Public Service Reform and Healthcare Service Delivery in Developing Economies: Experience from North Central, Nigeria
Keywords:
Public Service, Governance, Public Institutions, Public Accountability, Corruption, PerformanceAbstract
Public service reforms have been widely implemented in developing economies to strengthen governance, improve institutional efficiency and enhance healthcare service delivery. However, evidence of their effectiveness remains limited in resource-constrained settings such as Nigeria. This study examined the influence of public service reform on healthcare service delivery in North Central Nigeria as an experience from a developing economy. A cross-sectional analytical survey was conducted among 684 healthcare professionals, health administrators and healthcare users selected through multistage sampling. Data were collected using a structured questionnaire (Cronbach's α = 0.91) and analysed using descriptive statistics, Pearson correlation, multiple linear regression and Structural Equation Modelling (SEM) at a 5% significance level. Public service reforms were implemented to a moderate-to-high extent (mean = 3.78–3.92), while healthcare service delivery recorded a mean score of 3.95 ± 0.63. All reform dimensions showed significant positive correlations with healthcare service delivery (r = 0.587–0.654; p < .001). Public service reforms jointly explained 61.8% of the variation in healthcare service delivery (Adjusted R² = 0.618; F = 229.84; p < .001), with accountability and transparency (β = 0.257) and administrative reforms (β = 0.238) identified as the strongest predictors. SEM further confirmed a significant positive effect of public service reform on healthcare service delivery (β = 0.642; p < .001). Strengthening governance, accountability, workforce capacity, financial management and digital transformation is essential for improving healthcare service delivery and health system performance in developing economies.
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Copyright (c) 2026 Walliyy Olakunle Sarumi, Adepeju Latifat Sarumi, Godwin John, Aishat Attahiru
This work is licensed under a Creative Commons Attribution 4.0 International License.
This work is licensed under a Creative Commons Attribution 4.0 International License (CC BY 4.0). You are free to share and adapt the material, provided proper credit is given.
