A Systematic Review of Maintenance Management in Public Healthcare Facilities: Challenges and Implications for Sabah, Malaysia

Abstract

Background: Effective maintenance management implementation are critical for ensuring patient safety, equipment availability, and operational efficiency in public hospitals. Despite growing recognition of their importance, significant gaps persist in standardized practices, particularly in resource-constrained settings.
Aim: This systematic review examines contemporary the challenges and implication of maintenance management practices in hospital settings globally, with specific focus on identifying evidence-based strategies applicable to Sabah’s public hospitals. The study synthesizes empirical evidence from 2020-2026 to inform maintenance technicians and Facilities and Engineering Management Services (FEMS) heads.
Methods: A comprehensive literature search across multiple databases identified 893 papers published between 2020-2026. Following systematic screening using the PRISMA 2020 framework and quality appraisal with the Critical Appraisal Skills Programme (CASP) checklists, 30 highly relevant studies were analyzed using descriptive synthesis. Inter-reviewer reliability was established through Cohen's kappa coefficient (κ = 0.84). Key dimensions examined included maintenance strategies, risk assessment frameworks, implementation challenges, competency requirements, and digital transformation initiatives.