Architect Calls For Stakeholder Management In Siting Hospital Facilities To Curb COVID-19

As cases of Covid-19 rise after the elections, Christmas and New Year festivities, the nation is getting back to serious measures to curb the pandemic in Ghana. Aside the daily protocols that ought to be adhered to stringently, the readiness of hospital infrastructure and associated facilities in the event of emergencies to isolate and manage Covid-19 patients comes into play. From March 12, 2020 when Ghana first confirmed 2 reported cases of COVID-19, the nation currently has recorded 56,230 cases with 1,261 being active and 388 deaths; as at January 07, 2020.

Consequently, experts in the health sector and all other concerned stakeholders are putting their acts together to help curb the situation. When it comes to hospital infrastructure, architects have their part to play as well, as there have been instances of residents and whole communities kicking against the siting of Covid-19 isolation centres in their neighbourhood.

One such voice is Dr.  Arc. Emmanuel Eyiah-Botwe, Registrar of the Architects Registration Council (ARC) in Ghana, who believes that the way forward for a consensus to achieve success in establishing these Coronavirus isolation centres is a well-thought-out stakeholder management approach, rather than stakeholder engagement.

Speaking to Real Estate Africa Times, the Architect commended the President, Ministry of Health (MOH), Ministry of Information and the Ghana Health Services (GHS) for taking bold and right decisions, and instituting periodic public engagements in managing the pandemic, which included closing of borders, enforcing lock downs (in the cities of Accra the epicenter, Kumasi and Kasoa) and Covid-19 protocols; as well as emergency preparedness and surveillance in 2020.  

Nevertheless, Arc. Eyiah-Botwe notes that a major part of efforts to curb the virus is the ultimately and urgent need for quarantine and isolation centres for case management globally.

“The developed nations including the US, UK and China had to hastily build covid-19 treatment centres. For instance mobile and prefab hospitals, convention of open spaces, old warehouses as treatment centres have been witnessed. Again, a major challenge has been the crucial need for personal protective equipment (PPEs) for frontline workers, considering causalities in line of duty. That challenge is compounded by the inadequate resources resulting in the need to use existing school accommodation and the benevolence of some individuals providing personal residences for treatment and isolation centers.”  

According to him, “the attempt to have enhanced surveillance aimed at increased testing has brought up challenges with the preparedness of the populace to cooperate. There have been reports of suspected individuals with COVID-19 absconding.  Similarly, some suspected, family members and contacts of COVID-19 patients have refused to be tested both in Wa and Accra. More disturbing is the recent report of community resistance to the setup of isolation centers in Cape Coast, Efutu, Assin Fosu and Prampram. Considering the effort to curb the spread of COVID-19, stakeholder attitudes and the current happenings raise three questions: 

1. Is there proper stakeholder identification? 

2. Are we employing stakeholder engagement or management? ∙

3. What are the key constructs considered?” he quizzed.

He explained that every project has individuals, firms or organisations who can be affected or affect the project’s outcome. The individuals and entities affect or are affected by the outcome of the project; and equally impact or are impacted by the project and are thus referred to as stakeholders. Therefore, stakeholders have a stake in a project or its outcome, and for any project to be successfully carried out, effective consideration of stakeholders is very essential. Studies suggest that a key construct in stakeholder management (SM) or stakeholder engagement (SE) is stakeholder identification.  

Dr.  Arc. Emmanuel Eyiah-Botwe expounded that “Stakeholder identification is the starting point of many SM processes, that requires a meticulous effort to identify all individuals and entities that affect or are affected by a project or its outcome. Emphasis should be on both current and potential stakeholders. More importantly during any stakeholder identification process is a common agreement on who is a stakeholder. Studies suggest that all stakeholders are unlikely to be identified hence the identification process should be conducted by experts or senior staff with experience in similar projects who should keep a stakeholder register. Names, contact, any structured information as well as keeping a register of stakeholders is required.”

He wondered  if the above considerations in the stakeholder identification process were made (in siting Covid-19 facilities) in neighbourhoods where resistance was registered, and also whether the nation was using stakeholder engagement (SE) or stakeholder  management (SM) approach, though both terms are occasionally interchanged.

He noted that, while SM entails systematic identification, analysis, planning and implementation of actions designed to engage with stakeholders, SE on the other hand is a practice aimed at influencing a variety of outcomes through consultation, communication and relationship building. Stakeholder engagement could be a key construct of SM. A careful consideration of the non-corporation of stakeholders regarding the use of proposed facilities for isolation centers is a clear indication of the lapses in both stakeholder identification and the use of SE rather than SM approach. Stakeholders have often kicked against decisions when only SE approach has been employed. The reason being that not much is done with stakeholder assessment, implementation, monitoring and evaluation.  While SE seeks to influence stakeholders to agree on an expected outcome through communication and consultation, Stakeholder management on the other hand considers a number of constructs that will ensure a successful project delivery and achieve stakeholder interest and satisfaction.

In this regard, a number of key factors ought to be considered including:  

1. An initial planning with the stakeholders agreeing on the project objectives  and implementation plans rather than influencing them to agree with the  project set targets, 

2. Careful identification of all relevant stakeholders, 

3. Classifying and prioritizing stakeholders, 

4. Agreeing on stakeholder engagement approach, 

5. Analysing stakeholder process and;

6. Agreeing on implementation, monitoring and evaluation plan with stakeholder involvement. 

Dr. Arc. Emmanuel Eyiah-Botwe buttressed this adding that “a careful consideration of the Tema West incidence in which residents demonstrated against the use of a hospital as an isolation center indicates the following: all stakeholders were not identified. While the owner of the facility assumed that the MOH and the Tema West Municipal Assembly were the only stakeholders to determine the use of the facility, immediate interested groups such as residents of adjoining buildings were not considered together with residents and house owners’ associations.  Again it is evident that the community wasn’t considered as key stakeholders. It will be of interest to know the attributes used for the stakeholder classification:

1. Was it based on roles, responsibilities, interest, importance or proximity? ∙

2. What were the basis for prioritization? 

3. What was the extent of power, legitimacy and urgency consideration?”

He strongly urged Government to employ the ‘Stakeholder Management approach with establishing Covid-19 facilities to ensure smooth operations.

“If SM approach is not adopted and carefully considered, there is the likelihood that little will be achieved by the Government in spite of the much efforts made. The way forward thus should be a well-thought-out stakeholder management approach”, Arc. Emmanuel Eyiah-Botwe added.

Source: Yvette Appiah (Journalist, Real Estate Times Africa)