Feasibility and Economic Viability of Pooling Hospital Support Functions in Public Hospitals in Benin

Introduction: Hospital performance depends strongly on the effectiveness of support functions, such as maintenance, procurement, and transport. In sub-Saharan African countries, where these functions are often limited, pooling has emerged as a strategy to improve productive efficiency. This study assessed the feasibility of pooling support functions across public hospitals in Benin. Methods: A cross-sectional, mixed-methods evaluative study was conducted among hospital managers and support-function personnel. Quantitative data were collected using a structured questionnaire and analysed using Stata 14 to assess the sub-components of feasibility. Qualitative data were gathered through interviews and subjected to thematic analysis. Results: Most respondents expressed positive views towards pooling, perceiving it as a lever for enhancing efficiency and service quality. Feasibility index reached 85.71% for the environmental, organisational and legal sub-components, and 100% for the socio-economic sub-component. Investment appraisal demonstrated strong economic viability (NPV = approximately USD 155,667; IRR = 24%; payback period = 6.2 years). The overall feasibility index was 88.24%, surpassing the required threshold of 85%. Key obstacles identified included limited interoperability of information systems, insufficient formal coordination frameworks, and regulatory gaps relating to transport and procurement. Conclusion: The convergence of the evaluated sub-components indicates that conditions necessary for the successful pooling of support functions are met in the Ouémé Department. However, project success will depend on strengthening governance, coordination mechanisms and information systems. This study offers valuable insights for guiding hospital-system reforms and calls for further research into the operational modalities of implementing pooled support services.