Thesis:

Assessing Preparedness of Health Care Facilities in the Implementation of Universal Health Care in Nakuru West Sub-County, Kenya

Universal health care (UHC), all Kenyans are able to access essential quality health services without suffering financial hardship which depends on availability and competence of health care providers whose intent is to deliver health services to the Country’s population. The study aimed to examine the preparedness on the health care facilitieson the implementation of UHC in Nakuru West Sub-County in tier 1, 2 and 3 at public health facilities, private health facilities and faith-based health facilities. The study applied cross sectional design. Data collection was through administration of structured questionnaire to various staff at Sub-County hospital, health centres and dispensaries. Interviews were conducted on health key informants; a checklist was used on the availability of health facilities and Focus Group Discussion (FGDs) with community members who visited the health facilities. The stratified sampling was used to select facilities from six different wards which were grouped into hospitals, dispensary and community clinics, while stratified sampling was used on the health care providers, purposive sampling on the key informants and focused group discussion on the community members seeking health services in health facilities. The data was analyzed descriptively through determination of means and frequencies as well as inferentially through Spearman’s correlation analysis to determine to determine the relationship between the perception on the healthcare facilities readiness, the perception on the role played by CHVs and the perception on the satisfaction level of the CHVs with the successful implementation of the UHC. All the test was performed at 95% (P=0.05) level of significance. Data analysis was done by Statistical Package for Social Sciences (SPSS) 23rd version computer software. The study results indicated that the health care providersreceived somegeneral training as wellas supervision. However, some health care providershad not acquired adequate training on UHC, inadequate number of HCP, inadequate efforts to motivate them, inadequate funding making the healthcare facilitieslack essential commodities and also theCHVswere fundamental in the implementation of UHC;howeverthey received inadequate facilitationby county government. Most of theamenities necessary for the implementation of the UHC were still at inadequate state. It was only the level of electricity connection and labeling of the rooms within the health facilities which showed strongest and statistically significant positive Spearman’s correlation with readiness for UHC implementation (R=0.944 and P=0.045 & R= 0.922 and P=0.038 respectively). In conclusion, CHVs had significant contribution to the implementation of UHC(High R values and P values of <0.05). There satisfaction had significant contribution on the implementation of UHC (high R values and P values of <0.05). For effective UHC implementation, there is need for the national and county governments to avail adequate funds to all facilities for improvement of the amenities provide proper facilitation on UHC, adequate appreciation of HCP.Recommendation, recruiting adequate numbers of HCP, more funds on policy facilitation, upgrade of health facilities amenities and adequate funds to support CHVs. There is need for further study to be conductedto establish the community members’ uptake of UHC.