Here is the complete section of code just in case it helps anyone in the future:
#Create field map for spatial joins
arcpy.AddMessage("Mapping fields for future use in iteration")
mapFields = ["ITEM_ID", "PRIME_GEO"]
fieldMappings = arcpy.FieldMappings()
for mapField in mapFields:
    fieldMap = arcpy.FieldMap()
    fieldMap.addInputField(aoi, mapField)
    fieldMappings.addFieldMap(fieldMap)
#Begin iterations for each country
arcpy.AddMessage("Beginning loop")
for country in countries:
    cc = str(countries)
        
    #Feed in featureclasses
    arcpy.AddMessage("Reading input featureclasses into in-memory layers")
    arcpy.MakeFeatureLayer_management(countryGdbLTDS + "/StructurePnt", "buildingLyr", dqBuilding)    
    #define output location for temp building tables
    buildingOutput = scratch + "/" + cc + "_AOI_Building"
    #Spatially join buildings
    arcpy.AddMessage("Testing for existing building output files. Any found will be deleted")
    if arcpy.Exists(buildingOutput):
        arcpy.Delete_management(buildingOutput)
        arcpy.AddMessage("Deleted")
        arcpy.AddMessage("Performing Spatial join on Building points")
        arcpy.SpatialJoin_analysis(aoi, "buildingLyr", buildingOutput, "JOIN_ONE_TO_ONE", "KEEP_COMMON", fieldMappings,"INTERSECT", "", "")        
    else:
        arcpy.AddMessage("None Found to delete")
        arcpy.AddMessage("Performing Spatial join on Building points")
        arcpy.SpatialJoin_analysis(aoi, "buildingLyr", buildingOutput, "JOIN_ONE_TO_ONE", "KEEP_COMMON", fieldMappings, "INTERSECT", "", "")
    appendList.append(buildingOutput)