AN APPRAISAL OF BUSINESS POLICY MODELS IN THE MANAGEMENT OF MISSION HOSPITALS IN THE SOUTH-EAST NIGERIA


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AN APPRAISAL OF BUSINESS POLICY MODELS IN THE MANAGEMENT OF MISSION HOSPITALS IN THE SOUTH-EAST NIGERIA                                                         ABSTRACT:     The study on the appraisal of Business policy models in the management of mission hospitals in the South East was motivated by the need to proffer possible strategies and solutions by the use of open system and stakeholders’ business policy models in the management of mission hospitals in the South East Nigeria. The study was guided by six key objectives from which appropriate research questions and hypotheses were formulated. The study adopted survey design. The research instruments were questionnaire and oral interviews. The population of the study was 6000 staff of the 27 selected mission hospitals drawn from 57 registered mission hospitals in the five states comprising: Abia, Anambra, Ebonyi, Enugu, and Imo States of South East Nigeria. A sample size of 375 was determined from the population using Taro Yamane’s formula while Purposive sampling technique was used in selection of the mission hospitals.  Cronbach Alpha was used in testing the validity and the reliability of the research instrument. The result was 0.98 indicating a high degree of relationship. The hypotheses were tested using parametric and non parametric statistical techniques which included:  Friedman Chi-square (X2), ANOVA (one-way) and Z-test. Findings reveal that the quality of service to patients in the mission hospitals to a large extent is contingent on having appropriate equipment, competent doctors and availability of drugs as contained in the open business policy model.  Stakeholders’ business policy model to a large extent also contributed to sustainability of operation in the management of mission hospitals. The study also indicated that open system business policy model to a large extent promoted competitiveness in the management of mission hospitals. There was a significant relationship between open business policy model and human resource management in the mission hospitals. Environmental turbulence and uncertainties such as ‘government policies on taxations and importation’ constituted the greatest challenges to the adoption of business policy models in mission hospitals. Stakeholders’ business policy model also impacted positively on the supply chain management through drug availability, quality drugs and good treatment in mission hospitals. Based on the results of the study, the following recommendations were made: hospitals Organizations should work toward greater relationship management institutionalize sustainability factors that can boost the confidence of staff, restructure the rules of management by adopting new strategies that encourages interactions and interdependence between the hospital and its environments. Hospital management should undertake continuous service innovation of activities and put in place in all the hospitals, boundary spanners who are expected to keep management informed about the environmental changes which could affect business policy adoption.  Private public partnership in the healthcare institutions should be fostered in the mission hospitals. The study concludes that adopting open system and stakeholders’ business policy models are vital and important for high performance management of the mission hospitals. With appropriate implementation of  business policy as was identified in this work the following outcomes will be inevitable: service quality will be assured, sustainability of operation will be improved, competitive advantage will be maximized, human resource management will be stable, effective and efficient, supply chain management will be optimized and environmental challenges will be predicted, adapted to and managed. TABLE OF CONTENTSTitle Page ----------------------------------------------------------------------------------------------- iApproval Page ----------------------------------------------------------------------------------------- ii  Certification Page ------------------------------------------------------------------------------------- iiiDedication ---------------------------------------------------------------------------------------------- ivAcknowledgements ------------------------------------------------------------------------------------ vAbstract ----------------------------------------------------------------------------------------------------viList of Tables-----------------------------------------------------------------------------------------------xiList of Figures ----------------------------------------------------------------------------------------------xiiCHAPTER ONE: INTRODUCTION1.1    Background of the Study                                 11.2    Statement of the Problem                                51.3     Objectives of the Study                                61.4    Research Questions                                    61.5    Research Hypotheses                                    71.6    Significance of the Study                                81.7     Scope of the Study                                    91.8     Limitations of the Study                                91.9    Profile of the Selected Mission Hospitals                         101.10   Definition of Terms                                                                                                    24    References                                                                                                                