BARRIERS TO QUALITY HEALTH INFORMATION SERVICE DELIVERY IN UNIVERSITY TEACHING HOSPITALS: A COMPARATIVE STUDY OF NORTHWEST AND NORTH-CENTRAL NIGERIA

Abstract

Health information professionals in Nigerian teaching hospitals work under constraints that limit
the quality of services they deliver to patients and clinicians. This study compared the barriers to
quality health information service delivery reported 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, covering 234 health information
managers in six NW teaching hospitals and 135 health information professionals in four NC
teaching hospitals. Both surveys used yes/no checklists of barriers. Barriers common to both zones
were compared using two-proportion z-tests, and zone-specific barriers were compared
thematically. Three human-resource barriers were common to both zones and were reported by
most respondents: inadequate motivation (NW 74.7%; NC 82.2%), deployment of untrained or
non-specialist staff (70.5%; 77.0%) and shortage of qualified or skilled manpower (70.1%;
77.8%). Although these barriers were reported more often in the NC zone, the differences were
not statistically significant (p = .095 to .174), indicating a shared, system-wide workforce problem.
The zone-specific barriers differed in kind: NW barriers centred on digitisation and capacity
development (lack of computerised records, 69.2%; poor system maintenance, 68.4%; lack of
training, 68.4%; lack of sponsorship, 67.1%; epileptic power supply, 63.2%), while NC barriers
centred on physical space and paper-based logistics (lack of filing space, 84.5%; poor working
environment, 70.4%; distance of the records library from clinics, 67.4%; delayed supply of forms
and registers, 66.7%). The study concludes that workforce motivation and professional staffing
are the most urgent shared priorities, while the zones differ in their stage of transition from paper
to digital records. It recommends national action on health information workforce motivation and
staffing, and zone-tailored investment in electronic records (NW) and records storage and logistics
(NC).