Quality Decision Will Impact the Health Sector Positively

 Dr. Sampson Parker served as the Commissioner for Health in Rivers State under the previous administration. In this interview with Segun James, he spoke on a number of issues including making proactive government plans for the management of issues in the health sector

You were recently given an award by the African Institute of Public Health Practitioners, AIPHP, in recognition of your role in the control of the spread of Ebola in Rivers State during the infamous incident in which one of the quarantined contacts defied restrictions and came to Port Harcourt. How do you feel about the honour bestowed on you?

The award by the African Institute of Public Health Practitioners (AIPHP) was for my humble role in leading the health sector under the previous government in Rivers State to an effective control of the potential spread of the Ebola virus throughout the state and possibly to nearby states. In containing the spread and preventing further spread, the health sector and other teams, including the media and other stakeholders saved the country from a disaster of uncertain dimensions.

As I clearly highlighted before, one helped to lead in mobilising and coordinating the required resources to ensure that everything that needed to be done was done, but we must always remember the frontline technical and administrative people who were very professional in ensuring that the goals we set were attained and that we ensured that ultimately, Rivers State remained a safe and exciting place to reside or visit and not a ghost town as would have been the case, if the virulent disease had not been stopped. So in reacting to the honour, I am filled with a profound sense of accomplishment for myself and on behalf of all those who played their roles effectively to ensure that collective success.

Given the current state of preparedness, do you think that the country and Rivers State will be able to control such a potential health disaster with the same effectiveness, if it presents again?

Well, I am certain there are professionals within the state with institutional memories and the required competencies, but having been away from the system, I cannot make a direct assessment of the current state of facilities which were all put in place at that time, If those facilities are still in place, in the conditions which we left them, then one might assume so, however if they have been left in disrepair and allowed to decay, then one cannot give such assurances.

In terms of public health risks, a society should be prepared for those hazards and risks that have the highest possibility of occurrence based on the context, by increasing the resilience of society to such potential incidents, while some specific preparations should also be in place in case of some unknowns. For these reasons you keep training and retraining personnel, in this instance public health and epidemiology as well as community health professionals, particularly, and all medical and ancillary personnel in general, to be able to respond to such issues whenever the occasion arises.

What governance challenges restrains governments in Nigeria from making proactive management plans for such health challenges?

If there are any such challenges, it will be because we do not do enough visioning, brainstorming and scenario simulations. Normally progressive governments plan rationally for the known and simulate possible unknowns. In simulating, you can therefore reasonably prepare to some degree for the unexpected. Frequent simulations will prepare the administrator for different degrees or intensities of possibilities. But you cannot simulate all possible uncertainties, therefore there may still be some adversities which you can only mitigate their impacts by heuristic measures. So if there are any governance challenges it may be in the extent with which we take preparations for the known and unknown seriously enough to commit resources in terms of time, funds and personnel to planning preventive, mitigating, response and recovery measures to known and unknown possibilities.

What can be done to institute better governance measures to increase capabilities in managing such challenges generally?

Governance is mainly practices and traditions for guiding decision-making towards reaching corporate goals. Hence the first measure for increasing capabilities generally is to improve the quality of decision-making at all levels. As I have highlighted above you make rational decisions, when you know all the angles, where information is available or can be made available through the mobilisation of resources. And where you have time, which is a very important resource and must always be respected, because it is the only resource you cannot replace if you lose it. Where you don’t know all the angles, where you cannot get all the required information, you must then rely on what is called, bounded decision-making, that is, you are limited in what you can know about the problem or issue.

Under bounded decision-making situations you are dealing with uncertainties, which means your decisions are riskier and more hazardous, under such conditions you need a different set of decision making skills from what you use under rational conditions, hence you can’t make long term plans, you rely on benchmarks, that is, previous experiences of similar problems, heuristics, that is learning as you go along, incrementalism, muddling-along, fish-bone approaches and such bounded-decision-making techniques until you get optimal to maximal solutions.