Potential of open data and information in enhancing access, quality and accountability in health service delivery at the local level in Kenya
This study was premised on the possibility to enhance health service delivery by understanding data and information needs, the channels to deliver both and the barriers to health service delivery encountered by both citizens and government officials. The findings of this study are intended to offer ideas on overcoming the challenges and barriers to effective service delivery and improve accountability, quality of basic health services and ultimately development outcomes at the local level in Kenya, through enhancing access to data and information. This study was designed to contribute to improved access, accountability, quality of basic health services and ultimately health development outcomes at the locality level in Kenya. The specific objectives were; To establish the open data, information and service delivery needs of citizens and government health service providers that can improve access to quality healthcare at the district facility level; To establish the channels through which the open data or information can be effectively relayed ,to overcome challenges and barriers to quality health service delivery at the district facility level; To determine the access to mobile phones by citizens and their willingness to receive health data and information through them, in order to support efforts to integrate health data into mobile apps and websites, and; To investigate the existing opportunities for citizens and government health service providers to access and use open data and information to create new spaces for engagement, networking and mobilizing common actions. The research employed both qualitative and quantitative methods in gathering data and information, with the data collection methods deployed sequentially, progressively focusing community members and health service providers to understand the case in context. A structured questionnaire was the main data collection instrument, with simple random sampling used to collect data from 100 community members and health service providers in five dispensaries within five locations in Matinyani District, Kitui County. Vll Data analysis was carried out using descriptive statistics with frequencies and percentages used and the data presented in diagrams, charts and tables. The study concluded that the kind of health data or information that respondents needed included availability of drugs, family planning methods, methods of preventing HIV infections, nutrition and reproductive health information, among others. It was deduced from the study that radio is most effective way of providing health information to citizens within Matinyani District, followed by chief's barazas, mobile phones, then community health workers and the least is through leaflets and newspapers, in that order. The study also concluded that the attitude of staff to patients, inadequate drugs and availability of equipments contributed to the perception of quality healthcare services by the community, while absence of health workers contributes the least to the same perception. Citizens in Matinyani District consider the provision of medicine as most important when it comes to improving delivery of services, followed by provision of personnel, reduction of outpatient waiting time, involving community in management of healthcare, providing equipment, reduction of costs of services, provision of free health care to the poor and construction of hospitals among others. From the field observations it was established that posters and verbal messages are used to pass health messages in most dispensaries. Additionally dispensary walls are used to display health data and messages, including service charters. Key recommendations include, First; the Ministry of Health makes deliberate attempts to provide adequate, good quality and easy to understand information about availability of drugs, family planning methods, methods of preventing HIV infections, nutrition and reproductive health information, among others, in Matinyani District. This has the potential to improve access to information and quality healthcare at the district level in Kenya. Second; radio is the most effective way of providing health information to the community in Matinyani District since it was the most preferred channel of receiving Vlll information. It was followed by the chiefs barazas, mobile phones, and then community health workers in that order. Key messaging for health communications in Matinyani should therefore be channeled through radio. Chiefs barazas are weekly scheduled meetings at the location level that provide a convenient and cheap alternative to disseminating health information to citizens and should be frequently used by health service providers. There exists great potential in the use of mobile phones to deliver health information. This should be explored further since it emerged as the third most preferred channel to receive health communication. Furthermore other findings revealed 78% of respondents had access to a mobile phone and are willing to receive health messages through the same. Third; Since the attitude of staff to patients, inadequate drugs and availability of equipments contribute the most to the community perception of quality healthcare services, greater emphasis should be placed in customer care training to improve attitudes of service providers for better and satisfactory delivery of health services. Adequate drugs should also be provided and oversight mechanisms established to monitor absenteeism. Much more needs to be done to seek opportunities for citizens and government health service providers to access and use open data and information to create new spaces for engagement through partnerships and collaboration between all the stakeholders and holding more targeted community information meetings. Finally, the study recommends that, more medicines should be provided In order to improve health service delivery. More medical personnel and equipment should be deployed to reduce outpatient waiting time in order to improve service delivery. It is recommended that the community be involved in health care management in addition to reducing the costs of services, provision of free health care to the poor, where possible, and construction of more facilities.