Factors affecting budget implementation for successful delivery of primary health care building facilities within Nigerian health sector

Maintenance of public hospital buildings in Nigeria – an assessment of current practices and policy options

Purpose

The recent COVID-19 pandemic has exposed the declining conditions of many of the hospital buildings, especially in developing countries. Past studies have shown inadequate maintenance practices but how far regarding Nigerian public hospital buildings is yet to receive empirical research. This paper aims to investigate the underlying issues leading to inadequate maintenance practices and proffers policy options to improve Nigerian public hospital buildings via an unexplored dimension.

Design/methodology/approach

The study used a mixed research design method involving both qualitative and quantitative data. First, results from the qualitative phase were analysed and verified at the quantitative phase through a well-structured questionnaire, developed from the qualitative findings across hospital maintenance experts (work/maintenance department, health-care provider, design team and health-care building/service contractor) in Abuja, Lagos and Benin City.

Findings

Insufficient funds for maintenance works, absence of planned maintenance programmes, inadequately trained personnel, etc., emerged as the maintenance inadequacies in the public hospital buildings across the cities covered. The paper categorised the cause of inadequate maintenance practices of public hospital buildings into six groups: statutory requirements, design stage, construction stage, budget for maintenance task, managing maintenance unit activities and user’s perception regarding maintenance management.

Research limitations/implications

This paper is limited to maintenance practices of Nigerian public hospital buildings. Future research is needed to evaluate factors that will enhance outsourcing maintenance and the use of the 4th industrial revolution (building information modelling for refurbishment and building automation systems) amongst others in maintenance practices of public hospital buildings.

Practical implications

As part of the practical implication, the government and hospital administrators should make provision for adequate funding and accountability of annual maintenance budgetary allocation. Also, the government should establish a national maintenance policy for public infrastructure with an emphasis on preventive maintenance and contractor’s reputation, outstanding pedigree, technical and financial soundness during build maintenance contract award, etc., were recommended.

Originality/value

This paper reveals that the stakeholders, especially hospital administrators, policymakers and political office holders that are concern with maintenance budget, approval and disbursement concerning maintenance practices in public hospital buildings need to reawaken to her responsibility because of the inadequate implementation across the cities covered.

Maintenance practices in Nigeria’s public health-care buildings: a systematic review of issues and feasible solutions

Purpose

Health-care building maintenance has been receiving concern because of the recent global pandemic. However, there are inadequate broad studies affecting health-care facilities maintenance and feasible solutions in Nigeria. This study aims to conduct an all-inclusive review of public hospital building maintenance issues and proffer possible solutions to improve maintenance practices in health-care buildings via a framework that will support studies in the future.

Design/methodology/approach

A review of published papers from 2006 to 2020 was conducted. Based on the keywords, 3 pertinent databases were searched and descriptions of the findings from 40 studies were recognised and used in line with Preferred Reporting Items for Systematic Reviews and Meta-Analyses.

Findings

Two main themes (issues and feasible solutions to improve practices) emerged from public health-care building maintenance practices. The study developed a framework that describes the relationship between issues and possible solutions with an emphasis on how to improve human development, management efficiency, technical competence and professional skills, cost-minimisation and others.

Practical implications

As part of the paper implications, emerged issues were group into five categories (human development, management, technical, limited financial resources and others). The proposed framework for future studies will attempt to mitigate issues and proffer feasible solutions to improve hospital building maintenance practices in Nigeria and other developing countries that are facing similar challenges.

Originality/value

To the best of the author’s knowledge, this paper is possibly the first comprehensive review of public health-care building maintenance practices in Nigeria. Moreover, this review demonstrates how the proposed feasible solutions can mitigate problems.