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An examination of performance management in Nigeria’s public health sector through two case studiesExtant literature has called for contextual studies on performance management to maximise its effectiveness. Following this call is a study of performance management that considers the practice, its system and context. Scholar also presents that performance management researches conducted in less developed countries’ context loosely align their studies with a theoretical framework or use none within the study. This exploratory research study built upon Ferreira and Otley's (2009) framework as the theoretical underpinning to guide the research to address these problems and achieve its aim. This research aims to investigate performance management within the Nigerian public health sector. An interpretivist philosophy and abductive reasoning were the methodological choices employed while using a case study strategy. Data collected for this research include 40 semi-structured interviews and a document review across two Federal Hospitals in Nigeria. Thematic analysis was adopted to examine the data collected for this study using NVivo 11. The findings identified issues (such as union, godfather, organisational needs) that affect performance management. These issues elaborate the third level (contextual factors and culture) in Ferreira and Otley’s framework and pervade the organisational, sectoral and national level. Again, the findings also identified the informal activities (such as mentoring encouragement) used by managers in the study context. The findings further suggested that actors of performance management interpret the phenomenon as continuous and integrated and the practice within the context is at multi-level - departmental and organisational. The implication of the findings reinforces the significance of including the performance management practice, its system and context to fully again in-depth or insight into the contextual understanding of PM across different context. The originality of this study is the conceptualisation of performance management within the Nigeran Public Health Sector building upon Ferreira and Otley (2009). The contribution to knowledge includes the elaboration of the outer level in Ferreira and Otley’s framework with the identification of the v contextual factors challenging performance management within the Nigerian public health sector. The development of knowledge on performance management within the Nigerian public health sector is another contribution as there is a dearth in research studies. Again, the study contributes to the on-going debate by scholars on the relevance of understanding performance management within its context in order to maximise its effectiveness. The practical implication for hospitals managers is the awareness of the factors affecting performance management, which consequently will maximise its effectiveness within the Nigerian public health sector. Further studies on performance management should investigate and identify contextual factors and how these would affect its effectiveness within the different contexts.