Public Policy and Health Sector Development: An Appraisal of Abandoned General Hospitals in Imo State Between 2015–2025

Despite heavy public funding for general hospital infrastructure in Imo State between 2015 and 2025, there still exists an apparent disconnect between health policy statements and infrastructural inflows, with several flagship health facilities remaining abandoned or nonfunctioning 4-13 years downstream of publicised commissioning. This gap between publicly expressed health policy and lived infrastructural realities has reduced access to secondary health care and increased reliance on private, unregulated health-seeking behaviours in these deprived communities. This study evaluates the nature, causes, and effects of general hospital abandonment in Imo State and assesses the extent to which subsequent project transitions have brought these projects in line with stated government health policy goals. Using a cross-sectional, mixed-methods comparative case study design, the study triangulates hospital facility audits, in-depth interviews with key informants, and a review of health policy documents across an intentionally selected sample of 20 hospitals. The study finds that implementation and institutional discontinuity drive abandonment more than limited financial resources and emphasises that health project continuity and facility monitoring can support future health facility investments.