Factors influencing community participation in healthcare programs: a case of Siaya County, Kenya

Abstract

The concept of strengthening community action within the context of disease prevention is gaining popularity among health cycles. In Kenya for example, key stakeholders in health sector have recognized the benefits of multi-sectored response to health issues based on partnership among stakeholders. This study examined the factors influencing community participation in Kenya with particular reference to healthcare programs in Siaya County. The specific objectives of the study were: To determine the influence of capacity building on community participation in healthcare programs in Siaya County, To ascertain the influence of culture on community participation in healthcare programs in Siaya county, To establish the influence of attitude on community participation in healthcare programs in Siaya County and To assess the influence of socio-demographic factors on community participation in healthcare programs in Siaya County. The study was of significance to the management of healthcare programs in Siaya County, the government, other stakeholders and the researcher in understanding the factors influencing community participation in healthcare programs in order to assist in developing regional strategies and effective policies targeted at improving involvement in governance of healthcare. The descriptive survey targeted 267 staff across the constituencies of Siaya County. Primary data was collected through the use of semi-structured questionnaires. Descriptive and inferential statistics were carried out with SPSS version 20; qualitative data was grouped into themes and analyzed. Regression analysis was used to determine the strength of association of sociodemographic factors and level of involvement and contribution of capacity building and culture to community participation using coefficient of regression (r), level of significance being at 0.05 (P< 0.05) at 95% CI. More males (OR=5.56, 95% CI=3.65-8.63) were involved in decision making regarding healthcare than their female counterparts (OR= 2.54, 95% CI= 0.54-3.24). Participants who had more years in education were more likely to participate in the healthcare programs than those with less education. Capacity building was found to contribute more when appropriate technology was used (m= 2.111, sd= 0.89499) and when there was adequate representation of all stakeholders in the process (m= 2.2444, sd= 0.88306). Cultural factors were the major barriers to community participation. Community involvement and participation in health programs is key to sustainable development in Siaya County. Strategies should be sought to address the challenges identified in this study to foster community participation and ownership of health programs thus improving health services utilization with improved health outcome.

Programs should be locally led and managed by local healthcare professionals, supported and assisted by community health workers. A comparative study of this study should be carried out to compare the findings in urban areas.