to assisting couples desirous of pregnancy.

• General Gynecology: This involves managing menstrual disorders, treating pre-invasive diseases of the reproductive organs and performing surgeries for pelvic tumors.

• Minimally Invasive Surgery: I use less invasive techniques, which are starting to gain traction in some centers in Lagos and Abuja, especially for fibroids.

• Obstetrics: I offer comprehensive care during pregnancy and postpartum, encompassing prepartum, intrapartum, and postpartum care.”

Challenges and Advancements in Nigerian Healthcare

With your experience, what are some of the current challenges and advancements in Nigeria’s healthcare sector?

“Though some advancements are evident, such as the adoption of minimally invasive surgery in select cities, traditional open surgeries remain common for conditions like fibroids. Embracing minimally invasive methods is essential to reducing surgical risks and enhancing outcomes.

Another significant issue is data management. Unlike many international hospitals, most Nigerian institutions lack reliable data publication. This gap hampers the ability to monitor outcomes, identify areas for improvement, and set benchmarks aligned with global standards.”

Proposed Reforms for Nigerian Healthcare

If Nigeria were a patient, what treatment would you prescribe for its healthcare system?

“Improving transparency, adopting minimally invasive techniques, and implementing data-driven practices could significantly enhance healthcare quality in Nigeria. Nigeria’s healthcare budget has stagnated, largely due to political issues and inadequate funding allocations. We need strong leadership committed to elevating healthcare.

Investing in research is also critical. During my years as a medical student at the University of Lagos, we faced frequent academic strikes, which hindered learning opportunities. Nigerian medical universities today should foster research to encourage evidence-based practices.

I also propose establishing regional centers of excellence across the country to handle advanced care, supported by networks of community hospitals and local health centers. This model, combined with accountability measures, would optimize healthcare spending and resources.”

Addressing Broader Issues in Nigeria

Can we attribute Nigeria’s healthcare issues to its leadership?

“Our leaders bear a considerable responsibility. From my childhood to now, the Nigerian populace has rarely benefited from strong governance. One solution I advocate is to revisit the ‘Option A4’ electoral model, introduced in 1993 by Professor Humphrey Nwosu, which emphasized community-based leadership selection. Reintroducing this system could strengthen grassroots governance, allowing more informed and capable leaders to emerge.

In education, we could encourage students to explore topics relevant to Nigeria’s needs. For example, post graduate students could investigate infertility trends in Nigeria.

By the way this country has a high twin birth rates but increasing female reproductive age or age of first conception is related to high rate of infertility.”

Comparison with International Healthcare Systems

“The average Nigerian faces a much greater burden of disease than those in Europe or North America. While Nigeria’s 2023 healthcare budget was approximately two billion USD, Canada, with a much smaller population, allocated around 300 billion USD, and Ireland, with only about 5 million people, budgeted approximately 30 billion USD. This funding disparity places immense pressure on Nigeria’s limited healthcare resources.

Moreover, Nigeria’s healthcare infrastructure relies on federal, state, and local government funding, yet resources are often insufficient. COVID-19 underscored the consequences of underinvestment, as travel restrictions forced Nigerian leaders to rely solely on local facilities. If we aim for a self-sustaining system, it’s imperative to increase funding and improve resource allocation across the sector.”

Solutions for a Healthier Future

What long-term solutions do you envision for Nigeria’s healthcare system?

“Creating regional healthcare centers and enhancing training programs could transform Nigeria’s healthcare landscape. International specialists could train local providers in advanced procedures, reducing the need for Nigerians to seek treatment abroad. Over time, this focus on skills and infrastructure development could eliminate the need for ‘health tourism.’

Ultimately, Nigeria’s healthcare system has the potential to serve its people effectively. By prioritizing funding, enhancing accountability, and fostering skill development, Nigeria could build a healthcare infrastructure capable of meeting its population’s needs.”

Dr. Ade-Conde’s insights provide a roadmap for addressing Nigeria’s healthcare challenges and reflect a deep commitment to advancing healthcare standards in Nigeria. Through collaborative efforts and increased investment, he envisions a future where every Nigerian can access quality medical care in their home country.