Hospitals play a crucial role in providing health services in communities and in the nation as a whole. From routine services like medical check-up, drug prescription, child delivery to more complex services like transplants, fertility treatments etc, hospitals quickly remind us that “health is wealth”. However, because of the sensitive nature of the hospital business, it is important to comply with regulatory requirements when venturing into the hospital business environment.

The regulatory requirements for starting a hospital business in Nigeria include:

Licences/ Permits

• Business Registration: It is necessary that you begin by registering your business with the Corporate Affairs Commission (CAC).
• Practising License: All hospitals are expected to have a practising license which is authorised by Medical and Dental Council of Nigeria (MDCN) and is subject to annual renewal[1]
• Authorization: The Federal Ministry of Health will have to confirm that you have the required qualifications that give you the legal right to operate a hospital in Nigeria.

Educational Qualifications/ Staffing

• Doctors: He/ she should possess a minimum educational qualification of Bachelor of Medicine and Bachelor of Surgery (MBBS), and must have completed his/ her medical internship programme.
• Nurses: He/ she should be a Registered Nurse with the Nursing and Midwifery Council of Nigeria (NMCN). According to NMCN, any registered and properly trained nurse with a minimum of five years working experience can set up a hospital to handle only minor cases.
• Staffing: The significance of employing the right staff cannot be over emphasized. In Lagos for instance, qualified professionals required to be employed in your hospital include:

• • One Medical Practitioner in-charge with a minimum of 5 years post qualification experience.
  • One Medical Practitioner per shift.
  • One Registered Nurse in-charge of Nursing Services.
  • One Registered Staff Nurse/Midwife or Staff Nurse per 8 in-patients beds per shift.
  • One Laboratory Assistant/Technician.
  • One Registered Pharmacist for a Hospital/Pharmacy Technician.
  • Medical Records and Secretarial Staff.
  • Ward Assistant or Aides (optional).

Infrastructural Requirements

The minimum basic facility requirements according to the Health Facility Monitoring and Accreditation Agency (HEFAMAA) include[2]:

– Building

Your building which must be composite not forming part of normal residential accommodation must have:

For Out-Patient

• Waiting / reception room of 4x3meters with sitting facilities, registration table.
• Medical record facilities.
• Consulting room (s) of 4x3meters with examination couches wash-hand basin, towels and basic diagnostic tools.
• Treatment room of 4x3metres with Instrument / drug cabinet, pedal bin and wash-hand basin and towels.
• Toilet facilities with water closet.
• Staff / cloak room.
• Dispensing room with pharmacy technician dispensing if compounding a registered Pharmacist is required.
• Oxygen cylinder with gauge and mask and suction machine.
• Other services – ambulance and fire extinguisher.

For In-Patient

• Lying-in ward with minimum distance of one meter between two adjoining beds of 1x3metres between two rows of beds.
• Ward(s) with locker and over-bed table for each bed (separate Rooms for male and female patients).
• Delivery rooms (where applicable) of 12 sq. meters.
• First stage labour room (where applicable).
• Suitably equipped theatre with floor to ceiling ceramic tiling.
• Sluice room.
• Toilet facilities – 1 water closet per 8 beds (separate for male and female).
• Bathroom facilities – 1 bathroom per 8 beds (separate for male and female).
• Nurse bay.

– Equipment

Your hospital facility is expected to be equipped amongst others with:

• Adequate and suitable theatre equipment/instruments for minor/ major surgeries.
• Suction machine
• Oxygen cylinder with gauge and mask
• Anaesthetic machine (arrangement with Anaesthetist may be made to provide when needed
• Operating lamp
• Adequate delivery/ labour room equipment.

Other minimum facility requirements according to HEFAMAA include:

• Clean and adequate water supply pipe borne, borehole water tank
• Washable floors
• Adequate drainage
• Adequate ventilation
• Adequate illumination.
• Laundry
• Kitchen
• Fire extinguisher

Health Regulatory Authorities in Nigeria

Health regulatory authorities in Nigeria have been put in place to ensure the quality, safety, and efficacy of all clinical establishments in the country. According to the Federal Ministry of Health, the authorised health regulatory bodies in Nigeria among others include[3]:

• Medical and Dental Council of Nigeria (MDCN)
• Nursing and Midwifery Council of Nigeria (NMCN)
• Pharmacist Council of Nigeria (PCN)

Each state in the country has its own regulatory body for monitoring health facilities in its state. In Lagos state for instance, the Health Facility Monitoring and Accreditation Agency (HEFAMAA) have been positioned to ensure that health facilities meet required standard.

In conclusion, it is paramount when starting a hospital business that you comply with regulatory requirements so that you are in a position to offer quality healthcare services.

[1] Medicalworld Nigeria, Nov 11, 2016, Reminder: MDCN Review of Practicing Fees Takes Effect with 2017 Annual Practising License Renewal, https://www.medicalworldnigeria.com/2016/11/reminder-mdcn-review-of-practicing-fees-takes-effect-with-2017-annual-practising-license-renewal#.WNuhBdIrLIV accessed Mar 14, 2017

[2] Health Facility Monitoring and Accreditation Agency, PRIVATE HOSPITAL OR MEDICAL CENTRE, https://www.tetryte.com/hefamaa/registration/private-hospital-or-medical-centre/ accessed Mar 16, 2017

[3] Federal Ministry of Health, Department of Hospital Services, http://www.health.gov.ng/index.php/department/hospital-services accessed Mar 5, 2017