27CHAPTER TWO:    REVIEW OF THE RELATED LITERATURE2.1    Theoretical Frame work                                312.2    Conceptual Framework                                392.3    Service Quality and Open Business Policy in Hospitals                442.4    Stakeholders Business Policy in Sustainability of Operations            502.5     Competitiveness in management of Mission Hospitals                                        61    2.6      The Human Capital Elements  in Mission Hospital Management                             702.7    Environmental Analysis and Challenges of Adopting Business Policy Models in Mission     Hospitals     862.8    Influence of Stakeholder Business Policy Model in Supply Chain Management     106                           2.9    Summary of the Related Literature Review                        109    References                                                                                                                 112CHAPTER THREE:    RESEARCH METHODOLOGY3.1    Research Design                                    1343.2    Sources of Data                                    1343.3    Population of the Study                                1353.4    Sample Size Determination                                1373.5    Description of Research Instrument                                   140                       3.6    Validity of the Instrument                                1403.7    Reliability of the Instrument                                1403.8    Methods of Data Analysis                                 141    References                                                                                                                  142CHAPTER FOUR: DATA PRESENTATION, ANALYSIS AND INTERPRETATION                                                                   4.1       Questionnaire Distribution and Response Rate                                                          1434:2     Hypotheses Testing                                                                                                      1604:3        Discussion of Results                                                                                                 170References                                                                                                                             180CHAPTER FIVE: SUMMARY OF FINDINGS, CONCLUSION AND RECOMMENDATIONS5.1     Summary of Findings                                                                                                       1835.2     Conclusion                                                                                                                        1845.3    Recommendations                                                                                                             1845.4     Contribution to Knowledge                                                                                              1865.5    Areas for Further Research                                                                                               188          Bibliography                                                                                                                      189         Questionnaire                                                                                                                      216        Appendix 1                                                                                                                          223       Appendix 11                                                                                                                        229       Appendix 1II                                                                                                                        230                                                                                                                                                                                                      Appendix IV                                                                                                                         231       Appendix V                                                                                                   232                                                                                                                                                                                                                                  CHAPTER ONEINTRODUCTION 1.1    BACKGROUND OF THE STUDY Business is an organized approach to providing customers with the goods and services they want. The word business also refers to an organization that provides these goods and services. Most businesses seek to make profit, where revenues exceed the costs of operating the business.  However, some businesses seek to earn enough to cover their operating costs. These businesses are commonly called nonprofit organizations; they are primarily nongovernmental service providers. Examples of nonprofit businesses are social service agencies, foundations, advocacy groups, and mission hospitals (Redmond, 2009). Every business organization is guided by laid-down rules, norms, principles, procedures and policies. Any business without policy operates in a vacuum and lacks direction.  