Factors Influencing Provision Of Healthcare Services In The Devolved System Of Government In Kisumu East Subcounty, Kenya

Abstract

Health is an important aspect of human life proper health uplifts social development and also has a direct bearing on development of key sectors of the economy and politics. The United Nations establishment WHO that champions the advancement of human health worldwide through policies, partnerships with various donors and organisations to establish healthcare centres and also give donations to avert humanitarian crises. Many countries worldwide especially developing countries such as Nigeria, India, Brazil and those in sub-Saharan Africa grapple with many problems in the health sector such as few medical staff due poor working conditions and migration, inadequate health facilities, skewed location of health facilities and poor medical equipment supply. Kenya established the KHPF- Kenya health policy framework blue print that gives direction on provision of health services. KHSSP-Kenya health sector strategic investment plan blue print aims to transform the health sector to provide better services in health by reducing infant mortality rates, reducing cases of malaria and incidences of infectious diseases such as H.I.V and T.B. The Kenyan health sector however has had a fair share of challenges that have have hampered its operations. The Kenya health sector was devolved in 2013 in line with the Kenyan constitution since devolution was seen as the best way to provide health services however the decision has encountered numerous challenges that have paralysed provision of health services leading to strikes and many advocating for the reversal of the decision. The research set out to investigate the factors influencing provision of healthcare services in the devolved system of government in Kisumu east sub county by looking at the objectives of location of health facilities, medical staffing, management and medical equipment procurement on provision of healthcare services. The research uses a descriptive survey research design and a case study design in studying the factors, the research targeted medics and patients twenty two health facilities in Kisumu east sub-county which were dispensaries, health centres, sub-county hospitals, one county hospital and one referral hospital. Since the area had few health facilities all the facilities were considered for study and no sample was taken. The research will involve use of qualitative and quantitative data. The instrument of data collection was questionnaires, interview schedule and analysis of secondary data. Secondary data was from ministry of health documents such as reports which were analysed, the data collected was be analysed by descriptive statistics analysis technique, and content analysis technique. The data was also coded and tabulated on frequency distribution tables, the summarized data was analyzed using percentages and frequencies and presented using tables and pie charts and graphs, mean, median mode and standard deviations was analysed with help of Statistical software SPSSv20. From the analysis of the data it most people in the area have medical centres located within a radius of two kilometres and they only travel an average of twenty five minutes with the most preferred means being public unless its an emergency. The medical centres have a shortage of medical personnel with an acute shortage of doctors causing long treatment waiting time for patients. Most of the nurses, clinical officers and doctors feel recruitment of more staff would ease the workload. Concerning management there is a general feeling that the county government lacks the capacity to manage healthcare and that the decision should be reversed poor funding, lack of facilities, corruption and poor payment were some of the factors cited to strongly hamper proper provision of healthcare services most the, ICT was not adequately embraced with computers only found in the registry and many centres lacking CCTVs medical personnel believed allocation of more funds and accountability would greatly solve these problem many strongly believed seminars and trainings would be of great help. A significant number believed solving staff issues on time and construction of staff houses would motivate the medical staff and enhance service delivery. Many people believed procurement of medical equipment was hampered by corruption and lack of accountability, poor policies and poor funding of the medical centres.