Influence of Health Systems’ Support Factors on Provision of Quality Health Services at the National Referral Spinal Injury Hospital.

Abstract

Quality healthcare is a basic human right. Quality in healthcare is a product of mutual interaction of both the patient, the healthcare provider and the environment of care. Quality in healthcare results in satisfaction for the clients, the provider and overall better performance for the organization. This study sought to evaluate the influence of Health Systems’ Support factors on provision of quality Health Services at the National spinal injury hospital. The study focused on the service delivery pillar. The study was based at National spinal Injury hospital. The specific objectives were to determine the influence of governance, health workforce, and information communication technology and hospital infrastructure on provision of quality health services. The Donabedian model, a paradigm in quality health care guided the study. The study adopted a descriptive cross sectional study design. A census method was done on 80 health workers using Likert based structured questionnaires and at least 10 in-depth interviews were conducted purposively on patients. Quantitative data was analysed using IBM-SPSS version 24, for descriptive and inferential statistics. A response rate of 78 (97.5%) was attained. Male respondents were 29 (37%), female 49 (63%). Majority of the respondents were between (36-45) years, 46% were degree holders with only 37% having a diploma qualification. All the staff had served the facility for over a year with the majority 54% having served for between 6-10 years. The results of the bivariate analysis indicated that, Governance (p<0.001), Health workforce (p< 0.001), Information Communication technology (p< (0.001) and Hospital infrastructure (p<0.001) were significantly associated with Provision of quality health services. Further, multivariate regression analysis indicated that Governance (p< 0.008), Health workforce (p<0.016) and Hospital infrastructure (p<0.032) were significantly vii associated with Provision of Quality health services while Information Communication Technology (p-value=0.078) insignificantly influenced provision of quality health services. The four independent variables combined accounts for 50.9% variation of the dependent variable(NagelKerke R2 =.509) with a goodness of fit (X2=,14.493;p value=0.75)This study concludes that staff and systems responsiveness, shared direction and accountability are embraced in the facility, Health workforce were well trained, well supervised and well-motivated, The information system infrastructure was in place although not well utilised, Facility was well designed to support spinal injury patients. The study recommends that the hospital should adopt a horizontal system of leadership with the aim of promoting the relationships between the management and the employees and also the facility to embrace support supervision to the staff and establish non-punitive measures for error admission and error reporting. The facility to introduce a reward system aimed at promoting the morale of the staff, also more specialised training to be done on emerging SCI technologies. Sufficient training should be done on staff on the use of ICT at the facility for ease of decision making. The facility’s management should seek the services of architects, engineers and other construction planners with the aim of improving the existing structures or constructing new ones aimed at promoting the quality of services provided.