Such a business is difficult to assess and in most cases cannot achieve its objectives. Policy is therefore a guide for making decisions (Massie, 1992). The above explanation notwithstanding, policy can also be defined from two perspectives: as a definite goal, course or method of action to guide and determine present and future decisions, or as a set of rules to administer, manage and control access to network resources (Johnson, 2003).Business policies are the guidelines developed by an organization to govern its actions. They define the limits within which decisions must be made and also deals with acquisition of resources with which organizational goals can be achieved (Hanson, Goodman and Mill, 2008). Business policy as regards hospital management provides the guidelines for mobilizing and deploying   resources for the efficient provision of effective health services (Olumide, 1997).  This involves planning, organizing, controlling and directing/leading.There are basically two business policies approaches, most organizations adopt in their effort towards realizing their organizational objectives. Some run their organization from a closed system perspective.  Traditional theories regarded organizations as closed systems—autonomous and isolated from the outside world. An organization was thus considered as system of managers, employees and resources and the role of external factors were underplayed (Bola, 2011).  In the 1960s, these mechanistic organization theories, such as scientific management, were spurned in favour of more holistic and humanistic ideologies. Recognizing that traditional theory had failed to take into account many environmental influences that affected the efficiency of organizations, most theorists and researchers embraced an open-systems view of organizations (Bola, 2011).The term "open systems" reflected the new found belief that all organizations are unique and should therefore be structured to accommodate unique problems and opportunities. For example, research during the 1960s showed that traditional bureaucratic organizations generally failed to succeed in environments where technologies or markets were rapidly changing. They also failed to realize the importance of regional cultural influences in motivating workers (Kahn, 2010).An open business policy model in hospital management stipulates the guideline that governs the hospital’s interaction with its environment. A hospital cannot shut itself from its patients, suppliers, competitors, political cum cultural and religious environment.  Many subsystems within the hospital as the laboratory department, nursing department, pharmaceutical department etc need to be highly controlled and predicted, possessing a considerable degree of self regulation. However a truly open system needs to be able to cope with controllable and unexpected inputs and deal with these in predictable and contingent ways (Katz, 2004).Open business policy is also linked with stakeholder’s business policy model as input, through put, and output sources of the organization. A corporate stakeholder is a party that can affect or be affected by the actions of the business as a whole. The stakeholder concept was first used in a 1963 internal memorandum at the Stanford Research institute. It defined stakeholders as those groups without whose support the organization would cease to exist (Freeman, 2004). A  Stakeholder  Approach,  tries  to  build  a framework that  is responsive  to  the  concerns  of  managers  who  are  being  confronted  with unprecedented levels of environmental turbulence and change. Freeman (1984) argues that “gone are the good old days of worrying only about taking products and services to market, and gone is the usefulness of management theories which concentrate on efficiency and effectiveness within this product-market framework”.The persistently low quality and inadequacy of health services provided in public facilities has made the private sector an unavoidable choice for consumers of health care in Nigeria.  The problems with government owned hospitals start with the attitude of doctors and nurses who usually are egoistic (Tate and Taylor, 1983).  It is so terrible to see patients or their family members exchange words with nurses in public hospitals.  Hardly, would you walk into any of these hospitals and not find nurses quarreling with either patients or visitors. The attitude of nurses at the various National Teaching and Orthopedic hospitals simply tells you that it is your fault for bringing your accident victim to them and that the authority lies with them on whether to receive your victim or have him/her rejected by referring him/her to other hospitals. Patients are simply treated like the rejected in the society.  It is for this reason that Nigerians regard government hospitals as mortuaries, forbidding going anywhere near these hospitals, a situation which sees chemists and pharmaceutical outlets being patronized more than our public hospitals (Olumide, 1997). The current state of the Nigerian health system is quite worrisome; our health indicators and statistics are abyssal. The nation is yet to make any significant improvement in the area of maternal and child health, life expectancy of our men and women falls below 50 years; and doctor to population ratio is 3 per 10,000.  The scourge of malaria, tuberculosis and acquired immune deficiency syndrome (AIDS) is not abating. Access to safe, clean water in our cities and villages is to say the least poor.  Top on this, is the man-made carnage from road traffic accidents which kills many people at the prime of their lives (Osemwota, 2001).It is no longer a secret that Nigeria is at a significant risk of not meeting the Millennium Development Goals (MDGs) number four (4) and five (5) which call for reduction in mortality rate by  two-third, by the year  2015,of children under the age of five and  by three-quarter  in 2015,of the maternal mortality ratio, respectively. In fact, meeting the overall target of the MDGs in 2015 is still a mirage. Statistics has proved that every day in Nigeria; about 720 babies die (around 30 every hour).  