Internally generated revenue and perceived performance of public healthcare institutions in Edo state, Nigeria: a cross-sectional analytical study

Dominic Ativie; Enyinna Okpara; Patrick Ohikhena; Andrew Obi; Deborah Temitope Akintayo; Susan Chioma Udeh; Onosetale Sarah Ativie; Yabo Abusa; Olasehinde Stellamaris; Olufunso Victor Akinlolu-Ojo; Ofoegbu Okechukwu Uche

doi:10.18203/issn.2454-2156.IntJSciRep20261488

Authors

Dominic Ativie Department of Business Administration, College of Social and Management Sciences, School of Postgraduate Studies, Wellspring University, Edo State, Nigeria
Enyinna Okpara Department of Business Administration, College of Social and Management Sciences, School of Postgraduate Studies, Wellspring University, Edo State, Nigeria
Patrick Ohikhena Department of Business Administration, College of Social and Management Sciences, School of Postgraduate Studies, Wellspring University, Edo State, Nigeria
Andrew Obi Public Health and Community Medicine, University of Benin, Benin City, Nigeria
Deborah Temitope Akintayo Hull University Teaching Hospitals NHS Trust, City: Kingston Upon Hull, United Kingdom
Susan Chioma Udeh Godfrey Okoye University Teaching Hospital, Enugu, Nigeria
Onosetale Sarah Ativie Department of Zoology, Ambrose Alli University Ekpoma, Nigeria
Yabo Abusa Department of Accounting, School of Postgraduate Studies, Nasarawa State University, Keffi, Nigeria
Olasehinde Stellamaris Fortis College and Institute Wayne. New Jersey, United States
Olufunso Victor Akinlolu-Ojo Department of Business Administration, College of Social and Management Sciences, School of Postgraduate Studies, Wellspring University, Edo State, Nigeria
Ofoegbu Okechukwu Uche Department of Obstetrics and Gynecology, Aviation Medical Clinics, Lagos State, Nigeria

DOI:

https://doi.org/10.18203/issn.2454-2156.IntJSciRep20261488

Keywords:

Internally generated revenue, Healthcare performance, Public hospitals, Health financing, Nigeria

Abstract

Background: In Nigeria, sustained constraints in federal health funding have increased public hospitals' dependence on internally generated revenue (IGR). Despite its growing importance, evidence on the link between IGR and healthcare institutional performance at the subnational level remains limited. This study examined the association between IGR and the perceived performance of public healthcare institutions in Edo State, Nigeria.

Methods: A cross-sectional analytical design was employed. Data were collected from July to November 2025. Structured questionnaires were administered to 150 purposively selected administrative, financial, and clinical staff across four public hospitals in Edo State. A total of 120 valid responses were analysed. Reliability testing showed acceptable internal consistency (Cronbach's alpha≥0.76). Data were analysed using descriptive statistics, Pearson correlation, and simple linear regression in IBM SPSS version 26.

Results: Respondents reported high perceptions of IGR functionality and institutional performance. IGR showed a strong positive association with healthcare performance (r=0.742, p<0.001) and significantly predicted performance, explaining 55.1% of the variance. Major challenges identified included weak accountability, limited autonomy, and inadequate monitoring.

Conclusions: IGR is strongly associated with improved perceived performance of public healthcare institutions in Edo State, highlighting the need for stronger governance mechanisms.

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