Thesis

Human resource management practices influencing performance of nursing officers in Nyeri County, Kenya

Thu, 01 Aug 2019 00:00:00 GMT

Human resource management practices influencing performance of nursing officers in Nyeri County, Kenya Ongori, Jeremiah Motari Various organizations employ different human resources initiatives in order to increase efficiency. The most common initiatives employed to improve efficiency include performance contracts, internal contracting, contracting-out and outsourcing of services among others. Employing such initiatives are considered among the primary HRM practices, which are aimed at determining the equilibrium between workforce supply and the ability of healthcare practitioners to practice effectively and efficiently to ensure improved and quality care in healthcare systems. This study deliberated on HRM practices that influence the performance of nursing officers at Nyeri County, Kenya. The explicit objectives of this study were to determine how recruitment affects the performance of nursing officers, to examine how training influences performance of nursing officers, to determine the influence of deployment practices on the performance of nursing officers, and to determine the influence of motivation on the performance of nursing officers. The study targeted nursing staffs and managers in Nyeri County public health institutions and at the County Director’s Office. A stratified sample of 248 was selected and surveyed. Data was collected using self-administered questionnaire. Descriptive and inferential statistics using statistical package for social sciences SPSS 23 was conducted. The researcher found that recruitment processes in Nyeri County comprised of internships (f=109, 44%) and field placements (f=82, 33%). Selections were made via individual interviews (f=225, 91%) while job orientation (f=237, 96%) was the main orientation technique. Through the study, the researcher found that training of nurses was conducted but there was a limitation in the diversity of approaches used. Results showed indicate that on the job training (f=156, 63%) training courses (f=70, 28%) were the major approaches of training. The researcher found that there were gaps in the deployment practices with mean value of 2.73, SD=1.132. Deployment in some departments was deemed as disciplinary action (M=3.09, SD=1.325) and managers response to deployment needs per department or ward or facility (M=3.07, SD=1.218) were rated to moderate extent. The researcher also found that motivation of nurses was not well done with a mean of 2.84, SD=1.090, and there were no upgrading and promotion opportunities (M=1.81, SD=1.133) for nurses in the county. There was a moderate performance of nurses with a mean value of 3.75, SD=1.100. Chi-square analysis showed that training (χ2= 34.500, df=12, p=0.001) and motivation (χ2 = 28.860, df=16, p=0.025) were significant at 95% confidence level. All the Cramer’s V values were positive indicating that HRM practices enhance performance. The Cramers’ V values show that motivation (v=0.473) was the most influential factor followed by training (v=0.422). The researcher concluded that unsatisfactory performance of nurses is due to inadequate training and lack of motivation. The researcher therefore recommended that training programs in the health sector should be reviewed in order to employ more techniques in the training of nursing officers in service. In addition, motivation approaches and techniques used in the health sector should be overhauled as they are not effective. In particular, remuneration of nursing staffs who have upgraded should be reviewed according to human resources policy.

Assessment of factors affecting healthcare waste management system in Machakos County, Kenya

