Impact of Technological Infrastructure on Quality of Service in the Nigerian Health Sector

Abstract

Background: This study investigated the level of infrastructure in Nigerian hospitals, assessed the quality of service in the hospitals and examined the impact of infrastructure on quality of service. Methods: Survey method was used. Two sets of questionnaire were administered on patients and workers in primary, secondary and tertiary health care facilities. Summary of Results: There were 207 respondents made up of 92 health workers and 115 patients. Inadequacy of manpower and utilities was generally reported by the health workers. The overall mean for (Doctors, Nurses, Ward aids and Laboratory staffs adequacies) were 1.31, 1.31, 1.49 and 1.21 respectively with laboratory staff as the most inadequate. Also, among the diagnostic facilities, laboratory equipment is very inadequate (mean of 1.06). Perception by patients also shows gross inadequacy of manpower with overall mean of 1.94, 1.88, 1.65 and 1.50 for doctors, nurses, ward aids and laboratory staffs respectively with laboratory staff as the most inadequate similar to the perception by the hospital workers. Majority (44.3%) of the patients were satisfied with the services rendered by medical doctors and the nurses (50.4%), but a weighted average of 1.82 shows that they were not satisfied with the services rendered by the laboratory staff. Similarly, a weighted average of 1.87 shows that patients were not satisfied with the total time taken before medical care was given. Concerning mode of payment through National Health Insurance Scheme (NHIS), majority (92.2%) were not satisfied due to their non-awareness of the scheme. Most (51.3%) of the patients made payment by self but a weighted average of 1.87 shows general dissatisfaction with it.  Impact of staff/infrastructure inadequacy on quality of service shows statistical significant relationships (p<0.05) with gross mismatch of patients and workers. On regression analysis about impact of infrastructure on the quality of service, the effect is 48% of the total variation in gross mismatch, and F value is high (7.324) with health workers’ p-value of 0.00. Therefore, there is a significant impact of the infrastructure on the quality of service. Conclusion: The study concludes that there is a need to improve on the quality and quantity of modern health infrastructure provided for Nigerian health care centres.