Evaluating Accommodation Spatial Capacity, Trainee Well-Being, and Academic Engagement at the Nigerian Navy College of Health Sciences: An Institutional Quality Assurance Survey

Optimizing spatial carrying capacity and residential environmental quality is a key operational priority for tertiary health-training institutions in low- and middle-income countries (LMICs). As student enrolment continues to expand, establishing baseline spatial and environmental indicators is important for supporting student welfare and effective learning environments. This study assessed accommodation density and students’ perceptions of the residential environment, well-being, and academic engagement at the Nigerian Navy College of Health Sciences (NNCHS), Offa, Nigeria. A descriptive cross-sectional study was conducted among students of NNCHS, Offa, Nigeria, between May and June 2026. The study population comprised 315 registered students residing in institutional hostels. Using Yamane’s formula, a minimum sample size of 176 was determined. Participants were selected through proportionate stratified random sampling across seven academic departments. Data were collected using a validated, structured, self-administered questionnaire assessing perceived overcrowding, perceived health-related experiences, perceived academic engagement challenges, and proposed mitigation measures. Descriptive statistics and composite domain scores were generated and summarized using frequencies, percentages, means, and standard deviations. Associations between participant characteristics and overall perceived overcrowding burden were examined using Pearson’s chi-square test. The overall perceived overcrowding burden score was derived using a 14-item index (comprising perception, health, and academic domains) and dichotomized using the sample median (≥ 60), with statistical significance set at α = 0.05. Of the 176 questionnaires distributed, 167 were completed and analyzed, yielding a response rate of 94.9%. Most respondents were female (55.7%) and aged 18–21 years (49.1%). Participants were relatively evenly distributed across academic levels: ND I (32.3%), ND II (34.7%), and HND/Final Year (33.0%). More than two-thirds (71.3%) resided in rooms accommodating more than four occupants. Institutionally, 315 students were housed in facilities designed for 251 occupants, representing a capacity deficit of 64 bed spaces and an occupancy excess of 25.5%. Substantial proportions of respondents reported perceived environmental and spatial constraints, including excessive room occupancy (79.6%), inadequate personal space (85.0%), poor ventilation (82.0%), and excessive noise (81.4%). Frequently reported health-related experiences included headaches (97.6%), sleep disturbances (95.2%), stress (85.0%), physical discomfort (82.0%), and mental fatigue (78.5%). Reported academic engagement challenges included reduced classroom participation (95.8%), limited private study time (94.0%), impaired reading or learning ability (92.2%), and reduced concentration during lectures (83.2%). Composite domain scores suggested a high perceived burden across all assessed domains. High mean domain scores were observed across all constructs: Overcrowding Perception (16.55 ± 2.39; per-item mean = 4.14), Health Effects (21.61 ± 3:10; per-item mean = 4.32), Academic Effects (21.59 ± 2.41; per-item mean = 4.32), and Mitigation Measures (22.90 ± 2.60; per-item mean = 4.58). Bivariate analysis using the revised 14-item Perceived Overcrowding Burden Index (sample median = 60) demonstrated a statistically significant association between perceived overcrowding burden and level of study (χ² = 8.361, df = 2, p = 0.015). High perceived burden was reported by 51.9% of Year 1 students, 62.1% of Year 2 students, and 78.2% of Final Year students. Students perceived substantial overcrowding-related challenges within the institutional environment, including limited personal space, noise, poor ventilation, health-related concerns, and reduced academic engagement. Higher levels of perceived overcrowding burden were observed among more senior students. These findings highlight the need for institutional strategies aimed at improving accommodation capacity, environmental quality, and alignment between enrolment and available infrastructure to support student well-being and learning conditions in health-training institutions.