PHARMACY SERVICES, WATER, SANITATION AND PHYSICAL AMENITIES: CAREGIVERS’ PERSPECTIVES FROM A TERTIARY HOSPITAL IN NIGERIA

Abstract

Assessing satisfaction is essential for improving hospital service delivery, particularly Good Pharmacy Practice and the care environment, including water, sanitation, and basic amenities, is now recognized as core to health system performance. In Nigeria, routine satisfaction surveys are uncommon despite SERVICOM, and family caregivers who commonly support inpatient care and can judge services are infrequently surveyed. This study assessed caregivers’ perspectives on pharmacy services and selected amenities at Irrua Specialist Teaching Hospital (ISTH). Irrua Specialist Teaching Hospital (ISTH) is a 435-bed federal tertiary facility in Edo State. A three-month cross-sectional descriptive survey (March–May 2025) was conducted among caregivers of inpatients in female medical, male medical, and paediatric wards who had used hospital services for at least 48 hours and consented. Using interviewer-administered structured questionnaires, 151 caregivers were recruited through proportionate ward allocation and random selection; amenity items (kitchen, lighting, water, toilet) showed good reliability (Cronbach’s alpha=0.85). Analyses (descriptive statistics, chi-square, and forward stepwise multivariable logistic regression) showed caregivers’ mean age was 39.7±12.7 years; 74.8% were female and 45.0% had tertiary education. Patients’ ages ranged from <1 to 95 years (median 38; IQR 6–64), 29.8% were ≥60 years, median admission duration was 10.5 days (IQR 5–18), and 53.8% were admitted for NCDs. Pharmacy staff care was satisfactory for 68.2%, but obtaining medicines was often difficult due to perceived drug unavailability and higher hospital pharmacy costs. Satisfaction differed by illness type (p=0.016); NCD admission predicted dissatisfaction versus infectious disease (aOR 3.75, 95%CI 1.54–9.08), while caregiver age 40–59 years reduced odds versus 18–39 years (aOR 0.32, 95%CI 0.13–0.75); model p<0.001. Lighting rated highest; water, kitchen, and toilets lowest. Strengthening medicine supply systems and addressing WASH and support services are actionable priorities to improve caregiver-perceived quality and patient-centred inpatient care in under-resourced settings.