Analysis of the perception of institutional function for health sector reform in Nigeria.

Institutional function reflects the institution's understanding of the world around it, its ability to locate itself within that world and to make decisions in relation to it. Three dimensions of institutional function were identified as management, environmental mastery and service delivery. This study analysed the perception of institutional function of four hospitals in Nigeria by 507 healthcare professionals and managers and its influence on the implementation of the health sector reform programme in the country. The respondents were doctors and dentists (30%), nurses (27.2%), pharmacists (8.9%), managers (15.5%) and other allied healthcare workers (18.4%). The overall perception of institutional function was 56.3%. The perceptions of the three dimensions of institutional function were management 52.7%, environmental mastery 50.8% and service delivery 62.6%. Three out of 12 statements on institutional function had levels of perception that were lower than 50%. These were adequacy of management skills (49.7%), functioning management information systems that are used in management decision-making (47.9%) and degree of autonomy for the hospitals (42.4%). There is the need to strengthen the institutional function of Nigerian hospitals, especially the acquisition of management skills by the healthcare professionals and managers, management information systems and autonomy for the hospitals.