THE ROLE OF CARE MANAGERS IN HANDLING OF PATIENTS WITH CRIMINAL BACKGROUND IN MILITARY RECEPTION STATION

1.1 Introduction

Managers in healthcare have a legal and moral obligation to ensure a high quality of patient care and to strive to improve care. These managers are in a prime position to mandate policy, systems, procedures and organisational climates. Accordingly, many have argued that it is evident those healthcare managers possess an important and obvious role in quality of care and patient safety and that it is one of the highest priorities of healthcare managers (Berwick et al., 2007).

As a prelude to other parts of this study, this chapter will discuss the background upon which this study was initiated, the statement of problems that led to this study, the Aim and Objectives of the study. Others are Significance of the study, Scope of work, Research hypothesis and questions, Limitations of the Study and Definition of technical terms.

---

1.2 Background of Study

Despite Nigeria’s progress on democratic, economic and political reforms, Nigeria’s prisons are yet to make appreciable impact on the welfare of the inmates. A recurring debate within contemporary academic circles, criminologists, health workers and prison experts, is to ensure an appropriate health template for proper prison administration that will reflect its objectives. Even though crime and other vices need to be deterred, it should be to the extent that inmate’s health should be adequately taken care of during and after imprisonment; it is therefore needful to be logical and rational in terms of health delivery while in custody.

Beyond healthcare, there is clear evidence of managerial impact on workplace safety (Dea et al., 2001). Within the literature on healthcare, there are non-empirical articles providing propositions and descriptions on managerial attitudes and efforts to improve safety and quality. This literature, made up of opinion articles, editorials and single participant experiences, present an array of insightful suggestions and recommendations for actions that hospital managers should take to improve the quality of patient care delivery in their organization (Conway et al., 2008). However, researchers have indicated that there is a limited evidence base on this topic (Glickman et al., 2007). Others highlight the literature focus on the difficulties of the managers’ role and the negative results of poor leadership on quality improvement (QI) rather than considering actions that managers presently undertake on quality and safety (Thorman et al., 2006). Consequently, little is known about what healthcare managers are doing in practice to ensure and improve quality of care and patient safety, how much time they spend on this, and what research-based guidance is available for managers in order for them to decide on appropriate areas to become involved.

Seven years into the new millennium, health for all prison inmates in Nigeria and many African nations has remained mirage. Recent assessment of African Prison Health systems indicates a gloomy picture of weakness in performance (African Regional Health Report, 2006). The inability to provide quality and equitable access to prison health care services through much reliance on western health care framework have further widening the existing health inequalities in many African countries and the Nigerian prisons in particular. This scenario has also the poor and the rich, urban and rural dwellers, inmates and the “free” at different axis of the production spectrum of health care delivery in Nigeria. A good example of this unfavourable equation becomes obvious when the health of special groups like the prisoners is critically examined (Health in African Prisons, 1999). Evidence has linked major determinants of health in modern populations to socioeconomic, political and cultural factors and as such inequalities in health have remained problematic across cultures, socio-economic class, gender or ethnicity (Bambra et al., 2005).

Therefore, in Ada Barrack, Taraba State where the research was carried out, the activities that was conducted is to know the Role of Care Managers in Handling of Patients with Criminal Background in Military Reception Station.

---

1.3 Statement of Problems

The unsavory nature of Nigeria prisons health care system leaves one in doubt, with too many questions and fewer answers; being that majority of persons become susceptible to diseases and infections than when they never went behind bars and commit more heineous crimes. Officers and men of Nigeria prisons epitomize have not taken the health of prison inmates seriously which many are certainly not satisfied with their conditions of service delivery health wise. Interestingly, prison still remains indispensable in correcting, reforming and rehabilitating “perceived convicts” in Nigeria. It is worrisome that recommendations and suggestions made to government for prison health reforms are yet to be implemented.

---

1.4 Aim and Objectives of Study

The aim of the study is to scrutinize the Role of Care Managers in Handling of Patients with Criminal Background in Military Reception Station using Ada Barrack in Taraba State as a case study. In achieving this aim, the following specific objectives were laid out as follows:

1. To examine the health condition of Patients with Criminal Background in Military Reception Station inmates.
2. To assess the environmental condition of Nigeria Military Reception Station.
3. To assess the benefit to effective health care delivery in Nigeria Military Reception Station.
4. To examine the challenges to achieving an effective health care delivery system for prison inmates.
5. To recommend ways of improving health care delivery in Nigeria Military Reception Station.

---

1.5 Research Questions

The study came up with research questions so as to be able to ascertain the above stated objectives. The specific research questions for the study are stated below as follows:

• Does Patients with Criminal Background limited toward proper health care in Military Reception Station?
• Is there any significant challenge influencing the effective health care delivery system for prison inmates in Nigeria?
• What are the environmental conditions of Nigeria Military Reception Station?
• What are the benefits to effective health care delivery in Nigeria Military Reception Station?

---

1.6 Research Hypothesis

In order to pursue the objective of this study, the following generalized statements have been designed to guide and aids in obtaining the result for the experiment to be conducted. For this work, the null hypothesis will be represented with H0 while the alternative hypothesis will be represented with hypothesis H1.

Hypothesis One

• H0: There are no challenges to effective health care system in Ada Barrack Military Reception Station.
• H1: There are challenges to effective health care system in Ada Barrack Military Reception Station.

Hypothesis Two

• H0: Health care delivery system does not have any impact on the state of health of the inmates of the Ada Barrack Military Reception Station
• H2: Health care delivery system does have impact on the state of health of the inmates in Ada Barrack Military Reception Station

---

1.7 Significance of Study

The study would greatly benefit the Nigerian prison service, Military Reception Station and the federal government as it would reveal the benefits of effective health care system and the challenges of achieving effective health care system in Nigerian prisons across the country. The study would also be of immense importance to students, researchers and scholars who are interested in developing a further study on the subject matter.

---

1.8 Scope of Study

The study focuses on the Role of Care Managers in Handling of Patients with Criminal Background in Military Reception Station using Ada Barrack in Taraba State as a case study.

---

1.9 Limitations of the Study

During the course of this study, many things militated against its completion, some of which are:

1. Time Constraint: The time frame given to accomplish this project was very short due to school academic calendar and it was carried out under pressure which made the researcher not to implement some necessary features.
2. Research material: availability of research material is a major setback to the scope of the study.
3. Frequent power failure: This made the researcher append more money on fuel to ensure sustainable power.
4. Financial Constraint: Insufficient fund tends to impede the efficiency of the researcher in sourcing for the relevant materials, literature or information and in the process of data collection (internet, questionnaire and interview).

---

1.10 Definition of Terms

Inmates: A person who is confined to an institution such as a prison or hospital.

Prison: A prison, correctional facility, detention center, jail or remand Centre is a facility in which inmates are forcibly confined and denied a variety of freedoms under the authority of the state.

Health care: Health care or healthcare is the maintenance or improvement of health via the diagnosis, treatment, and prevention of disease, illness, injury, and other physical and mental impairments in human beings.