Sun, 01 Sep 2019 00:00:00 GMT

Assessment of factors affecting healthcare waste management system in Machakos County, Kenya Mwania, Michael Musango In general, most local authorities in Kenya have been unable to cope up with the segregation, the treatment and methods of waste disposal especially healthcare waste. Health facilities in Machakos County have poor practices when it comes to the segregation of healthcare waste, its treatment & disposal; the general population, the patients, the health workers including waste handlers are exposed to certain risks such as needle stick injuries, a higher risk of infection of HIV/AIDS and hepatitis B&C. This study, therefore, focused on the reinforcement of the service delivery pillar of Health Systems, through addressing aspects of securely managing healthcare waste in medical facilities in Machakos County. The general objective of this study was to ascertain factors affecting the management system of healthcare waste in Machakos County in Kenya. The study was governed by four specific objectives; to determine the process of healthcare waste management, the role of health Managers, human resource factors, and how the implementation of healthcare waste management policy affect the management of wastes in the healthcare facilities in Machakos County. To obtain data for the study, a survey research-based study was used. Stratified random and purposive sampling techniques were used in drawing a sample size of 187 respondents. Questionnaires and interview guides were used in the collection of primary data, whereas existing literature that is related to the current research topic under study was used for the purposes of secondary data. The study findings showed that all the four independent variables healthcare waste management process health manager’s role, human resource factors, and healthcare waste management policy implementation had positively and significantly influence on the management of healthcare waste system. From the findings, the health manager’s role had the strongest positive and significant influence on the management of the healthcare waste system. The study concluded there is an inefficient healthcare waste management process in Machakos county health facilities, Health Managers understands their role in waste management but lack capacity building and enough funding to purchase required healthcare waste management commodities. Main human resource factors were lack of capacity building through continuous medical education on healthcare waste management and enough healthcare waste management commodities hence leading to inefficiencies on waste management. Most Health workers had little or no information on customized healthcare waste management policies and guidelines. The study recommended there a need for training on healthcare waste management to all healthcare staff and waste handlers in line with existing healthcare waste management policies for the healthcare waste management in Machakos County and in Kenya. County governments need to provide adequate budgets to health facilities to enable procurement of adequate healthcare waste management commodities and also adopt safe treatment technologies.

Determinants of uptake of national hospital insurance fund primary care scheme among service providers within the scope of NHIF Nakuru town branch

Sun, 01 Sep 2019 00:00:00 GMT

Determinants of uptake of national hospital insurance fund primary care scheme among service providers within the scope of NHIF Nakuru town branch Wagura, Elizabeth Wanjiku There is a growing international consensus on the importance of providing social protection through financing and providing access to healthcare services. Kenya has embraced this through the National Hospital Insurance Fund (NHIF). Despite these efforts, the uptake of the NHIF primary care scheme among service providers in the country is still low. This study sought to assess the uptake of NHIF primary care scheme amongst service providers within the scope of NHIF Nakuru Town branch. The study objectives were to: determine the influence of knowledge of service providers, examine the influence of perceived benefits of the NHIF primary care scheme, establish the influence of health facility organization capacity, and determine the influence of barriers associated with NHIF and health facilities on the uptake of NHIF primary care scheme. The study adopted a cross-sectional research design targeting 120 service providers from 60 health facilities as well as getting key information about the scheme from officers in NHIF office managing the scheme as key informants. A random sample of 96 service providers was drawn from 48 health facilities and 2 officers from NHIF Nakuru branch. Data was collected using a structured questionnaire and an in-depth guide. Quantitative data was analyzed using descriptive and inferential statistics with the aid of Statistical Package for Social Sciences version 21.0 while content analysis was used to analyze qualitative data. From the findings of this study, there was a significant, weak, positive correlation between knowledge of NHIF and uptake of NHIF primary care scheme (r =.266, p<.05). Pearson correlation computed between perceived benefits of NHIF Primary care scheme and uptake of NHIF scheme was significant, moderate and positive (r=.297, p<.05). The health facilities had adequate; ICT facilities, human resource and physical facilities for effective implementation of NHIF primary care. Pearson correlation coefficient between health facility organization capacity on the uptake of NHIF scheme was not significant (r=.109, p<.05). Thus, it was concluded that variations in the level of the health facility organization capacity was independent of the uptake of NHIF primary care scheme. All the constraints combined were likely to negatively impact on the uptake of NHIF primary care. Results of Pearson correlation revealed that the relationship between barriers of the health facilities on the uptake of NHIF primary scheme was moderate, significant and negative (r =-.246, p<.05). The study therefore concluded that NHIF should develop clear policy details on the various benefits and risks involved for health facilities that are not willing to take up the implementation of the scheme. The study recommends that the management of the NHIF scheme should i) embark on a campaign of knowledge dissemination and education of all potential consumers of their services, ii) develop clear policy details on the various benefits and risks involved for health facilities, and iii) sensitize the management of health facility on the requirements for accreditation for provision of NHIF out patient services.

