International Journal of Perceptions in Public Health

Volume 1, Issue 1, December 2016, P 50-58

ISSN 2399-8164 www.ijpph.org

Research Article Open Access

Assessment of Fire Safety Preparedness in Selected Health

Institutions in Niger State
Ahmed Abdulsalam1, Russell Kabir2, S.M. Yasir Arafat3
1
Senior Medical Officer, Niger State Primary Health Care Development Agency, Minna, Nigeria
2
Senior Lecturer, Department for Allied and Public Health, Anglia Ruskin University, Chelmsford,
Essex, UK
3
Resident, Department of Psychiatry, Bangabandhu Sheikh Mujib Medical University, Dhaka,
Bangladesh

*Corresponding author: Dr. Ahmed Abdulsalam, Senior Medical Officer, Niger State Primary Health Care
Development Agency, Minna, Nigeria, Email: yatalaa@gmail.com

Citation: Abdulsalam, A., Kabir, R. and Arafat, S.M.Y (2016). Assessment of fire safety preparedness in selected
health institutions in Niger State. International Journal of Perceptions in Public Health, 1(1):50-58.

Copyright © 2016 Abdulsalam et al. This is an open access article distributed under the Creative Commons
Attribution License, which permits unrestricted use, distribution and reproduction in any medium, provided the
original work is properly cited.

Received Date: November 7, 2016 Accepted Date: November 30, 2016 Published Date: December 20, 2016

Abstract

Fire is one essential goods for human beings, but it becomes a danger when it occurs where it
is not needed. The damage caused by fire disaster reflects in many ways, and the impacts can
be as complex as the economy itself. The paper aimed at assessing fire safety preparedness in
some selected health institutions in Niger State. A structured pretested questionnaire was
administered on a cross-section of 15 hospitals which cut across government, private, specialist
and primary health care. The result revealed that the level of fire emergency safety
preparedness in the health institution in Niger is low especially among the primary and
secondary healthcare facilities. From the findings, it was revealed that the mitigation and
prevention of fire were not a priority in most of the health institutions.

Key words: Fire safety, Health, Preparedness, Nigeria

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International Journal of Perceptions in Public Health
Volume 1, Issue 1, December 2016, P 50-58
ISSN 2399-8164 www.ijpph.org

Introduction

A disaster may be natural or human-made incident that causes destruction that cannot be
relieved without assistance. The damage caused by fire disaster reflects in many ways, and the
impacts can be as complex as the economy itself. (Bartelmus, 2002). Disaster is also defined
as a phenomenon that produces large-scale disruption of societal infrastructure and the normal
healthcare system, that presents immediate threat to public health, and requires external
assistance for response (Bradt and Drummond, 2007). As population increases, fire occurrence
increases in various forms which seem to be inseparable from man’s carelessness such as illegal
electrical connections, domestic use of fire and storing of fuel at home amongst others. These
results into outrageous fire disaster causing a significant pain, loss of lives and property, stress,
the wreckage of social and family ties with the environment. According to Rowland et al.,
(2007) there are four major problems associated with fire disasters that retard or impede
development namely; (I). Loss of resources (II) Interruption of programmes and switching
from crucial resources to other, shorter-term calamities (111) Disruption of the non-formal
sector and (1V). The adverse impacts on investment climate.

According to hospital involvement, disasters may be classified as internal disasters that

occur inside the health care facility or external disasters that occur outside the health care
facility (Iserson, Holdnack & Feldman, 2008). Burger ( 2007) pointed out that Health
institutions are well prepared for external hazards that can cause a surge in patients but an
internal risk such as fire is more disruptive and puts an increased amount of stress in the facility
due to the need to maintain the safety of the patients, visitors, and staffs. Recent events have
brought disaster medicine into the public focus, both the government and communities expect
hospitals to be prepared to cope with all types of emergencies (Bartley et al., 2006). This is
essential because Hospitals and clinics are institutions composed of various people ranging
from doctors, nurses and cleaners that are usually familiar with the system and patients and
visitors who are unfamiliar with the layout of the building and steps to take in case of a fire.
Within these facilities are the elderly and very young; they may have acuity or a combination
of these handicaps; they may be in intensive or post-operative care, or under the influence of
medication (Wilkinson & Pickett, 2006). Similarly, the health institutions are usually made up
of various departments and unit which include laboratory, pharmacy, maternity, accident and
emergency unit, intensive unit (ICU), pediatrics, medicine, and surgery department. All these
departments above and units depend on hospital machines, apparatus, and various devices to
enhance human health and to prevent the occurrence of any hazard or ailment that may
endanger human health. Furthermore, different hospital units and department do encounter fire
accident as a result of negligence or accident from daily usage of machines which eventually
claim lives and property worth million and possible billions of naira (Bradt & Drummond,
2007).

