dc.contributor.author | Mugo, Josephine W | |
dc.date.accessioned | 2013-05-03T15:21:19Z | |
dc.date.available | 2013-05-03T15:21:19Z | |
dc.date.issued | 2007 | |
dc.identifier.citation | M.A (Medical Sociology) Thesis 2007 | en |
dc.identifier.uri | http://erepository.uonbi.ac.ke:8080/xmlui/handle/123456789/18823 | |
dc.description | Master of Arts Thesis | en |
dc.description.abstract | Health care provision is a challenge facing most developing countries. Financial
constraints continue to be a stumbling block at all levels of public health provision. Even
with introduction of cost sharing, health provision has still not met the rising demand for
the services. Due to this, concern about the quality of health services provided is
becoming relevant as increases in health needs become evident.
This study was designed to examine the quality of health services delivered at the NCC
health centers with regard to health service users. Specifically, the researcher sought to
find out the factors influencing user satisfaction and utilization if the health services
provided. It was also important for this study to find out how effective the centers were in
delivering services.
The study was guided by situational approach theory that sees human behavior as
determined by situations. This model sees individuals' health seeking behavior as
determined by factors real to them. Their definition of a situation is followed by a process
of thinking, in which the possible cause of action taken or selected will be based on their
relative high value to the individual. Health seeking behavior is sometimes influenced by
the relative value placed on certain health facilities depending on the individuals'
situation. Another theory utilized was the social systems theory. Health care facilities are
parts of social systems that act independently of each other and yet must wholly function
together to achieve their goal. The success of NCC health centers solely depends on all
other actors in the-interactive relationship to function as a healthcare provider.
The researcher focused on health service users visiting the selected NCC health centers at
the time of the study. Information in the field was collected by use of structured
interviews that were administered to the health service users at the end of the health
service delivery (exit interview). Interview guide was also used for the key informants.
An observation checklist was used to record physical infrastructure and equipment in use
at the centers. The data obtained was analyzed using SPSS and presented through
descriptive statistics.
The study revealed several factors that influence users in choice of a health facility. Time
and distance were seen as important factors in health seeking. Majority of the users were
satisfied with using those facilities near to where they lived or worked. Studies indicated
that affordability was important in health consumption. The users found to frequent the
NCC centers were mostly people from low income groups who were in lowly paying jobs
or were not working at all.
Reliable treatment was another factor that respondents felt was important in health
services. Indeed the findings showed that health users were satisfied with the services
offered in these centers. This, as the study found, was directly related to the provision of
drugs that had improved within 3 years previous to the study. The respondents reported
faster recovery with the treatment given and even indicated that they would use the same
facility again incase of an illness episode. However key informants indicated that there is
shortage of staff and lack of essential resources despite improvements in drug stock out.
The study revealed that health service users were concerned with qualification of health
service providers. Indeed, they revealed that the qualification of providers in private
health clinics is often suspect and they felt that public health facilities had qualified
personnel as they are under government management.
Some of the constraints that emerged from the study were under-funding in the centers
and lack of utilizing the revenue collected. The key informants felt that provision of
services depended highly on availability of funds. At the time of the study, it was
revealed that there are no mechanisms to utilize the funds collected during registration of
the health users' attendance. The health centres administration staff were still waiting for
advice from the management board on the way forward. | en |
dc.description.sponsorship | University of Nairobi | en |
dc.language.iso | en | en |
dc.title | The quality of health service provision by Nairobi city council health clinics | en |
dc.type | Thesis | en |
local.publisher | Depatment of Sociology, University of Nairobi | en |