This is the highest number of new born death in Africa and the second highest in the world (Chukwu, 2011).The erosion of confidence in the public health system, arising from mismanagement, poor development and implementation of business policies, had contributed to the growth of the private sector in general, and the rise in the informal private sector as a source of treatment in particular (Hanson, Goodman, Meek and Mills, 2008). Patients often resort to the unregulated private healthcare providers, where treatment may be inappropriate but at lower cost (Onwujekwe, 2005).   It is against this background that many Christian churches in the south-east Nigeria sought to address these challenges in the public health sector.   The church is concerned about the physical health of man as she is about the soul.  For man to be saved means that man is fully alive, in his totality, body and soul.  Therefore, as the continuation of the saving and healing ministry of Jesus and as an active response to Jesus’ own mission: that the blind see, the lame walk, those suffering from sickness are healed (Mt. 11:4 – 5). Mission hospitals seek to bring consolation and hope to the sick, to give a new meaning to the suffering, while invoking the mercy of Jesus; the comforter and healer per excellence. The church has remained a leading stakeholder in the health sector in Nigeria. Mission hospitals provide well over 40% of the country total health services. Available statistics indicate that, there are about 320 mission hospitals in Nigeria (Chukwu, 2011). In Anambra state alone, there are about 37 Catholic hospitals, maternity homes and primary health centers, spread across urban towns and rural communities of the state caring for the sick and giving comfort to the dying (Omutah, 2006). These hospitals were established to recognize the value of every person and are guided by their commitment to excellence and leadership. They are generally established on the following objectives: Providing exemplary physical, emotional and spiritual care for each patient and their families, balancing the continued commitment to the care of the poor and those mostly in need with the provision of highly specialized services to a broader community, building a work environment where each person’s value is respected and has opportunity for personal and professional growth and advancing excellence in health services education. That these aforementioned results are not realized in most of the mission hospital has giving impetus to this study.1.2 STATEMENT OF PROBLEM There is a growing concern about the poor management of health institutions by both private and public health care providers in Nigeria. The quality of services provided in these hospitals is so poor that most Nigerians who have the means prefer to be treated abroad and many other poor Nigerians resign to their fate. The Mission hospitals established generally to cover the shortfall or inadequacies in public health care sector are not able to perform to optimum level expected of them. Experience has proved that this gap in performance is basically a management problem. This is sequel to the kind of business policy models that are operative in such health care institutions. Some of these mission hospitals adopt policies that do not improve all round interaction between the employees, management, government and other stakeholders. Some others adopt models that do not promote team spirit, thereby not taking into cognizance that hospital is composite organization made up different professionals from different fields. While other policy models are highly bureaucratic and do not involve workers or employees participation, nor do they empower the employees to take their initiative concerning some minor issues. In such health facilities, there exist gap in communication between the management and the employees. Communication only flows from top to bottom and never from bottom to top thus discouraging a two-way channel of communication both vertically and horizontally. Gap in communication often breeds misconceptions, distrust, rumours and low staff morale that can in turn lead to labour unrest and low work output.The excessive rigidity by top management, often lead to bureaucratic bottleneck. For example, there are delays before supplies (drugs, x-ray materials, laboratory reagents, etc) are provided because requisition passes series of authorities for approval. Patients spend long period of time in the Out Patient Department before they can collect their drugs. Even patients who were brought in under emergency situation are often kept on wheel chairs and stretchers for hours due to routines that are fragmented and performed without element of flexibility. This often leads to patients’ prolonged suffering. Thus, the study focuses on an appraisal of business policy models in the management of mission hospitals in the South East Nigeria.1.3 OBJECTIVES OF THE STUDY The study has the main thrust of critically evaluating business policy models in the management of mission hospitals with a view to achieving the following specific objectives:1.    To ascertain the extent to which the quality of service to patients in the mission hospitals is contingent on having appropriate open system business policy model.2.    To determine the extent to which stakeholder business policy model can improve the sustainability of operations in the management of mission hospitals. 3.    