By Iroyin Yoruba Television
Nearly half of the healthcare facilities assessed in Lagos State have inadequate infection-prevention and control systems, raising concerns about the ability of hospitals and clinics to safely manage emerging and re-emerging disease outbreaks.
The finding was disclosed during the 2026 Scientific Conference of the Guild of Medical Directors, Lagos State Branch, where medical experts examined Nigeria's preparedness for infectious-disease emergencies.
According to the assessment presented at the conference, 415 healthcare facilities in Lagos were evaluated using the World Health Organisation's Infection Prevention and Control Assessment Framework.
Of those facilities, 48.8 per cent were found to fall within the inadequate range.
The result has raised concern among medical professionals because healthcare facilities are expected to serve as a critical line of defence during disease outbreaks.
Hospitals and clinics are often the first places where patients with unusual symptoms present for treatment.
If infection-prevention and control systems are weak, health facilities can become vulnerable to transmission among patients, healthcare workers, caregivers and visitors.
The assessment therefore highlights a challenge that extends beyond individual hospitals.
It raises questions about the wider readiness of Lagos State's health system to respond to diseases that can spread rapidly through communities.
The issue has become increasingly important as Nigeria continues to experience outbreaks of infectious diseases and remains exposed to emerging health threats.
Medical experts at the conference warned that hospitals without adequate infection-prevention and control systems could amplify outbreaks rather than contain them.
Infection prevention and control, commonly referred to as IPC, covers a broad range of practices designed to prevent infections from spreading within healthcare environments.
These measures include hand hygiene, the appropriate use of protective equipment, safe injection practices, sterilisation of medical equipment, environmental cleaning, waste management and procedures for isolating patients who may have contagious diseases.
The system also requires trained personnel who understand how infections are transmitted and how healthcare facilities should respond when a suspected outbreak occurs.
The finding that 48.8 per cent of assessed facilities were classified as inadequate therefore indicates that a substantial proportion of the facilities evaluated require improvement.
The assessment does not necessarily mean that every facility in the inadequate category is unsafe in every aspect.
Rather, the classification indicates that the facilities do not meet the expected level across the range of infection-prevention and control measures evaluated.
That distinction is important because IPC is not a single activity.
A facility may have adequate handwashing facilities but lack sufficient personal protective equipment.
Another may have trained personnel but inadequate waste-management systems.
A third may have appropriate equipment but insufficient procedures for monitoring compliance.
Effective infection control requires all these elements to work together.
Healthcare workers are particularly vulnerable when systems are weak.
Doctors, nurses, laboratory personnel, cleaners and other staff can be exposed to infectious diseases during routine duties.
An infected healthcare worker can then potentially transmit an infection to colleagues, patients or family members.
Protecting healthcare workers is therefore also a public-health measure.
The concern is particularly significant during outbreaks involving diseases that can spread through respiratory droplets, bodily fluids or contaminated surfaces.
Hospitals may receive patients before a particular infection has been diagnosed.
This creates a period during which healthcare workers must rely on symptoms, medical history and appropriate precautions.
If those precautions are not consistently applied, an infectious patient may expose other people before the diagnosis is confirmed.
That is why infection-prevention systems must function routinely rather than only after an outbreak has been declared.
The Guild of Medical Directors conference focused specifically on emergency preparedness for emerging and re-emerging diseases.
The timing of the discussion reflects growing concern about the ability of health systems to respond to diseases that can appear unexpectedly or return after periods of reduced transmission.
Nigeria has experienced outbreaks of diseases including Lassa fever, diphtheria, cholera and other infectious illnesses.
Some diseases can spread rapidly when conditions allow.
Health facilities must therefore be prepared to identify unusual cases, isolate patients when necessary and notify public-health authorities.
A weak IPC system can make those tasks more difficult.
The Lagos assessment provides an opportunity for health authorities and facility managers to identify specific weaknesses.
The next step should be determining why nearly half of the assessed facilities fell into the inadequate category.
Possible factors include shortages of equipment, insufficient training, poor infrastructure, inadequate funding, inconsistent supervision or weak implementation of existing procedures.
Understanding the reasons is essential because different problems require different solutions.
If facilities lack handwashing stations, infrastructure investment may be necessary.
If staff lack training, regular education and competency assessments may be required.
If facilities have policies but fail to implement them consistently, stronger monitoring and accountability systems may be needed.
The assessment can therefore serve as a baseline for improvement.