Determinants of utilization of national hospital insurance fund outpatient services by private university employees in Nairobi

Sun, 01 Sep 2019 00:00:00 GMT

Determinants of utilization of national hospital insurance fund outpatient services by private university employees in Nairobi Kironji, Keziah M. The NHIF is a mandatory health insurance fund covering public and private formal sector workers and their dependents as the main health insurer in Kenya. NHIF has embarked on an ambitious reform program intended to convert it to a Social Insurance Health Scheme with an aim of serving as workers’ first pillar of social insurance. The national formal scheme members are entitled to all outpatient services after selecting their preferred facilities from a list of the NHIF accredited ones. However, there are some members on the National formal scheme whose contributions are remitted to NHIF by their employer every month but do not utilize the outpatient services. This study sought to determine if the NHIF benefit package, the perceived quality of care, the NHIF communication strategy and the administrative processes influence utilization of outpatient services by the national formal scheme members in Nairobi County with a focus on private University employees. It sought to assess the reasons for none or underutilization of NHIF outpatient services. This study adopted a cross-sectional descriptive design. Multistage sampling with simple random sampling was used. Quantitative data was corrected using self-administered questionnaires and analyzed using descriptive statistics. Likert and semi-structured type of questions were used as the main tool for collecting data. SPSS version 24 was used to analysed the data. The rationale of this study was to inform top management of NHIF to undertake decisions in regards to utilization of outpatient services by NHIF members in the formal National Scheme by understanding how quality service, benefit package, NHIF communication strategy and administrative processes influence utilization of outpatient services. The study finds that respondents have and will utilize NHIF outpatient services (M=3.80, SD= 0.84). They agree with NHIF administrative processes (M=3.4, SD= 0.89) and have knowledge of NHIF benefit package (M=3.42, SD= 0.82). They disagree with quality of NHIF outpatient services (M=3.21, SD= 0.66) and NHIF communication strategy (M=2.94, SD= 0.73). The study found that knowledge of NHIF outpatient benefit package (X1; t = 1.142, p = 0.255 ˃ 0.05), perceived image of NHIF outpatient services (X2; t = 1.196, p = 0.241 ˃ 0.05) and NHIF communication strategy (X3; t = 1.196, p = 0.241 ˃ 0.05) have no influence on utilization. However, NHIF administrative processes (X4; t = 4.579, P = 0.000 ˂0.05) positively contribute to and have a significant influence on utilization of NHIF outpatient services by private university employees in Nairobi county. The study recommends that a) NHIF creates awareness on the NHIF outpatient benefit package to the members, b) NHIF should vet facilities they accredit to offer outpatient services to ensure safety of healthcare services, availability of physicians, sufficient number of health workers and a well-stocked pharmacy, c) NHIF should improve on their means and frequency of communication, feedback and complains mechanisms, engage the citizens more for improvement and ensure staff are available to respond to issues, and d) Staff in NHIF accredited facilities should be made aware of patient’s entitlement to care, ease patients identification and facility selection process. This will strengthen health systems and thus improve utilization of primary health care services.

Implementation of hospital management information systems on service delivery: a case of Moi teaching and referral hospital