To examine the extent to which open system business policy model can promote competitiveness in the management of mission hospitals. 4.    To examine the relationship between open system business policy model and the management of human resources in the mission hospitals. 5.    To determine the greatest challenge of adopting business policy models in mission hospitals. 6.    To examine the influence of stakeholder business policy model on the supply chain management of mission hospitals. 1.4    RESEARCH QUESTIONS Given the objectives of the study, the following research questions guides the conduct of the study: 1.    To what extent is the quality of service to patients in the mission hospitals contingent on having appropriate open system business policy model? 2.    To what extent can stakeholder business policy model improve the sustainability of operations in the management of mission hospitals?  3.    To what extent can open system business policy model promote competitiveness in the management of mission hospitals? 4.    What is the relationship between open system business policy model and the role  of human resources management in mission hospitals? 5.    What is the greatest challenge of adopting business policy models in mission hospitals? 6.    How does stakeholder business policy model influence the supply chain management of mission hospitals? 1.5     RESEARCH HYPOTHESES The following research hypotheses served as aids in finding answers to the research questions and in fulfilling the objectives of the study. 1, Ho: The quality of service to patients in the mission hospitals is not significantly contingent on having appropriate open business policy model. H1: The quality of service to patients in the mission hospitals is significantly contingent on having appropriate open business policy model.     2, Ho: Stakeholders business policy model cannot significantly improve the sustainability of operations in the management of mission hospitals.      H1: Stakeholders business policy model can significantly improve the sustainability of operations in the management of mission hospitals. 3, Ho: Open system business policy model does not significantly promotes competitiveness in the management of mission hospitals. H1: Open system business policy model significantly promotes competitiveness in the management of mission hospitals.4, Ho: There is no significant relationship between open business policy models and human resource management in the mission hospitals. H1: There is significant relationship between open business policy models and human resource management in the mission hospitals.5, Ho:  Environmental turbulence and uncertainties do not significant constitute challenge to the adoption of business policy models in mission hospitals.H1 Environmental turbulence and uncertainties significant constitute challenge to the adoption of business policy models in mission hospitals.6, Ho:   Stakeholders’ business policy model does not impact positively on the supply chain management of mission hospitals. H1: Stakeholders’ business policy model does  impact positively on the supply chain management of mission hospitals.1.6     SIGNIFICANCE OF THE STUDY This study will be of immense significance to the stakeholders in the health sector such as the proprietors (legal owners), the government, the (patients), the workers, and scholars.Proprietors (Legal Owners): Through the results of this study they will come to realize that for there to be effectiveness and efficiency in the running of these mission health care facilities, they are expected to be more actively involved in the formulation, implementation and execution of business policy models.The Government: The findings of this study will  assist government at all levels in the area of formulating  policies  that will create an enabling environment for the country’s health sector, and also the study will lead the government into thinking of public- private partnership in the health sector.The Hospital Employees: The outcome of this work will bring about synergism among the different department of the hospital, thus increasing team spirit in the work place.The patients: The findings of this study will be of high benefit to the patients since the reason for the evaluation of the business policy models is to bring about improved quality of service to the patients. The Scholar: The study will serve as reference point to any future researcher and in addition add credence to existing literature. 1.7    SCOPE OF THE STUDY The study concentrates on evaluation of business policy models in the management of mission hospitals in the South East Nigeria. Open system and stakeholders business policies were used in evaluating the quality of service, sustainability of operations, competiveness, the human resource, the supply chain and the challenges of adopting these models in the management of mission hospitals. Twenty –seven (27) mission hospitals in the southeast of Nigeria were selected for the study. The study recognizes the cultural and religious similarities in this region hence whatever applies to the mission hospitals in these two states will to large extent be applicable to the other states within the geo-political zone (Eze, 2000) .The study was therefore limited to Five (5) hospitals in Enugu, twenty (20) hospitals in Anambra, one (1) hospital in Imo state and One (1) hospital in Abia state.The study was carried out within the period of three years from 2008-2011.1.8    LIMITATIONS OF THE STUDYIn the process of conducting the research, the researcher was impeded by some constraints such as:Finance- This was a major constraint as sourcing for some vital information from some