Rather than viewing the finding solely as a criticism of healthcare facilities, authorities can use the information to identify priorities and allocate resources more effectively.
Hospitals can also use the results to strengthen their internal systems.
Healthcare facility managers have a responsibility to ensure that infection-prevention measures are integrated into everyday operations.
This includes ensuring that staff have access to appropriate protective equipment and that supplies are replenished before they run out.
It also requires regular training.
Infection-control guidance can change as new evidence emerges, and healthcare workers need opportunities to update their knowledge.
New employees also require orientation before beginning clinical duties.
Regular audits can help facilities determine whether policies are being followed.
For example, hospitals can monitor hand-hygiene compliance, availability of protective equipment, waste disposal procedures and environmental cleaning.
The results can then be used to identify areas requiring corrective action.
The assessment also highlights the importance of leadership.
Infection prevention cannot be left solely to nurses or infection-control officers.
Hospital management must provide the resources and authority needed to implement effective systems.
Medical directors, administrators and clinical leaders need to treat infection control as a core component of patient safety.
This is particularly important in private healthcare facilities, where resources and management structures can vary considerably.
Lagos has one of Nigeria's largest concentrations of healthcare facilities and serves a huge urban population.
The movement of people through the city means that infectious diseases can spread rapidly if an outbreak is not detected and contained.
Hospitals therefore have an important role in protecting not only individual patients but the wider population.
A patient who arrives at a hospital with a contagious disease may have travelled through several locations before seeking treatment.
If the facility identifies the infection quickly and applies appropriate precautions, the potential chain of transmission can be reduced.
If the infection is missed and the patient spends time in a crowded waiting area, however, exposure could occur before the diagnosis is made.
This makes triage particularly important.
Healthcare facilities need systems that allow staff to identify patients who may require additional precautions as early as possible.
Waiting areas also need to be managed carefully.
Crowded rooms can increase the risk of transmission for diseases spread through respiratory droplets or close contact.
Facilities may need designated areas for suspected infectious cases depending on the nature of the disease and available infrastructure.
Ventilation can also be important.
Adequate airflow can reduce the concentration of certain infectious particles in indoor environments.
However, improving ventilation may be difficult in older facilities that were not designed with modern infection-control standards in mind.
Infrastructure therefore remains a major component of preparedness.
The assessment's findings could encourage facility owners and policymakers to examine the physical condition of healthcare buildings.
This includes water supply, sanitation, waste disposal, ventilation, isolation areas, sterilisation facilities and other infrastructure.
Reliable water is particularly important.
Hand hygiene is one of the most basic and effective methods of preventing healthcare-associated infections.
If water supply is unreliable, healthcare workers may struggle to maintain appropriate hygiene practices.
Soap, alcohol-based hand rubs and other supplies must also be available at points where they are needed.
Waste management is another critical area.
Healthcare facilities generate different categories of waste, some of which can pose infection risks if not handled correctly.
Sharps, contaminated materials and other clinical waste require appropriate collection, treatment and disposal.
Poor waste management can expose healthcare workers, patients and surrounding communities to unnecessary risks.
The assessment therefore points toward a broad systems problem rather than a single weakness.
Emergency preparedness requires hospitals to consider the entire pathway through which a patient moves.
From arrival and triage to diagnosis, treatment, discharge and follow-up, infection-control measures need to be integrated into each stage.
Laboratories also play an important role.
Rapid and accurate diagnosis allows healthcare workers to determine whether a patient has an infectious disease and what precautions may be required.
Laboratory personnel need appropriate protective measures because they handle potentially infectious samples.
Specimen collection and transportation must also be managed safely.
A breakdown in any part of that process can create risks.
The Lagos assessment could therefore encourage stronger collaboration between hospitals, laboratories and public-health authorities.
Information about suspected outbreaks must reach surveillance systems quickly.
Nigeria's public-health authorities depend on timely information from healthcare facilities to detect disease trends.
If private healthcare facilities are not fully integrated into surveillance systems, important information could be delayed.
This makes the broader issue of health-sector coordination relevant to infection control.
The private sector provides a substantial proportion of healthcare services in Lagos.
Strengthening IPC systems in private facilities can therefore have a significant effect on the state's overall preparedness.
Public-health agencies and professional organisations can support private providers through training, technical guidance, standards and monitoring.
Healthcare facilities can also learn from one another.
Facilities with strong infection-control programmes can share practical approaches with those that need improvement.
