An investigation into causes of deterioration in health physical infrastructure transitioned from donor to national management
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Date
2019
Authors
Mutale, Bwalya Helena
Journal Title
Journal ISSN
Volume Title
Publisher
The University of Zambia
Abstract
The health sector has seen tremendous increase in the construction and expansion of physical infrastructure. Much of this infrastructure development has been spearheaded by donors who have facilitated the funding and construction of these structures. Presently, most funders are moving away from direct funding and support of such services to an approach that is more predisposed to national ownership to foster sustainability of services. Maintenance of physical infrastructure transitioned to national ownership from donor management has been a challenge leading to a considerable number of physical infrastructure dilapidating to a deplorable state. The study aimed at investigating the issues affecting effective maintenance of physical infrastructure in the health sector as well as to help identify tangible solutions that can be employed to improve maintenance activities.
A mixed methodology approach was used for data collection. Data collection techniques used included interviews, questionnaires and a review of the literature available on the subject matter. The relative importance index was used to determine the ranking of the results of the study.
The study findings revealed that 33% of the respondents in the facilities had no knowledge on minor and routine maintenance activities in both rural and urban settings, while 29% had limited knowledge, another 29% had working knowledge with only 8% having very good maintenance skills. Maintenance plans were in place in most urban facilities as compared to rural areas, however, adhering to maintenance plans was hindered by lack of funding for maintenance activities.
The study recommends improved budget allocation for maintenance activities from the Ministry of Health, use of smart technologies to alert personnel on scheduled maintenance works and reintroduction of patient user fees to assist in increased financial in flow to be allocated for use for minor maintenance works in the facilities.
Key words: Transition, National Management, Maintenance, Physical Infrastructure, Health Centres, Donors.
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Thesis
Keywords
National management--Health centres--Zambia