ORGANISATIONAL, ETHICAL AND LEADERSHIP DETERMINANTS OF QUALITY SERVICE DELIVERY BY HEALTH INFORMATION PROFESSIONALS: A COMPARATIVE ANALYSIS OF TEACHING HOSPITALS IN NORTH-WEST AND NORTH-CENTRAL NIGERIA

Abstract

Efforts to improve the service quality of health information professionals in Nigerian teaching
hospitals often focus on leadership or individual competence, yet the relative importance of
organisational and professional factors is unclear. This study compared the determinants of
quality service delivery by health information professionals in university teaching hospitals in
North-West (NW) and North-Central (NC) Nigeria, using the geopolitical zone as the unit of
analysis. A comparative design based on secondary analysis of two matched doctoral surveys
conducted in 2022 was adopted: the NW survey examined organisational culture and ethical
standard compliance (234 health information managers; 407 patients), while the NC survey
examined leadership style and cultural competence (135 health information professionals; 350
patients). Both measured quality service delivery with patients' SERVQUAL ratings. Standardised
regression coefficients were compared using Fisher's r-to-z test. In the NW, ethical standard
compliance (r = .350, R² = .122, p < .001) and organisational culture (r = .208, R² = .043, p =
.001) significantly predicted quality service delivery, and jointly explained 11.7 per cent of its
variance. In the NC, neither leadership style (r = .000, p = .996) nor cultural competence (r =
.165, p = .056) was significant, and together they explained only 1.5 per cent. Ethical standard
compliance was a significantly stronger predictor than leadership style (z = 3.35, p < .001). At
dimension level, the significant predictors were all practice-based and shared: involvement and
mission (NW), non-maleficence (NW) and cultural encounter (NC). The study concludes that
collective, practice-based factors, especially ethical practice and staff involvement, matter more
for service quality than formal leadership style, although all predictors studied explained only a
modest share of service quality. It recommends embedding ethical standards and staff involvement
in health information management practice and investigating structural factors such as staffing
and facilities.