Patterns of utilization of Presbyterian church hospitals in Kenya
Abstract
The Presbyterian Church of East Africa runs a health service in Kenya based on its three hospitals and a number of dispensaries all situated in the rural areas. The church is faced with increasing difficulties in providing adequate health care to these communities. Human and financial resources remain the major problems. It has become increasingly clear that hospital-based health care needs to be greatly modified to the changing needs of Kenyan communities. This can only be done after the problems have been thoroughly studied in order to formulate practical and relevant solutions. This study was designed to -. provide a beginning for such a process. The main objective of this study was to collect data on the way in which the hospitals under the Presbyterian Church of East Africa have been used in the past by their respective communities. This was done through establishing the categories of patients who used the hospitals by considering their age, sex and the distance they covered between their homes and the hospital. The topographical factors between the patient's residence and the hospital were also considered. The socio-political factors which prevailed during the years covered by this study were also discussed. The study was based on a sample drawn from each hospital's records. the samples were drawn from hospital records from the years 1955 to 1973. The data collected were analysed through frequency distributions, cross tabulations, bar charts and histograms were drawn to illustrate the use of the hospitals through selected variables such as age and sex of the patients. Maps were also drawn to show the flow of patients to the hospitals according to age and sex, distance and communication systems in each area studied. The actual research was carried out between the years 1974 and 1~75. The main findings of the study were that -. the majority of consumers of the hospital services were children and adult females. 1'hey formed over 60% of all inpatients to any of the three hospitals studied. The distances covered by patients between their homes and the hospItals, and the direction to which the patients went to seek health care were determined by the availability of means of communications and the topographical features found between the hospitals and the patients' homes. Irrespective of the distances and the natural obstacles, the quality of the hospital and its good reputation determined the patients' use of such a hospital. Hospital-based maternity services were utilized more by women of primigravida or those with history of difficult births. Socio-political factors which prevailed during such time periods as the Emergency, Pre-Independence and Independence years were also shown to be related to the type of patients using the hospitals. It is recommended that these findings could be used as a guide for future planning of the church health services. Kikuyu and Tumu Tumu hospitals could learn from Chogoria how to involve the communities with the improvement of the quality of the hospitals. The system of dispensaries or mobile - health services based in the 'communities could also improve the quality of the hospitals a great deal. Chogoria hospital again has set up a good example on this. Such services would overcome the problems of distance and natural obstacles which bar some members of the communities from using the services of the hospitals. It is also recommended that the categories of people that would need to be given top priority in planning of health services should be women and children