DETERMINANTS OF POOR SERVICE DELIVERY IN NIGERIAN PUBLIC HEALTH INSTITUTION: AN EMPIRICAL REVIEW

BY

JULIET NKIRUKA ONUCHUKWU

ABSTRACT

Quality healthcare service delivery is fundamental to patient satisfaction and public trust. Yet, Nigerian public health institutions continue to face persistent challenges that undermine service quality, prompting many patients to seek care in private facilities despite higher costs. This study investigates the determinants of poor service delivery at Sango Ota General Hospital in Ogun State, Nigeria, focusing on both service providers and patients. A mixedmethod approach was adopted, combining qualitative and quantitative designs. Data were collected from 60 respondents—30 healthcare workers and 30 patients—using structured questionnaires and interviews. Stratified and purposive sampling techniques ensured representation across staff categories and patient demographics. Findings reveal that poor motivation of service providers, inadequate tools and infrastructure, weak communication between leaders and subordinates, limited opportunities for professional development, and ineffective leadership practices are major contributors to poor service delivery. Patients reported dissatisfaction with long waiting times, lack of responsiveness, inadequate supply of medicines, and poor listening attitudes from staff. Statistical analysis confirmed significant relationships between these determinants and low levels of patient satisfaction. The study concludes that poor service delivery in Nigerian public health institutions is multidimensional, rooted in organizational inefficiencies and systemic weaknesses. Recommendations include strengthening supply chains for medicines and equipment, recruiting and training more healthcare workers, improving leadership communication and motivation, and enhancing accountability mechanisms. Addressing these determinants is essential for improving patient satisfaction, restoring confidence in public healthcare, and reducing reliance on costly private hospitals.

Keywords: Service delivery, public health institutions, Nigeria, patient satisfaction, healthcare quality, leadership, motivation

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