Monitoring And Evaluation System, Stakeholder Participation, Organizational Structure And Provision Of Curative And Preventive Tuberculosis Health Care Services In Public Health Institutions In Kisumu County, Kenya

Abstract

Healthcare service provision is paramount and regarded as fundamental right of an individual. This study sought to establish how M&E system, stakeholder’s participation and organizational structure influence on provision of curative and preventive tuberculosis health care services in public health institutions. It also sought to establish the intervening role of the stakeholder participation and the moderating role of organizational structure on the relationship between monitoring and evaluation system and provision of health care services in Kisumu County. This was done when there was an increasing demand of usage of M&E system in public health institutions accredited by the government. The study was significance due to the increasing demand, credible practice in the delivery of health care services. The study objectives was; to establish how human capacity for monitoring and evaluation influence provision of curative and preventive tuberculosis health care services in public health institutions in Kisumu County, to determine how logical framework influence provision of health care services in public health institutions in Kisumu County, to assess how monitoring and evaluation work plan influence provision of curative and preventive tuberculosis health care services in public health institutions in Kisumu County, to determine how data dissemination and use influence provision of curative and preventive tuberculosis health care services in public institutions in Kisumu County, to establish how combined monitoring and evaluation system influence provision of curative and preventive tuberculosis health care services in public health institutions in Kisumu County, to establish how the combined M&E system influence the provision of curative and preventive tuberculosis health care services in public health institutions in Kisumu County, to establish the intervening influence of stakeholder participation on the relationship between monitoring and evaluation system and provision of curative and preventive tuberculosis health care services in public health institutions in Kisumu County and to determine the moderating influence of organizational structure on the relationship between monitoring and evaluation systems and provision of curative and preventive tuberculosis health care services in public health institutions in Kisumu County. The study was guided by pragmatism paradigm. A descriptive survey design was employed in the study since it allowed collecting both quantitative and qualitative data and correlational design helped to test the hypotheses. Stratified random sampling was used in the study to obtain a sample of 221 from a population of 517 consisting of medical doctors, M&E officers, clinical officers, nurses and patients. A structured questionnaire with both open and close ended, with Likert type on 1-5 five point scale was used to collect data. Quantitative data was analyzed using descriptive and inferential statistics and data presented in frequency tables using means and standard deviations while qualitative data was presented in narrative form. Hypothesis was tested using linear regression at 0.05 level of significance to determine the degree and direction of relationships among variables. The study attained Cronbach Alpha of coefficient which was 0.6 and above for all items which was acceptable implying that the instrument was reliable. The results showed that human capacity for M&E (r2=0.98, p<0.05), logical framework for M&E (r2=0.98, p<0.05), M&E work plan (r2=0.98, p<0.05) and data dissemination and use (r2=0.98, p<0.05). Intervening stakeholder participation M&E system and provision of curative and preventive tuberculosis health care services in public health institutions had (r2=0.98, p<0.05) and organizational structure, M&E system and provision of curative and preventive tuberculosis health care services in public health institutions had (r2=0.98, p<0.05). The results showed that 60.3% (r2= 0.0427, p<0.05 of provision of curative and preventive tuberculosis health care services was attributed to combined M&E system. The study results indicated that M&E system contributes significantly to the provision of curative and preventive tuberculosis health care services in public health institutions. The study recommends for future studies in private sector to establish the influence of M&E system and service delivery.