Teamwork, Professional Identities, Conflict, and Industrial Action in Nigerian Healthcare

Figures & data

Table 1 Demographic Profile of the Participating Health Workers

Health Worker Category	Method/Case Setting	Age (years)	Gender	Years in Professional Role
Medical laboratory scientists	Focus group discussion-Q	48	M	14
		48	F	14
		48	M	14
		47	F	21
		44	M	18
		43	F	14
		42	M	9
		42	M	10
		37	M	7
	Focus group discussion-Z	50	M	16
		41	F	15
		41	M	17
		38	F	15
		37	M	10
		36	M	7
		34	M	7
		32	M	6
	In-depth interviewee-Q	38	M	8
	In-depth interviewee-Z	35	M	12
Nurses	Focus group discussion-Q	49	F	21
		48	F	19
		32	F	7
		28	F	5
	Focus group discussion-Z	49	F	26
		46	F	21
		42	F	22
		32	F	6
		31	F	7
	In-depth interviewee-Q	52	F	26
	In-depth interviewee-Z	44	F	17
Medical doctors	Focus group discussion-Q	43	M	11
		37	M	11
		35	M	5
		32	M	5
	Focus group discussion-Z	40	M	9
		37	M	12
		37	M	10
		33	M	6
		31	M	7
	In-depth interviewee-Q	32	M	7
	In-depth interviewee-Z	35	M	9

Note: The study sites were arbitrarily labeled “Q” and “Z.”

Table 2 Constructs of the Interview Guide

S/No	Interview Construct
1	What are your experiences working with professionals of other disciplines?
2	What do you feel are the barriers to teamwork?
3	As a nurse/doctor/medical laboratory scientist, what do you value most in your daily work life?
4	What do you feel are the causes of industrial action by health workers?

Table 3 Main Themes on the Causes of Conflicts Within Multiprofessional Healthcare Teams

Theme	Illustrative Quote
Professional hierarchy	Due to the current situation in Nigeria, where non-doctors want to be on the same level with doctors, acrimony has set in. I can also say there is an inferiority complex, because you’ll find that most of these other professionals were candidates who wanted to read medicine, but eventually they couldn’t do that. ki/doctor/Q
Role ambiguity	I think to a large extent, we don’t have systems, and that leaves everybody to try and define his role by himself, that is, each of the professional groups. In the process of self-definition of roles, of course, in the absence of an arbiter, there is bound to be cross-over, and those areas are now the breeding grounds for conflict. fgd/doctor/100Z
Poor communication	As a human being, If you’re [so] suppressed that you can’t communicate, because, for me, communication is the livewire of everything. When there is no effective communication, you vent it out, sometimes through industrial action. fgd/nurse/400Q

Table 4 Main Themes on the Causes of Industrial Actions by Health Workers

Theme	Illustrative Quote(s)
Leadership of the health sector	Those who head the hospitals are the medics … They ask for substandard equipment because of the kickbacks they want. The medics have really failed the Nigerian health system. The whole system is polluted. fgd/mls/800Z
Remuneration	These days, even a cleaner wants to earn what the nurse earns. A persons pay is not necessarily based on the number of hours. You must also look at the mental input to the task. fgd/doctor/100Q You [the doctor] park a powerful ride while I’m waiting for a keke [tricycle], and we both come to work and put in hours. fgd/nurse/200Q