Capacity of non-governmental providers in delivery of healthcare in Kenya
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The purpose of this study was to determine the capacity of the nongovernmental (NGO) sector in the provision of health care under normal and stressed circumstances by capturing the providers' and consumers' perspective using a random sampling method. The assessment of these provisions was based on the national nurses' strike of July 1997 to February 1998. The sample of conventional providers comprised 21 governmental (GO) and 58 NGO facilities, while the consumers' perspective was based on a random sample of 2018 urban and rural households. This study was able to gather a variety of perspectives from both providers (GO and NGO) and consumers of health care. Although most hospitals have health facilities that are equipped with necessary supplies, materials and infrastructure to ensure quality health care, the visibility of differences among them occurs when events such as the national nurse strike occur. Defects were detected in the GO method of handling quality care among users. From the perspective of users, quality of health care was based on the cost of services, drug availability, personnel issues, supplies and equipment, and the attitudes and actions of providers. Demographic characteristics, income, and expenditures were also determinants in users' choice of provider. During the national nurses' strike, the NGO sector showed a high degree of competency and flexibility in the provision of health care: under normal circumstances it was a much higher degree than that showed by the GO sector. The document concludes by offering recommendations and strategies for further improvement of the health care systems.