PERFORMANCE EVALUATION OF PRIMARY HEALTH CARE (PHC) BUILDINGS IN THE FEDERAL CAPITAL TERRITORY (FCT). | Blazingprojects Postgraduate Thesis
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PERFORMANCE EVALUATION OF PRIMARY HEALTH CARE (PHC) BUILDINGS IN THE FEDERAL CAPITAL TERRITORY (FCT).

 

Table Of Contents


  •           TABLE OF CONTENTS DECLARATION ................................................................................................................................... i CERTIFICATION ............................................................................................................................... ii ACKNOWLEDGMENT...................................................................................................................... iii ABSTRACT......................................................................................................................................... iv TABLE OF CONTENT....................................................................................................................... vi LIST OF FIGURES ......................................................................................................................... viii LIST OF TABLES.............................................................................................................................. ix LIST OF APPENDICES..................................................................................................................... x LIST OF ABBREVIATIONS.............................................................................................................. xi 

Chapter ONE

INTRODUCTION

  • ...............................................................................................1 
  • 1.1Background................................................................................................................................1 
  • 1.2Statement of the Problem .........................................................................................................4 
  • 1.3Significance of the Study...........................................................................................................5 
  • 1.4Aim and Objectives..................................................................................................................5 
  • 1.5Scope and Limitations...............................................................................................................6 .

Chapter TWO

LITERATURE REVIEW

  • .......................................................................................7 
  • 2.1Introduction...................................................................................................................................7 
  • 2.2Building Performance...................................................................................................................7 
  • 2.3Building Performance Evaluation (BPE)......................................................................................8 
  • 2.4User Satisfaction and Post Occupancy Evaluation (POE)..........................................................11 
  • 2.5Organization of Health System and Health System Reforms in Nigeria.....................................12 
  • 2.6Conceptual Basis of Primary Health Care..................................................................................13 
  • 2.7Health Care Building Architecture ..............................................................................................15 
  • 2.8Health Care Environment, its Impact on Patient’s Well-Being and Health Outcomes............16 2.
  • 8.1Theoretical Approach for Healing Environments..................................................................17 2.
  • 8.2Optimal Healing Environment Framework............................................................................18 2.
  • 8.3Healing Space Requirements in Built Environment..............................................................20 2.8.
  • 3.1Color and light as Healing Space Requirements in Built Environment ...............................21 2.8.
  • 3.2Art, Music and Sound as Healing Space Requirements in Built Environment ....................22 2.8.
  • 3.3Green Garden as Healing Space Requirements in Built Environment...............................23 2.8.
  • 3.4Space and Privacy as Healing Space Requirements in Built Environment..........................23 
  • 2.9Standard Criteria for Hospital Design and Design Quality Indicators (DQI)...............................24 
  • 2.10Healthcare Building Evaluation Toolkits...................................................................................30 2.
  • 10.1Achieving Excellence Design Evaluation Toolkit (AEDET) Evolution....................................31 2.
  • 10.2A Staff and Patient Environment Calibration Tool (ASPECT)...............................................34 2.
  • 10.3Inspiring Design Excellence and Achievements (IDEA)......................................................35 2.
  • 10.4NHS Environmental Assessments Toolkit (NEAT)..............................................................36 
  • 2.11Conclusion................................................................................................................................38 

Chapter THREE

RESEARCH METHODOLOGY

  • ....................................................................39 
  • 3.1Research Design ...................................................................................................................39 
  • 3.2Study Population..................................................................................................................40 
  • 3.3Sample Size and Sampling Procedure..................................................................................40 
  • 3.4Data Collection Technique ...................................................................................................44 
  • 3.5Data Analytical Technique ...................................................................................................
  • 463.6Ethical Considerations..........................................................................................................47 

Chapter FOUR

DATA PRESENTATION AND ANALYSIS

  • ANALYSIS AND DISCUSSION...........................48 
  • 4.1GENERAL INFORMATION ON THE RESPONDENTS ...................................................48 4.
  • 1.1General Information on Medical Staff ...........................................................................48 4.
  • 1.2General Information on Patients .................................................................................50 4.
  • 1.3General Information on Visitors .................................................................................52 
  • 4.2ASSESSMENT OF THE PERFORMANCE OF PHC BUILDINGS..............................53 4.
  • 2.1Perception of users on functionality of PHC buildings...............................................53 4.
  • 2.2Perception of users on Build Quality of PHC buildings. ............................................57 4.
  • 2.3Perception of users on Impact of PHC buildings. .......................................................60 
  • 4.3INFERENTIAL ANALYSIS (The T-Test) .....................................................................68 
  • 4.4DISCUSSION OF RESULTS...........................................................................................70 

Chapter FIVE

SUMMARY, CONCLUSION AND RECOMMENDATIONS

  • CONCLUSION AND RECOMMENDATIONS.....................76 
  • 5.1Summary of findings.........................................................................................................76 
  • 5.2Conclusions.......................................................................................................................79 
  • 5.3Recommendations.............................................................................................................80 REFERENCES..................................................................................................................................83

Thesis Abstract

           ABSTRACT 

Existing studies have established that the physical characteristics of buildings have significant influence on occupants’ satisfaction. However, studies has shown that the conventional ways that public hospital buildings in Nigeria are designed have contributed to stress, depression and anxieties because of loss of privacy, control over eating and sleeping times, and noise. And in addition contributed to dangers, allergies and other acquired infections called Hospital Acquired Infections (HAI) to patients and staff. This study assessed the performance of Primary Healthcare Centre (PHC) buildings which is identified to be the appropriate settings to tackle over 90% of the major causes of morbidity and mortality due to its proximity to about two-thirds of Nigerians. The objectives of this study were to; identify those standard performance criteria of healthcare buildings that aids healing of patients and positively influence users of PHC buildings; evaluate the perception of users on the performance of PHC buildings and outline appropriate steps to remedy the identified gaps to match up with the global standards. This was a descriptive cross-sectional study conducted in six PHC buildings across the six area councils of the Federal Capital Territory (FCT), Nigeria. A purposive sampling technique was used to select a total of 334 samples (patients, medical staff and visitors’) from the target population. Data were collected with the aid of an adapted version of - Achieving Excellence Design Evaluation Toolkit (AEDET) questionnaires. Both descriptive and inferential statistics were used to present simple mean, standard deviation and test for statistical significance of the results. Ten criterion, categorized into three criteria namely; functionality, build quality and impact were identified as the required standards for healthcare building performance. They aid in the healing of patients, improve the productivity of medical staff and attract patronage from visitors. The results show that users’ perception on the functionality and build quality of the PHC buildings which concerns the extent to which it facilitates or inhibits the activities of the medical staff who carry out the functions inside and around the building was poor. Also, the staff and patient environment which was addressed by impact was assessed to be poor. In view of these, patients in PHC buildings do not have privacy during their stay for treatment and cannot be alone with others to have private discussions because of the multiple bed system that is currently run. The toilets, bathrooms and other facilities for the use of staff, patients and visitor are not befitting and dignified enough to attract patronage. The study recommends that the National Primary Healthcare Development Agency’s (NPHCDA) Minimum Standards for Primary Healthcare and the Ward Minimum Healthcare Package upon which the design of PHC buildings in Nigeria is based should be updated and reviewed to reflect modern trends in healthcare architecture

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