| dc.description.abstract | Centralization has been at the core of Kenyan governance since independence with power
concentrated in the capital. As a result, Kenya has been marked by spatial inequalities during this
period of time. It is against this backdrop that healthcare devolution is currently taking place in
Kenya. The Kenya Health Policy 2012 – 2030 provides guidance to the health sector in terms of
identifying and outlining the activities in achieving the government‘s health goals. Most
Counties in Kenya, since the devolution of health sector, are faced with challenges ranging from
the referral systems, decentralization of staffing roles and the implementation of the devolution
process. It is important to recognize that implementation of County health programme is critical
to the attainment of the highest possible health standards in a manner responsive to the
population needs. The purpose of the study was to establish the determinants of implementation
of County Health programme in Turkana West Sub County. The objectives of the study was to
establish the influence of financial resources on the implementation of County health
programme, explore the extent to which human resource capacities influence the implementation
of County health programme, to determine the extent to which stakeholders support influence the
implementation of County health programme and to establish the extent to which infrastructure
influence implementation of County health programme. The study was conducted in Turkana
West Sub County on 96 health facilities‘ staff and 4 Sub County Health Management Team
members. The study employed a descriptive cross sectional design. Validity was ensured through
pilot testing and seeking the experts‘ judgment while reliability was established through test pretest
and checking the consistency of the responses to the questions. Data collection involved
administration of questionnaires and conducting Key Informant Interviews. Quantitative data
was coded, entered and analyzed using frequency counts and percentages, with the aid of SPSS
Version 17 and Microsoft excel. The data was presented using tables. Qualitative analysis
involved grouping the data with similar content as per thematic areas then analyzing by cross
referencing. The study established that the County health programme is currently underfunded
with 86 (90%) of the respondents stating that the funding level is inadequate to support the health
programme. Further analysis showed that source of funding influence the implementation of the
County health programme (P<0.05) and that adequacy of financial resources as a single factor
may not significantly have any influence (P>0.05). The study also established that the health
programme is understaffed with 69 (72%) of the respondents stating that staffing level is
inadequate to support the health programme. The study revealed that stakeholders currently play
an important role with 89 (93%) of the respondents acknowledging that stakeholders support the
implementation of the County health programme. The study recommends that health planners
should explore various healthcare financing reforms like improving allocation, proper
management of existing health resources and increase the role of private sector in healthcare.
Ensure equitable distribution of staff by numbers and cadres, their skills development and
motivation. There is need for active engagement with stakeholders in planning and
implementation health service delivery activities including resource mobilization to bridge
financial gaps. Support infrastructure development for the County health programme and put in
place mechanisms for regular maintenance of medical equipments. The researcher recommends
that further studies need to be conducted on the factors influencing the effectiveness of Turkana
County Health programme, determinants of health staff performance in the County and cost
recovery health financing approach in hard to reach populations of Turkana County. | en_US |
