AN ASSESSMENT OF PUBLIC HEALTH SERVICE FACILITIES

AN ASSESSMENT OF PUBLIC HEALTH SERVICE FACILITIES

ABSTRACT

The aim of this project is to carry out an assessment of public health service facilities with particular reference to General Hospital, Minna, Niger State. The research was designed to assess the present condition of the built environment, and to determine factors affecting maintenance management of public health facilities in Nigeria. Primary data were collected directly from the field through the use of oral interview, field observation, questionnaires and building survey conducted. 50 questionnaires were distributed and all 50 were returned fully responded to. Relative Index (RI) was employed for ranking and determination of significant factors affecting the state of the facilities through the collected data. The study determined that although there were facilities and services provided in the hospital, they were inadequate and at times not functioning effectively and efficiently. Use of poor quality components and materials and Absence of a form of planned maintenance programmes were ranked as the most significant factors responsible for poor maintenance management of public hospital buildings. The study recommended that: Government should equally make it as a matter of policy for private and public hospitals that there should be a maintenance policy guiding their maintenance programmes.

CHAPTER ONE

INTRODUCTION

1.1       BACKGROUND TO THE STUDY

Public facilities are facilities provided, owned, or being monitored by government either at the federal, state or local government level. Basically, they can be classified into two namely movable facilities which are facilities like earth moving equipment, vehicles, computers, typewriters, etc., that can change location from time to time and non-movable facilities like buildings, electricity lines, pipe lines for water, etc., that cannot change their location. All these facilities, irrespective of their group needs effective regular maintenance for proper functioning of the assets acquired. The performance of public facilities depends on the degree of effective maintenance. Unfortunately, however, maintenance is one of the major problems facing the public organizations with a resultant effect of having their premises littered with broken down plants/equipments which are allowed to rust away under rainy and sunny conditions and eventually are sold as scraps (Lawal and Adeyemo, 2004).

Maintenance management in the public sector in Nigeria has suffered from lack of funds for a considerable time. While the requirements for good practice in maintenance management of building stock have been established over a considerable period, the achievement of good practice is by no means universal (Turrell, 1997). Maintenance of the built environment impacts on the whole nation. The conditions of the surroundings in which we live and learn, is a reflection of the nation’s well being. (Lee, 1987) Maintainability of building has been identified as one of the key areas in which the construction industry must achieve significant improvement (Nayantharas de Silva et al, 2004).

According to Iyagba and Adenuga, (2003) it is impossible to produce buildings which are maintenance free, but maintenance work can be minimized by good design and proper workmanship carried out by skilled experts or competent craftsmen using suitable codes of installation, requisite building materials and methods. Management of any process involves assessing performance, and maintenance management of buildings is no exception (Turrell, 1997).

In order for any maintenance manager to measure performance and set priorities, the organizational needs have to be considered i.e. the function and performance of buildings and their appropriate standards will be independent on the user’s perception and their primary needs (Chanter and Swallow, 1996). Performance of hospital buildings and their component depends to large extent on continuous and planned periodical maintenance, which challenges owners and facility managers to institute precise planning based on a well-structured maintenance programmes (Shohet et al, 2002). Despite the ever-growing need for lower operational costs, facilities managers must ensure that facilities are constructed and maintained without compromising safety. In Nigeria, colonial architecture in some of the older public buildings especially hospitals which was hitherto famous for its sturdiness and functionality has now become less attractive because of the general neglect of the buildings. Overcrowding has also led to the deterioration of the facilities installed (Onifade 2003).

If no action is taken all these old buildings and facilities will decay and will only be replaced in function if the means are available. The inadequacy of the operation and maintenance of building and infrastructure in developing countries has serious consequences for economic and social development especially on the health sector.

1.2       STATEMENT OF THE PROBLEM

Existing health sector buildings in Nigeria lack adequate maintenance attention. Most public hospital buildings are in very poor and deplorable conditions of structural and decorative disrepair. While considerable of research have been carried out on factors responsible for the poor maintenance of public housing estates and offices in Nigeria but only scant attention has been given to the key parameters affecting the implementation of maintenance programmes for public hospital buildings. There is therefore a need to establish and evaluate the factor affecting maintenance management of public hospital buildings using appropriate analysis.

1.3       AIM AND OBJECTIVES

The aim of this project is to carry out an assessment of public health facilities in Nigeria with particular interest in  General Hospital, Minna, Niger State.

The specific objectives of this research are:

1. To assess the present condition of General Hospital, Minna, Niger State as carried out by the maintenance department.
2. To determine factors affecting maintenance management of public health facilities in Nigeria.
3. To make useful suggestions on improving the existing facilities in Public Health Facilities in Nigeria.

1.4       SIGNIFICANCE OF STUDY

This study evaluates the maintenance services that are provided in the General Hospital, Minna, Niger State. This provides an insight to the significance of the physical characteristics of the hospital in determining the level of satisfaction. Such information will enhance the skills of architects and housing administrators to ascertain specific actions that can maximize more satisfactory maintenance provisions in not only hospitals but in other government owned buildings and minimize dissatisfaction as much as possible, lessons learnt from the evaluations of existing projects can serve as input into ongoing or future projects.

It is expected that the main contribution of the study will be to propose an expanded approach to buildings and building services evaluations of government owned buildings, which goes beyond the limits of present day’s building industry.

1.5       SCOPE AND LIMITATIONS

The research is based on the study on “An assessment of Public Health Service Facilities: A Case Study of General Hospital, Minna, Niger State”. This study takes into consideration the services and facilities provided in the General Hospital, Minna, Niger State. This assessment focuses on the maintenance management and maintenance framework available at the hospital.

This study is limited to conducting a conditional survey of the General Hospital Minna, Niger State and make useful suggestions on improving the existing facilities in Public Health Facilities in Nigeria only.

1.6      RESEARCH METHODOLOGY

The research design involves the conducting of conditional health service facilities on General Hospital Minna, Niger State. The research involved two (2) stages of survey and the use of a designed questionnaire in relation to the objective assessment.

• Iinitial Inspection:

This involves the researcher interviewing the staff and patients about their views about the condition of the hospital building and its facilities.

During the initial inspection, the researcher took a detailed look at the whole building from a distance, inspecting the building, looking at the condition of adjoining buildings and other facilities.

• Facilities Survey

 The next stage is to undertake a present condition survey of the facilities. The facilities are measured. The characteristics of facilities are plotted onto a drawing or sketch of the building.

After which a questionnaire was introduced. The questionnaire is the main method used for data collection for this research and it was personally administered by the researcher. It consisted of simplified questions. Efforts were made to ensure that the target respondents were given the questionnaires to respond properly to the objective assessment needed for this research.