mission hospitals requires a lot of money. The researcher has not got enough money to carry out an in-depth study.Time Constraints- It was the original intention of the researcher to do a study of the mission hospitals in the whole states of the Southern Nigeria but time constraint constituted a big challenge that necessitated the restriction of the study to South East geopolitical zone of Nigeria. Hence some of the places where data and relevant information could have been obtained were not visited.Attitude of the Respondents - privacy of information and attitude of respondents were also big constraints. Most of the hospitals staff and management members were reluctant at releasing the required information as a result of prejudiced opinion conceived about the study.1.9      PROFILE OF THE SELECTED MISSION HOSPITALS UNDERSTUDYAnnunciation Specialist Hospital Emene, Enugu State Annunciation Specialist Hospital is a mission hospital, a project owned and managed by the Daughters of Divine Love (DDL) Congregation. Encouraged and supported by the Deutschorden Order in Germany, through their Hospital project – Deutschorden Hospital Work (DOH). It is the magnanimity and benefaction of this Religious Order that gave life to the idealism of Annunciation Specialist Hospital. Annunciation Specialist Hospital Emene-Enugu was officially opened  on the 9th day of February, 1988, with a capacity of 100 beds, 2 theaters, modern analytic Laboratory, E. C. G.; Ultra/Sound, Gastroscopy and X – ray. Mission To share in the healing ministry of Jesus Christ through the provision of health services that are based on a holistic approach and that affirms the dignity of the people we serve. Mother of Christ Specialist Hospital, Enugu StateThe Mother of Christ Specialist Hospital, Ogui, Enugu, was founded in 1958 as a maternity home.  Then in 1971, after the Nigerian civil war, the health facility metamorphosed into a hospital, rendering various health services more especially with respect to some of the victims of the civil war, which was so devastating.  This hospital with a vision of reducing maternal mortality and morbidity was upgraded to a 102 bedded specialist hospital in 1995.  This widely acknowledged baby friendly health institution is under the management of Immaculate Heart Sisters (IHS) congregation. St. Theresa’s Hospital and Maternity, Abakpa Nike, Enugu StateSt. Theresa’s Hospital and Maternity, Abakpa Nike, Enugu, is a Catholic health institution for the prevention, care and treatment of ailments.  It is under the auspices of Enugu ‘Catholic Diocesan Health Management Board and directly overseen by a six man management committee.  The hospital/maternity which was registered as a maternity/hospital with fifteen (15) beds under section 19 of Enugu state health institutions Edict of 1988; with registration number MH/M: PHI/814 on the 6th day of July, 1999, now has a capacity of thirty (30) beds of which twenty-three (23) are present. Ntasi Obi Ndi No N’Afufu Hospital, Trans-Ekulu, Enugu State Ntasi Obi Ndi No N’Afufu hospital is a non-governmental health institution owned by the catholic Diocese of Enugu.  It provides health care services and assistance to the inhabitants of Enugu and its environs in particular, and the larger society in general.  The hospital which was officially opened and blessed on the 6th day of January, 1995, by His Lordship Most Rev.Dr. Michael U. Eneja of blessed memory, the then Bishop of Catholic diocese of Enugu, however, commenced full operations on the 1st day of March, 1995.  On 8th May, 1996, the health institution was registered as a one hundred (100) bedded hospital with the Enugu state Ministry of health.  The hospital is supervised by a management board appointed by the Local ordinary (the Catholic Bishop of Enugu Diocese).Bishop Shanahan Hospital Nsukka, Enugu State Bishop Shanahan Hospital Nsukka is a private Catholic mission hospital built by His Grace Most Rev. Dr. Charles Heerey C.S.S.P of blessed memory.  It first operated as a maternity home from 1930 to 1948.  In 1949, it was upgraded to a full – fledged hospital by the then Eastern Region Ministry of Health. It was then called St. Theresa’s Maternity Hospital.  The Hospital was registered with 150 beds. In 1952, the School of Midwifery was opened for the training of Grade II midwives. The hospital continued growing in size and in service.  In 1962, the School of Nursing was opened for the training of Nigeria Registered Nurses.  With continued progress, the hospital was inspected again by the Midwifery Board of Nigeria and the School of Midwifery was upgraded to Grade I Midwifery School in 1964.  Unfortunately, facilities of both training schools and hospital were damaged during the civil war (1967-1970) but were rehabilitated in 1970.  The rehabilitation was carried out by the Diocese with the help of the Caritas and Misereor organization.  On February 23rd 1979, the school of Midwifery was inspected by the Midwifery council of Nigeria for suitability as an examination centre and was approved in April 1979 as an examination centre for the then Anambra State.After the war, the hospital fell into the management of the Sisters of Immaculate Heart Congregation until 1983. A generation of Doctors, Seminarians and Administrators managed the hospital from 1983 to 1988.  The hospital has been under the management of Sisters of the Daughters of Divine Love Congregation from 1988 to 2000. From 2000, the management came under the Rev. Fathers with Rev. Fr Bernard Eze as the present hospital administrator since 2003. In addition to the existing schools of the hospital, a third school – School of Medical Laboratory/Assistant Technicians was established in 2001 to train Medical Laboratory Technicians/ Assistants. Hospital Motto: Your health is our concern.  