RESOURCE UTILIZATION AND PERFORMANCE OF PRIMARY HEALTHCARE DEVELOPMENT CENTRES IN SOUTH-EAST NIGERIA

Abstract

Persistent underperformance in Primary Healthcare Development Centres (PHDCs) in South-East Nigeria, reflected in high mortality levels and low patient satisfaction, has raised concerns about the effectiveness of resource utilization practices. This study examined the associations between selected resource management practices—budget variance and absenteeism rate—and indicators of healthcare performance, namely mortality rate and patient satisfaction. Anchored on the Resource-Based View (RBV) theory, the study adopted a survey research design and targeted administrative heads of PHDCs across five states in South-East Nigeria, as they are responsible for planning, monitoring, and reporting resource use and performance outcomes. A population of 3,176 administrative heads was identified, from which a sample size of 359 was determined using Taro Yamane’s formula; 299 valid responses were retrieved through a structured questionnaire. Mortality rate and patient satisfaction were measured using administrators’ reports based on institutional records and routine service evaluations rather than direct patient surveys, a limitation acknowledged in the study. Face and content validity of the instrument were established by experts, while reliability was confirmed using Cronbach’s Alpha coefficients ranging from 0.789 to 0.924. Data were analysed using Pearson Product-Moment Correlation. The results showed that budget variance operationalized as deviations between planned and actual health expenditures was significantly and positively associated with mortality rate (r = .703, p < .001), while absenteeism rate was significantly and negatively associated with patient satisfaction (r = −.729, p < .001). The findings indicate that inconsistencies in financial execution and staff availability are strongly related to variations in healthcare performance outcomes. The study concluded that improving healthcare performance in PHDCs requires better alignment between resource planning and operational execution, though causal inferences are not implied by the correlational design. It therefore recommended that strengthened financial monitoring and staff attendance management to support more consistent healthcare delivery.