Recent natural disasters have highlighted the poor preparedness and infrastructure in place
to respond to mass causality events. In response, public health policy makers and emergency
planners developed plans and prepared emergency response systems (Chokshi, Behar, Nager,
Dorey, & Upperman, 2007). Similarly, all agencies now recognize that a response to any
emergency requires an interagency, interdisciplinary response, and that nearly all emergencies
have potential health consequences (Gebbie & Qureshi, 2006; Qureshi, Liu & Vogel, 2005)
Contemporary events all over the world have raised awareness of mass causality events and
the need for a capable disaster response. Schwab-Stone et al(1999), opined that well-designed

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International Journal of Perceptions in Public Health
Volume 1, Issue 1, December 2016, P 50-58
ISSN 2399-8164 www.ijpph.org

public education program can build the necessary attitudes to create a belief that preparedness
is important. Overtime, attitude can be shaped without extraordinary cost to individuals.

The negative consequences of fire disaster are enormous and tremendous based on this;
there is a need to curb the occurrence of fire disaster in our societies. There is a need to have a
better understanding of the nexus between fire outbreak and factors that predispose the society
to fire outbreaks. It is equally necessary to ensure better preparation for, as well as rapid and
well-coordinated response to complex fire outbreaks. Fire safety is of optimum importance to
everybody, and it demands a concerted effort towards attaining the status of a fire safe
environment. Many of the hospitals do not take fire awareness and preparedness as part of their
organization plan, they do not have fire preparedness policy, they neglect fire simulation. This
research is highly important because it is aimed at evolving scenarios that health institution
will be safe from fire outbreaks. Researchers have not been looking at the level of disaster
preparedness in healthcare facilities in our locality therefore there is a need to examine and
evaluate the nexus amongst all the intricate factors responsible for fire and safety preparedness.
On these terms, this research takes form in studying fire preparedness in health institutions in
Niger state.

Methods

This study is a cross-sectional descriptive study carried out at Niger state in the north central
geopolitical zone of Nigeria. The study is primary quantitative and personal observation. The
primary data was collected using pre-validated self-administered questionnaire. Additionally,
the researcher went around the selected health institution to observe the accessibility of the
hospitals, availability of fire escape in the premises, signage and fire extinguishing equipment
adequacy and function were checked. Convenient non-probability sampling technique was
used to select cross-section of 15 hospitals which cut across government, private, specialist and
primary health care. Simple percentage tabulation procedure analysed with microsoft excel
software. And personal observation were reported.

Convenient non-probability sampling technique was used to select 15 hospitals which cut
across government, private, specialist and primary health care. This provides fair representation
of all levels of health facility. Federal Medical Centre Bida, IBB Specialist Hospital Minna
which represented the federal and state own tertiary health institutions respectively were
selected for the study. The secondary health facilities chosen for the study were General
Hospital Minna, Umaru Sanda general Hospital Bida, General Hospitals in Suleja and Mokwa.
Whereas the remaining hospitals to complete the list were primary health institution that is a
mixture of private hospitals and primary health care and they include Bay Clinic Hospital
Minna, Top Medical Hospital Minna, Unity clinic hospital, Standard hospital, Mustapha
specialist hospital Minna, Savannah hospital Minna, Faith Clinic, PHC Old Airport Road, PHC
B Kpakungun all in Minna. Only 2 PHC were selected because most of the PHC are replicated
structures across the state.

Results and discussion

Table 1 shows that 13.3% of the selected hospitals render tertiary health care services, 33.3%
render secondary healthcare service, and 53.3% render primary healthcare services which
make up the majority. Table 1 also shows that 53.3% of the selected health facilities are
owned by the government while 46.7% are private owned health facilities.