St. Charles Borromeo Hospital Onitsha, Anambra StateArchbishop Charles Heerey had always believed that the physical health of man must be pursued along the salvation of the soul.   He had a vision for a big healthcare facility for the protection and promotion of human health, relief for the suffering and improvement of the quality. Few years after he started the Holy Rosary Hospital Waterside, Onitsha the project for the major Archdiocesan Hospital, St. Charles Borromeo Hospital, where people can get the best treatment medical science and staff can give started. Rev. Fr. Godfrey Okoye led the negotiation for the site of the hospital.  The project was jointly financed by the catholic Archdiocese of Onitsha, Cardinal Montini (later Pope Paul VI) and Misereor Germany. The construction of the hospital was completed in a record time and was blessed on the evening of June 5, 1964 and officially opened by January 1965. Chief B. C. Okwu, who was the then minister for Health, Commissioned the hospital.  The hospital is registered with the ministry of health and other relevant government authorities.  The administration of the hospital was then entrusted to the Holy Rosary Sisters.  The first matron to the Hospital was Sr. Auscillia. She worked from 1964 to 1967.  A few years after the opening of St. Charles Borromeo Hospital, the Civil War broke out.  The hospital buildings and infrastructures suffered severe war damages. Soon after the civil war, Archbishop Francis Arinze (now Cardinal) reconstructed the hospital to meet the dire need of the war turn and ravaged people of Igboland. He was able to get it reopened again in 1970.  The administration was then handed over to the Immaculate Heart Sisters.  The first post war matrons were: Sr. M. Chrysostom Okoye and Sr. M. Bide Njoku (1970-1983). The hospital was re-registered in 1984. Mission: sympathy to the sick and the needy through Medicare and general health care delivery. Immaculate Heart Hospital Nkpor, Anambra StateThis hospital was established by the Immaculate Heart Sisters Congregation in 1989. It started as 8 bedded maternity home at Nkpor, Idemili North L.G.A. Anambra State. Presently it has grown to a 54 bedded hospital and offers 24hrs healthcare services. In 1990, it was officially approved by the Anambra State Ministry of health. Sr. Mary Emmanuel Ezeasor was the first matron and Sr. Dr. Virgie Onyeador was the first medical doctor to the hospital. The hospital is housed in a two storey building which is the main block and three other bungalows.  The hospital blocks consist of the following sections: 2 theaters (main and minor theatres), labour ward, 4 private room wards, general ward, emergency room, 4 consulting rooms, pharmacy department, 2 palpation rooms, 3 administrative offices and a school of medical laboratory technicians attached to the hospital. The hospital offer the following 24 hours services: Obstetrics/Gynecology, Surgery, Dental, Internal Medicine, Physiotherapy, X – Ray, Sonography, Child immunization Services, HIV/AIDS counseling and testing, etc. Fatima Catholic Hospital Awka –Etiti, Anambra StateFatima Catholic Hospital Awka-Etiti was the brain child of His Grace Francis Arinze (now cardinal); the idea to build this hospital came up after the catholic community has successfully completed the building of St. Joseph Catholic Church Awka-Etiti.  It was out of real necessity to provide healthcare to Awka-Etiti indigenes. The construction of Fatima Catholic Hospital started in the year 1981 by the very enterprising and good people of Awka-Etiti Catholic community.  The goal was to provide health care delivery close to the Awka – Etiti people. In a period of three years, the gigantic edifice of the 122 beds hospital equipped with modern facilities was completed.  The Awka-Etiti Catholic Community thereafter handed over the property and its management completely to the Catholic Archdiocese of Onitsha.  This was done with a view to maintain quality healthcare services and efficient management for which the church is known. His Grace, Francis Arinze in December 1982, requested the Immaculate Heart Sisters to take over the administration of this hospital and Sr. M. Consolata Anyacho was its first matron.  The hospital was officially open in 1983 and Dr. George from Borromeo Hospital Onitsha conducted the first clinic.  In 1984, it was registered with the ministry of Health, Anambra State. Holy Rosary Specialist Hospital and Maternity Waterside, Onitsha, Anambra StateThe history of the Holy Rosary Specialist Hospital and Maternity started in the mid thirties, with Bishop Charles Heerey.  To this end, a small hut located behind the present hospital laundry was used as a dispensary for the sick within and around Onitsha metropolis. With the maternity dispensary established, pregnant mothers need not travel from Onitsha to Emekuku to deliver their babies to ensure their physical and spiritual safety. The Holy Rosary Maternity unit started in 1941 at Amaobi junction, between Emejulu Street and Mission Road, Onitsha at Mr. Amaobi’s house.   The building used for the maternity was rented to the sisters.  The maternity was started with eight beds in the main ward, a private room of two beds and one room for the nurses.  The first matron of the hospital was one of the Holy Rosary Sisters, Sr. Mary Imelda. In 1942, the patients flow to the maternity home increased very rapidly and immensely. The available accommodation was no longer enough to take the increasing patient flow and the staff. The health care provided was hampered by the insufficient available structures and space in which it was carried out.  