Professional associations can help disseminate best practices.
The Guild of Medical Directors' conference provides one platform for that exchange.
The focus on emerging and re-emerging diseases also highlights the importance of preparedness before an emergency occurs.
Waiting until an outbreak begins to establish infection-control systems is risky.
Facilities need protocols and trained personnel before patients begin arriving.
They also need supplies in reserve and clear lines of communication with public-health authorities.
Emergency plans should be tested periodically.
Simulation exercises can help staff understand their roles during an outbreak.
Such exercises can reveal weaknesses that may not be obvious during normal operations.
For example, a hospital may discover during a simulation that it lacks enough isolation space or that staff are uncertain about who should notify public-health authorities.
Identifying such problems before a real emergency can save valuable time.
The Lagos assessment therefore provides an important warning but also an opportunity.
The 48.8 per cent inadequate rating can be used to establish measurable improvement targets.
Health authorities could set objectives for increasing the proportion of facilities meeting acceptable IPC standards.
Facilities could also be required to develop improvement plans.
Progress could then be assessed through follow-up evaluations.
Such a process would turn the assessment into a tool for continuous improvement rather than a one-time report.
Funding will inevitably be part of the discussion.
Healthcare facilities require resources to purchase protective equipment, improve infrastructure, train staff and maintain supplies.
Private facilities must also consider the financial sustainability of these investments.
However, the cost of inadequate infection control can be much higher.
Hospital-acquired infections can increase treatment costs, extend hospital stays and expose facilities to reputational and legal risks.
During major outbreaks, the economic consequences can become even greater.
Businesses may be affected by workforce illness, while families may face additional medical expenses.
Preventing infections inside healthcare facilities is therefore an investment in both health and economic stability.
The issue is also important for patient confidence.
Patients expect hospitals to provide a safe environment.
If people become concerned that healthcare facilities may expose them to infection, they may delay seeking care.
That can create additional health problems.
Trust is therefore an essential part of healthcare delivery.
Facilities that demonstrate strong infection-control practices can build confidence among patients and staff.
Lagos State has a large and complex healthcare system, and improving IPC across hundreds of facilities will not happen immediately.
The assessment nevertheless provides evidence that action is needed.
Authorities, professional bodies and facility managers can use the findings to identify the most urgent gaps.
The focus should be on practical improvements that can be measured.
This may include increasing access to hand-hygiene facilities, improving waste management, expanding staff training, strengthening surveillance and ensuring that appropriate protective equipment is available.
The most important goal is to make infection prevention part of everyday healthcare practice.
It should not be treated as a special programme that becomes active only during an outbreak.
Every patient encounter should be managed with appropriate safety precautions.
Every healthcare worker should understand basic infection-control principles.
Every facility should have procedures for recognising and responding to suspected infectious diseases.
That culture of preparedness can reduce the risk of healthcare-associated transmission.
It can also improve the response when a new outbreak occurs.
The warning from medical directors comes at a time when Nigeria is confronting multiple public-health pressures.
The country needs health facilities capable of dealing with routine illnesses while remaining prepared for unexpected outbreaks.
Lagos, as one of Nigeria's most densely populated and economically important states, has a particularly important role.
A major outbreak in the state could have consequences beyond healthcare.
It could affect schools, businesses, transportation and other parts of the economy.
Strengthening hospital infection control is therefore part of wider emergency preparedness.
The latest assessment has put a specific number on the challenge: 48.8 per cent of the 415 facilities assessed were classified as inadequate under the WHO framework.
That figure should prompt a coordinated response.
The objective should not simply be to improve the rating for statistical reasons.
The ultimate objective is to protect patients and healthcare workers and prevent hospitals from becoming centres of disease transmission.
The next stage should involve detailed facility-level assessments and improvement plans.
Facilities need to know precisely where they fall short and what resources are required to correct those weaknesses.
Health authorities can then monitor progress and provide targeted support.
If that process is sustained, Lagos could significantly strengthen its readiness for future outbreaks.
The current warning therefore represents both a challenge and an opportunity.
Nearly half of the assessed facilities have been identified as needing stronger infection-prevention and control systems.
Addressing those gaps before the next major outbreak could save lives, protect healthcare workers and strengthen public confidence in Lagos' health system.
The message from medical experts is clear: emergency preparedness begins long before an outbreak arrives.
Hospitals must be ready before the first patient appears, not after transmission has already begun.