This technical brief looks at the work of the Partnership for Transforming Health Systems Programme (PATHS 1) to develop a planned preventive maintenance (PPM) culture in the Nigerian state of Enugu. The public health sector in Nigeria is characterised by poorly maintained facility infrastructure and it is common to find vital equipment in a state of disrepair. This greatly affects the quality of service delivery and undermines clients’ trust in services. PPM enables infrastructure, equipment and vehicles to be kept in as healthy a state of repair as possible through instruction regarding best practise of use, planned monitoring, regular maintenance to prevent breakdowns, and speedy repair to prevent unnecessary deterioration and decay.
This brief describes how the planned preventive maintenance system worked in Enugu, the training given to PPM staff, the steps taken to recategorise and redeploy staff to improve PPM coverage, and the linkages between the PPM system and routine integrated supportive supervision. It looks at some of the tangible benefits resulting from the introduction of PPM in Enugu, including the successful introduction of equipment asset registers and improvements in minor equipment maintenance at health facilities. The initiative also increased awareness among health service managers of the state of facility infrastructure. The brief highlights some of the challenges associated with shifting from a reactive to a proactive and carefully planned PPM approach, the funding implications, and the urgent need to establish additional training schools for planned preventive maintenance staff throughout Nigeria.