Abstract: Healthcare structural aspects such as physical structures, equipment and human resources are still a major challenge in the world. The structural measures of quality of healthcare assesses the capacity of the service provider and enables users to assess quality of services they access. Africa and other developing countries are still constrained in providing quality services due to poor and inadequate structural aspects. In Kenya, the Ministry of Health has initiated different measures and strategies to address these challenges to improve the quality healthcare. However, the recent change in policy introducing free maternal and neonatal services to increase demand and access to care also increased workload on the MNCH service functions, with varying impact on service quality.
Methods: Using a cross-sectional design, structural measures (based on WHO, Kenya healthcare quality and Kenya human resources for health standards) were applied to assess the quality of physical structures, equipment and human resources of all 7 tier 3 public health facilities in Kisumu County. Data was analysed both descriptively and by using Principal Component Analysis to determine impact of structural aspects on service quality. Factor loading/impact weights with absolute values ≥ 0.4 are considered to contribute sufficiently to the overall variability in quality accounted for by the factor, and those <0.4 are either irrelevant or don’t explain the observed variability. A positive impact weight indicates a positive relationship with the factor, whereas a negative sign suggests an inverse relationship.
Results: At least 5 of the health facilities were adequate in 5 of the 7 listed items of the physical aspects; 2 of the 5 cadres of human resources, and 5 of the 22 equipment types assessed. For all the factors/indicators assessed, the impact weights obtained had absolute values <0.4.
Conclusion: More than half of the facilities had adequate quality of most items listed for physical aspects required for MNCH. However, unavailability and lack of adequate quality of majority of the items listed for human resources and equipment still pose considerable drawbacks to providing quality MNCH services. These are critical to correctly performing recommended technical and functional maternal, newborn and child health care tasks. These results indicate a clear need for improvement intervention strategies to strengthen all the structural components of MNCH service delivery functions in Kisumu County.
Keywords: Maternal, Newborn and Child Health, Structural aspects, quality healthcare, tier 3 public health facilities.
Title: Healthcare structural factors that determine quality of Maternal, Newborn and Child Health services at tier 3 public health facilities of Kisumu county, Kenya
Author: Vincent O. Ibworo, Bernard Guyah, Dickens Omondi
International Journal of Healthcare Sciences
ISSN 2348-5728 (Online)
Research Publish Journals