Coincidentally, the Holy Rosary College then at the waterside was moved to Ihiala.  The maternity unit was quickly moved from the existing Amaobi junction to the present site-waterside. Sr. Mary continued to lead the management of the hospital with the assistance of the first indigenous nurse, Mrs. Anastasia Ebosie (Nee Iwegbu), who was transferred from Eke. When the Nigeria civil war ended in 1970, the Holy Rosary Sisters who were the expatriate sisters were compelled by the Federal Government to leave the country-a very sad and tragic event in the Nigerian history indeed.  Consequently, the then Archbishop of Onitsha, His Grace, Most Rev. Dr. Francis Arinze (now Francis Cardinal Arinze) the proprietor of the hospital, appointed the Immaculate Heart Sisters (Indigenous Sisters) to manage the hospital.  He also established the Board of Governors for the hospital.  The hospital has continued to grow to maintain a pride of place in healthcare delivery especially in antenatal/maternal care and child welfare services in the state.  The hospital, which initially started as 8 bedded maternity home, is today 150 bedded specialist hospital.  Mission Clinic and Maternity Aguleri, Anambra StateThe Archdiocese of Onitsha established this Mission Clinic and Maternity Home Aguleri about the 1950’s as an outreach of the Holy Rosary Hospital Waterside, Onitsha.  The Holy Rosary Sisters, who organize routine weekly clinics to the facility, then managed it.  The goal was to reach the rural communities of Aguleri and its environs with basic health care services. In about 1961, the Immaculate Heart Sisters took over the work.   Star of the Sea Maternity Home Umueze-Anam, Anambra StateThe Star of the Sea Maternity Home, Umueze-Anam is a health institution built by the kind efforts of the people of Umueze-Anam Community, to serve the health needs of its people and its environs.The entire Umueze-Anam Community including their Igwe  then John Chukwuemeka and especially the Ojongo Age Grade and eight VIP signatories and elders of the town, for the betterment of health care deliver in their community, and for more effective administration, control and management of the health institution, as well as for sundry, other benefits for the town, and all persons therein, decided to handover completely to the Catholic Church Authority of Archdiocese  of  Onitsha the completed Health Centre Oda, Umueze-Anam on April 24, 1983, under the leadership of His Grace, Most Rev. Dr. Francis Arinze (now Cardinal), the then Archbishop of Onitsha through their Parish Priest (then), the Rev. Fr. Anastasius   Chikwendu Akpunonu. Presentation Maternity Home Okpoko, Anambra State The presentation Maternity Home, Okpoko is part of the Archdiocesan health services commitment to rural health care delivery.  It was established officially on October 29, 1981, under the Catholic Archdiocese of Onitsha, and managed by Rev. Sr. Vianney Okereke (IHM). The facility was commissioned by Dr. George C. Okafor- the then commissioner for Health in the Old Anambra State. It was registered as 8 bedded maternity home and was then the only reasonable health facility in the rural Okpoko slums of Onitsha metropolis, but in Ogbaru L.G.A. The management of Holy Rosary Specialist Hospital Onitsha administered the facility.  Although the maternity home has 2 resident nurses/midwives, 2 auxiliary nurses, 2 assistant pharmacists, and a security man, it is still served by doctors and nurses from the Holy Rosary Hospital who visits the maternity twice in a week for clinics and consultations. St. Theresa’s Hospital Abatete, Anambra StateThis clinic at Nsukwu Abatete came to be in 2003, through the effort of a Catholic Priest in the Onitsha Archdiocese Rev. Fr. Benedict Onwudinjo.  The health centre presently has no resident doctor and is administered from Holy Rosary Specialist Hospital and Maternity, Onitsha. Doctors and nurses from this hospital supply services and drugs to the centre on weekly basis. Immaculate Heart Maternity Home Abor Umuoji, Anambra State This Health facility was built in 1967 at Abor in Mgbago near St. Francis Catholic Church Umuoji.  The maternity home was built on a very large area of land given to the Catholic Archdiocese of Onitsha.  The management and services were supplied from the Holy Rosary Hospital and Maternity Waterside, Onitsha.  Its main objective is to help pregnant mothers deliver their babies safely and to provide children welfare and immunization to the new born babies. Immaculate Heart maternity home is a maternity ward of 12 beds; with consultation rooms, labour ward, delivery room and post natal facilities.  St. Martins Hospital Ugwuagba-Obosi, Anambra StateSt. Martins Hospital started in 1998 in an 8 room’s bungalow on a piece of land donated to the Archdiocese of Onitsha by Mr. Martin Anubunwa through the effort of Rev. Fr. Theo Odukwe. The hospital is located at Ugwuagba Obosi, a suburb of Onitsha metropolis Anambra State. The Ugwuagba area is a thickly populated suburb of Onitsha city. St. Martins hospital is envisioned to serve the huge population in the area.  It is located in a very serene environment and is almost a midway in between, such that it is conveniently accessible both from the Northward and Southward of Ugwuagba area. Over 70% of the population living in the area are low-income earners and/or without regular income.  Because of the high cost and other difficulties of going to hosp

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