| dc.description | The Alma Ata Declaration of 1978 emphasized the importance of primary care as an
approach to achieve health for all. Kenya has gradually expanded primary care health
service delivery to increase access and comprehensiveness of healthcare services. It has
equipped referral facilities with modern equipment, while primary care health facilities
continued to struggle with limited resources. As a consequence, this gap has become a big
impediment to Kenya’s quest to achieve universal health coverage. Structural arrangement
has been cited as the major contributing factor to quality health services delivery. This
study examined relationship between structural arrangements and provision of quality
primary care health service in public health centers. The objectives was to assess whether
infrastructural resources, financial resources, staffing and governance influence provision
of quality primary care services in public health centers in Nakuru County. Acrosssectional
study design with mixed data collection methods was adopted for this study. A
total of 110 respondents from 33 public health centers in Nakuru County were included in
the study sample. The respondents were Clinical officers, Nurses, Pharmaceutical
Technologist and Laboratory Technologists. Data entry and analysis was done using SPSS
Version 20. Descriptive analysis was used to profile the characteristic of the respondents.
Mean, Standard deviation, correlation and regression was used to determine the
relationships. The findings showed that modern equipment and adequate supply of
essential commodities was associated with high quality primary care health service delivery
(r=0.453, p<0.01). Sufficient funds and effective management of resources significantly
determined quality of primary care health service (r=0.365, p<0.01). Health worker skills,
experience and training were statistically associated with quality primary care service
(r=0.567, p<0.01). Transparency and accountability were strongly and positively associated
with improved quality of primary care service at the public health centers (r=0.613,
p<0.01). Regression analysis showed financial resource (β= 0.32) and governance (β= 2.49)
significantly improved quality of primary care health service delivery. Study concludes
good structural arrangements lead to good processes and ultimately good health outcome.
The study recommends that county government of Nakuru should i) supply adequate
equipment to perform the necessary work, ii) provide sufficient allocation and timely
release of funds to health centers, iii) provide career progression and continuous
professional development among its health workforce, and iv) institute staff retention
measures and frequent auditing of health centers assets and liabilities and provide a report
to the public. | |
