Public buildings asset management maturity in government institutions – the case of National referral hospitals

Abstract

This study examined the effectiveness of public infrastructure management in national referral hospitals with Kawempe National Referral Hospital as the case study. The study was guided by three objectives – i) examining the functional condition (functionality) of public infrastructure, ii) the factors affecting the effective management of public infrastructure, and iii) possible solutions to factors affecting the effective management of public infrastructure. The study used cross-sectional survey design and considered both qualitative and quantitative approaches. The study targeted 194 participants as a sample size but 140 respondents managed to respond back (72.2%). Data were collected using questionnaires and interview guides to managers, administrators and hospital users. The study revealed that despite the hospital buildings being well-built, well completed and the roof being well fixed, the functionality condition of the hospital was lacking, which is common to poorly managed public buildings. Some windows and doors were not well fixed, flush toilets were not in good condition, some walls and the floor were bowing and had cracks, there were broken and blocked sewage lines and some buildings had faded painting. Infrastructure management was affected by lack of adequate funds, poor infrastructure maintenance culture characterized by poor road supervision & inspection and lack of rehabilitation prioritization. Furthermore, there was indiscipline and ignorance of building users and lack of maintenance and repair policy guidelines in the hospital. To overcome such challenges, the study revealed that, there was need for increased funding, reparation of operation and maintenance plans, prioritizing maintenance and repair of buildings, fighting corruption, regular supervision and inspection, increasing political support, regular technical infrastructural assessments, sensitizing hospital users on proper ways of building, sourcing for skilled manpower and entering into Public private partnership to raise more funds. It was recommended that the central government's funding for hospitals has to be increased, implement robust internal controls to safeguard against and catch any fraud or misappropriation of funds in hospitals in light of the rising instances of official corruption, embezzlement, and theft of public funds. Furthermore, public entities need participate into public-private partnerships to help them raise more revenue and also help to develop maintenance & management plans and frameworks to guide and remind the hospital workers when to do repairs and rehabilitations of the buildings