Pioneering patient education in Nigeria.

University College Hospital in Ibadan is the 1st health care institution in Nigeria to create a health education unit. Since its inception in 1978, the unit has developed into an integrated and essential component of the total health care delivery system. The program encourages patients to recognize and respond quickly to early signs of illness, to comply with recommendations to overcome illness, to prevent the recurrence of disease, and to maintain life style changes needed to cope with chronic illness. The value of such services can be measured in terms of both health status and cost-effectiveness. In general, placement of a health education unit within an existing hospital department can inhibit coordination of educational activities with other departments. The 5 staff members of the unit at University College Hospital work in 4 outpatient departments (medicine, surgery pediatrics, and obstetrics-gynecology) and provide counseling to patients on admission. Plans are being made to expand the program to the special clinic for sexually transmitted diseases. Salient aspects of a patient health education service include: clinic-based services (individual and family counseling, training for self-care, support groups), community links (advisory boards, training of health workers, cooperation with other agencies, home visiting), indirect educational variables (service design, professional competence, patient flow, physical setting), and organizational support (policy statements, staff development, evaluation and research, referral and records systems). Future plans are to extend services to the grassroots level where more preventive action is possible.