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International Journal of Perceptions in Public Health
Volume 1, Issue 1, December 2016, P 50-58
ISSN 2399-8164 www.ijpph.org

Table 1. Characteristics of health facility (n=15)

Frequency Percentage
Type of healthcare rendered
Tertiary 2 13.3
Secondary 4 33.3
Primary 9 53.3

Hospital ownership
Government 8 53.3
Private 7 46.7

Table 2 reveals that only 26.7% of the health facilities have a schedule for fire safety
drills/training for the staff, organize fire safety drills/training once a year, have Health
Institution Fire Disaster Management Plan, and made available the copies of the fire safety
evacuation plan to their employees. In 26.7% of the selected hospital, external professional is
responsible for fire Risk Assessment Exercise. In 6.7% of the selected hospital internal
professional are responsible for fire risk assessment while 66.6% of them have no any form of
arrangement.
Table 2. Fire safety evaluations (n = 15)

Categories Frequency Percentage

Hospital Schedule for Fire Safety Drills/Training
Yes 4 26.7
No 11 73.3
Time Interval for the Fire Safety Drills/Training
Once a Year 4 26.7
Twice a year 0 0
Thrice a year 0 0
Once in 2 years 0 0
Not at all 11 73.3
Health Institution Fire Disaster Management Plan
Yes 4 26.7
No 11 73.3
In progress 0 0
Copies of the Fire Safety Evacuation Availability to Employees
Yes 4 26.7
No 11 73.3
Body/Unit Responsible for Fire Risk Assessment Exercise in
your Organization
Trained in-House Staff 1 6.7
External Professional 4 26.7
No any form of arrangement 10 66.6
Inspection schedule for the equipment available.
Weekly 1 6.7
Monthly 2 13.3
Yearly 5 33.3
Others 7 46.7

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International Journal of Perceptions in Public Health
Volume 1, Issue 1, December 2016, P 50-58
ISSN 2399-8164 www.ijpph.org

Figure 1 shows that 20% of the health facility has fire alarms installed, about 93.3% has fire
extinguisher, 40% has emergency exists and signs, 46.7% has first aid box, only 13.3% has
sand buckets in place, and none of the hospitals have smoke detector, emergency lighting,
sprinkler system, hose reel, floor plans and others. Findings from table 2 shows that only one
(6.7%) of the selected hospital inspect their firefighting equipment weekly, whereas 13.3% and
33.3% inspect them monthly and yearly respectively.

Figure 1. Fire Prevention/Fighting Equipment Available

93.30%
100%
90%
80%
70%
Percentage  %

60% 46.70%
50% 40%
40%
30% 20%
13.30%
20%
10%
0%

Equipment

Table 3 reveals that only 26.7% of the hospitals have insurance cover for their premises and
lives, and about 73.3% has no insurance/assurance covers for property/lives. Table 3 shows
that 2 hospitals representing 13.3% have property insurance cover for their assets, 2 hospitals
representing 13.3% have both property insurance and life assurance policy cover will over
73.3% have none.

Table 3. Insurance cover (n= 15)

Categories Frequency Percentage

Insurance/Assurance cover for premises and lives against fire
Yes 4 26.7
No 11 63.3
Type Insurance/Assurance cover for premises and lives against fire
Property insurance 2 13.3
Life insurance -
Both property/life 2 13.3
None 11 73.3

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Volume 1, Issue 1, December 2016, P 50-58
ISSN 2399-8164 www.ijpph.org

Table 4 reveals that staffs of 73.3% of the hospitals have the knowledge of the use of the
available fire extinguishers and staffs of about 26.7% of the hospitals have no ideas on how to
use the fire extinguishers. The analysis in Table 4 shows that staffs of the largest percentage of
the sample hospitals use the fire extinguishers without real knowledge of the various methods
or directions of using the equipment while only 13.3% know what they do while using the
equipment. Table 4 shows that about 46.7% of the hospitals have the fire service emergency
line while 53.3% of the hospitals do not have the fire service emergency line. From the analysis
in Table 4 it is revealed that only 13.3% of the hospitals have been certified by fire service for
meeting fire safety standards while over 86.7% of the hospitals have not been certified. From
the analysis in Table 4 it is revealed that only 13.3% of the hospitals have been certified by fire
service for meeting fire safety standards while over 86.7% of the hospitals have not been
certified.

