Factors Influencing Delivery of Quality Health Care in Kasarani Sub County
Abstract
Quality in health service delivery is key in ensuring patient satisfaction since delivering quality service has a direct influence on the customer satisfaction and management outcome. An assessment done in 2019 using Kenya Quality Model of Health (KQMH) monitoring and evaluation checklist showed that many facilities in Kasarani Sub County had stopped holding quality improvement meetings and lacked minutes for their quality improvement team. Some of the projects they were implementing in the comprehensive care centres had collapsed. Quality improvement meetings and total quality management are key indicators of KQMH activities and progress. This has necessitated this research, which sought to evaluate the factors influencing delivery of quality health care in Kasarani Sub-County. The study sought to determine factors influencing delivery of quality health care in Kasarani Sub-County. Specifically, the study analyzed how organizational factors, interpersonal factors, environmental factors and economic factors influence delivery of quality health care in Kasarani Sub County. The research was quantitative adopting a descriptive research design. The target population included 110 Health officers who are members of work improvement teams, quality improvement teams or departmental heads. The research was based on primary data acquired through a self-administered questionnaire. The data was analyzed using SPSS Version 24.0. For quantitative data, descriptive and inferential statistics were generated. Under inferential statistics both correlation and regression analysis were undertaken. The analysis' findings were given in tabulated form, along with relevant interpretations as well as discussions. In conclusion organization factors (r=0.516; p<0.05), interpersonal factors (r=0.457; p<0.05), environmental factors (r = 0.378; p < 0.05), and economic factors (r = 0.614; p < 0.05) were substantially linked to provision of quality healthcare in Kasarani Sub County. Organization, interpersonal, environmental, and economic factors explained 50.1 percent of the variation in the delivery of quality health care in Kasarani Sub County, according to the data. Economic factors (?4 = 0.274) were found to be the most critical factors while environmental factors (?3 = 0.179) were the least important factors. All the 4 null hypotheses were rejected and a conclusion made that organization, interpersonal, environmental and economic factors have a significant influence on delivery of quality health care. The availability of cash to acquire medicine, remunerate staff, and assure the daily running of health facilities was determined to be critical to the delivery of high-quality healthcare. It was also determined that a good organizational structure could improve the delivery of high-quality health care. It was critical to have a well-paid, motivated, and sufficient quantity of employees in order to improve health-care delivery. Economic issues were found to be extremely important in the provision of high-quality healthcare. Kasarani Sub County's health facilities should look for additional funding to cover their operating expenditures. They also should make certain that responsible leadership is in place, one that promotes transparency and accountability. The labor must be fairly compensated and motivated. Additionally, medicine and drug distribution should be prioritized based on need to avoid stock outs and guarantee that the quality of health-care delivery is not jeopardized.
Keywords: Organizational factors, interpersonal factors, environmental factors, economic factors, delivery, quality health care, Kasarani Sub County, Kenya
References
Adams, J., Mounib, E., Pai, A., Stuart, N., Thomas, R., & Tomaszewicz, P. (2016). Healthcare 2015: Win-win or lose-lose?A portrait and a path to successful transformation. IBM Corporation, United States of America.
Akacho, E. (2014). Factors influencing provision of health care service delivery in Kenya. A case of Uasin Gishu district hospital in Eldoret, Unpublished MA research project, University of Nairobi
Andel, C., Davidow, S., Hollander, M., & Moreno,D. (2012). The economics of health care quality and medical errors. Journal of Health Care Finance, 39(1), 112-123
Docteur, E., & Berenson, R. (2015). How does the quality of U.S. health care compare internationally? Timely analysis of immediate health policy issues. Urban Institute.
Donabedian A (2016). The definition of quality and approaches to its assessment. Ann Arbor: Michigan Health Administration Press.
Hurley, S., Doumbia, K., Roter, C., & Harbey A. (2018). Room for improvement: Patients report on the quality of their health care, The Commonwealth Fund. 45(1), 300-340.
Kimanzi, C. (2014). Factors influencing provision of quality services in the public sector in Mwingi Sub County, Unpublished MA research project, University of Nairobi
King, A., & Hoppe, R. B. (2013). “Best practice” for patient-centered communication: A narrative review. Journal of Graduate Medical Education, 5(3), 385–393.
Manaf, N.H. (2015). Quality management in Malaysian public health care. International Journal of Health Care Quality Assurance, 18(3): 204–216.
Mosadeghrad AM (2013). Healthcare service quality: Towards a broad definition. International Journal of Health Care Quality Assurance, 26(3): 203– 219.
Muithya, V. (2016). Factors influencing implementation of free maternal health care in government health facilities: A case of Kisima Location; Samburu County, Kenya, Unpublished MA research project, University of Nairobi
Muthui, R. (2018). Factors influencing the provison of quality services in health care facilities: A case of Kitui county referral hospital, Unpublished MA project, University of Nairobi
Mwancha, J. (2018). Determinants of healthcare service delivery in kenya: A case study of health centers in Nyamira county, Unpublished MA research project, University of Nairobi
Nairobi County Health Delivery Report (2018). Accessed on April 7th 2019 http://www.healthpolicyproject.com/pubs/291/nairobi%20county-final.pdf
Oketch, T.C. (2017). Devolution of public health care services in Kenya and its implication on universal health coverage. IOSR Journal of Pharmacy, 7(5/1), 9-23.
Panda, B., & Thakur, H.P. (2016). Decentralization and health system performance – a focused review of dimensions, difficulties, and derivatives in India. BMC Health Services Research, 16(Suppl 6), 1–14. Accessed on April 15, 2018 from http://doi.org/10.1186/s12913-016-1784-9
Watts, R.L. (2017). Comparing Federal Systems. (12th Ed.). Kingston, Ontario: McGill- Queen’s University Press for the Institute of Intergovernmental Relations.
World Health Organization (2016). Healthcare workforce 2030: Towards a Global Strategy on Human Resources for Health. Geneva: World Health Organization.
World Health Organization (2018). Regional Office for Africa. The Health of the People: The African Regional Health Report. Brazzaville: World Health Organization.
