Determinants of public primary health facilities preparedness for service delivery in Nyandarua County, Kenya

Abstract

The Kenyan primary health care (PHC) system is currently going through a major transformation, especially in the effort of actualizing the universal health coverage which is part of the “Big Four” national government agenda at a time when WHO regrets that at least half of the world’s population, especially in the Sub-Saharan Africa cannot obtain primary health care services. Health service is one of the building blocks in any health system. A health system with a strong PHC model delivers better outcomes. The main objective of this study was to evaluate the determinants of public primary health facilities preparedness for health service delivery in Nyandarua County. Specifically, to determine the influence of basic amenities, infection control precautionary measures, basic equipment and essential medicines on public primary health care services delivery. Data was collected using structured questionnaires from May to December 2018. The study was descriptive cross sectional with a desired sample of 47 facility in charges drawn from 47 facilities in three sub counties (Kinangop, Olkalou and Ndaragwa) out of the all the five sub counties. The study used both descriptive and inferential statistics in data analysis where 23 (49%) of the respondents indicated that their facilities had basic amenities, 32 (69%) said their facilities had basic equipment, while 39 (85%) said that infection control measures were in place and 29 (64%) said that there were essential medicines. The study found that health facilities with adequate basic amenities (p<0.05, OR=0.312, 95% CI), basic equipment (p<0.05, OR=0.195, 95% CI) and essential medicines (p<0.05, OR=0.728, 95% CI) were more likely to be prepared with primary health service delivery and added significantly to the primary health service delivery preparedness. The study concluded that the level of health care provided in primary health facilities is dependent on the level of the availability of adequate basic amenities, basic equipment and essential medicines. This study recommends that the department of health in the county should ensure timely delivery and availability of basic amenities, basic equipment and essential medicines. The department of health should also work in close collaboration with the department of roads to ensure all the primary health facilities are accessible to people seeking health services by improving the road network. A further audit can be done to all the primary facilities in the County to establish similar gaps and work towards improving them.