Table 4. Current Practice and the Best Practice

Categories Frequency Percentage

Knowledge of the use of fire extinguisher
Yes 11 73.3
No 4 26.7
Simple direction for using a fire extinguisher
P.A.S.S 2 13.3
A.P.S.S - -
S.S.P.A - -
S.S.A.P - -
(P.A.S.S means Pull, Aim, Squeeze, and Sweep)
Fire service emergency line knowledge.
Yes 7 46.7
No 8 53.3
Fire safety certification
Yes 2 13.3
No 13 86.7
Fire safety certification of your organization by fire service for
meeting safety standards
Yes 2 13.3
No 13 86.7
Responses to any workplace fire emergency within your hospital
within the last five years
Yes 2 13.3
No 13 86.7

Health Institutions Level of Preparedness to Fire Emergency

Figure 2 shows that analysis of the level of preparedness of the health institutions visited
during this research. The analysis shows that 33.3% of the health institutions are in level one
of preparedness, 53.3% level two, 6.7% level three and 6.7% in level four. It is also revealed
that most of the hospitals rely on the services of the government firefighting body for their fire
needs. Also, commence evacuation of property and persons immediately in the case of fire
outbreak.

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International Journal of Perceptions in Public Health
Volume 1, Issue 1, December 2016, P 50-58
ISSN 2399-8164 www.ijpph.org

Figure 2. Health Institutions Level of Preparedness to Fire Emergency

Level  5 0%

Level  4 6.70%

Level  3 6.70%

Level  2 53.30%

Level  1 33.30%

0.00% 10.00% 20.00% 30.00% 40.00% 50.00% 60.00%

Percentage  %

General Level of Fire Emergency Preparedness

Preparedness, as mentioned in the above paragraphs,was discussed from different angles.

It is better to conclude by discussing general fire emergency preparedness level in health
institutions. The preparedness level was ranked with a level from 1 to 5, one being the lowest
level of preparedness that means no preparedness at all. And a score of five being the highest
level of preparedness with emergency plans in place, protection equipment in place and
functional, availability of escape routes and accessibility all the time, hospital community
awareness in fire emergency and others. Only a few of the institutions visited (i.e. the two
tertiary health care institutions) had a high level of 3 and four preparedness in case of fire
emergency and the rests are below average.

About 33.3 percent of the health institutions visited were ranked at very low level of
preparedness, 53.3 percent were given score number two, which means low level of
preparedness, 6.7 percent were scored at level three of preparedness which means a satisfactory
level of preparedness and 6.7 percent were scored at level four of preparedness which means
an above average level of preparedness. On average, the preparedness level stands at score
level two which indicates a low level of preparedness in all the health institutions.
Also from the observation of the physical fire prevention facilities of the health institutions
both private and public hospitals, almost all of them reveal the same level of little preparedness
looking at the current standards things. The reasons because, none of the hospital has a
comprehensive emergency plans in place, inadequate protection equipment in place and
functional, insufficient awareness of availability of escape routes and accessibility all the time,
lack or inadequate knowledge of hospital staffs in fire emergency and others parameters.

The situation is not good at all, considering that the health center is the institution that
needs to be safe for the children and patients. One philosopher in disaster management said
that every dollar spent on preparedness it saves six to nine dollars during disaster response and
recovery (Wise, 2006). Therefore, it is better to spend less now for emergency preparedness,

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Volume 1, Issue 1, December 2016, P 50-58
ISSN 2399-8164 www.ijpph.org

prevention and mitigation than waiting to pay more to respond at the time you have already
lost people lives and properties.

Conclusion and Recommendation

From the findings, it was revealed that the mitigation and prevention of fire were not a priority
in most of the health institutions.
1.   Ministry of Health in collaboration with Disaster Management Department (National
Emergency Management Agency (NEMA)) should develop an emergency
preparedness manual for Health institutions.
2.   The fire safety program should be mainstreamed into the health plans of the ministry
of health to enable health practitioners understand how to avoid and respond to fire
incidents.
3.   Emergency education and awareness programs should be part of training and retraining
of health personnel.

Limitation

The study only cover selected health institutions and it does not in any way covers the health
institutions across the state.

Competing Interests

The authors declared that there are no potential competing interests with respect to the research,
authorship and/or publication of this paper.

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Volume 1, Issue 1, December 2016, P 50-58
ISSN 2399-8164 www.ijpph.org

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