Sun, 01 Sep 2019 00:00:00 GMT

Implementation of hospital management information systems on service delivery: a case of Moi teaching and referral hospital Cheruiyot, Bethwel Hospital Management Information Systems (HMIS) has the potential of improving the quality of services delivered as well as the efficiency and effectiveness of healthcare providers through integration of various hospital functional units. However, the benefits of this implementation in service delivery have not been adequately addressed. This study sought to appraise the impact of implementation of Hospital Management Information Systems, on service delivery in Moi Teaching and Referral Hospital, (MTRH). The objectives of the study were: To examine the level of implementation of Hospital Management Information Systems in MTRH, to establish the strategies motivating implementation and utilization of Hospital Management Information Systems, to assess benefits that have been realized in utilizing Hospital Management Information Systems, and to assess the effect of HMIS on service delivery in MTRH. Cross sectional descriptive research design was utilized in the study where sample size formula proposed by Cooper and Schildler formula was used to obtain 240 respondents from a target population of 587 users of HMIS. The researcher employed stratified sampling technique. A structured closed end questionnaire was administered for data collection, as well as interviews. Quantitative data was obtained, coded and entered into the computer using Statistical Package for Social Sciences version 25 software for analysis. A pilot testing was carried out at Rift Valley Hospital, Nakuru. Data was analyzed using descriptive statistics, i.e. mean and standard deviations and inferential statistics i.e. Pearson Correlation Analysis and Multiple Regression Analysis. A total of 240 questionnaires were distributed to the respondents and 192 were filled and returned, a response rate of 80%. With respect to familiarity with Hospital Management Information System results indicated that majority of the respondents 37.8% were familiar with the system. For the extent of implementation on the modules the Hospital Records module had the highest implementation level mean (4.0) with a while consulting doctor module posted the lowest mean (2.1). On the level of utilization of HMIS result indicates that the mean values were above average on a five point Likert scale. Further records module had the highest utilization level, mean (3.8) while consulting doctor module posted the lowest utilization level mean (2.0). On the strategies motivating the utilization of HMIS results indicate that the presence of information strategy is the leading motivator of utilization of HMIS mean (3.73). Results indicated that the anticipated benefits of HMIS were all in above the average. The results of the regression analysis suggested that HMIS implementation (β= .215, p˂0.05), HMIS utilization (β= ..697, p˂0.05), motivation strategy (β= .193, p˂0.05), and HMIS benefits (β= .045, p˂0.05) had a positive significant effect on Service Delivery, therefore the null hypothesis is rejected. The value of the F-statistic is (F=172.917, p˂0.05) is robust to indicate the variable relationships. The coefficient of determination value of R2= .787 means that 78.7% of the variation in service delivery at the hospital can be explained by HMIS. The study recommends that a policy be drafted to entrench HMIS implementation and utilization in the Country.

Influence of performance management systems on employee productivity in county referral hospitals in Kiambu County, Kenya

Thu, 01 Aug 2019 00:00:00 GMT

Influence of performance management systems on employee productivity in county referral hospitals in Kiambu County, Kenya Owino, Carolyn Akinyi Human resource for health is one of the core pillars of health systems and performance management is one of its subcomponents. A performance management system in public health facilities is one of the tools for reforms which have been introduced in Kenya so as to improve employee productivity. Since its introduction in Kenya most health care workers assume performance management system is setting only performance targets; the whole cycle is not addressed. In addition, the performance management systems are not used as a basis of promotions and rewards. The research was an investigation on the influence of performance management system on employee productivity in the county referral hospitals in Kiambu County. Aspects that were investigated included; performance planning, continuous feedback, appraisal and reward. In order to accomplish these research objectives, a descriptive cross-sectional study was used. Quantitative and qualitative data was gathered through literature review, key informant interview guide, and closed and open-ended questionnaires. The study targeted all the employees of the three county referral hospitals of Kiambu County and proportionate stratified sampling was used to get three hundred and ten employees to participate in the study. Purposive sampling was used to select county management heads. A pretest was done to improve reliability and validity of the research instruments. Cronbach’s alpha co-efficient was applied to ensure reliability and internal consistency of the instrument for data collection. Statistical Package for Social Sciences (SPSS) version 22 is a descriptive statistical package that was used by the researcher to provide detailed information concerning the data and draw out forms of relationships. Descriptive methods and inferential statistics were used to analyze data. Bivariate correlations and regression results were also used to test hypotheses. The results were presented in tables, charts and histogram and using frequencies, percentages, standard deviations and means. The results of correlation provided strong statistical evidence that a positive and significant influence exists between performance management systems components and employee productivity. All the four variables (planning, appraisal, feedback and reward) were found to have a significant and positive influence on employee productivity in the county referral hospitals in Kiambu County. From the key informant interviews, planning, appraisal, feedback and reward had an influence in employee productivity. In conclusion, regression analysis was done with the aim of determining which of the four components of performance management systems were most predictive of employee productivity when combined. The results were that performance planning and performance appraisal were found to be statistically insignificant in predicting employee productivity in county referral facilities of Kiambu County. However, feedback and reward of performance were the strongest predictors of employee productivity in county referral facilities of Kiambu County when all the four variables are combined. Recommendations of the study were that managers should set clear, realistic goals as a team, they should have regular performance reviews with their employees with discussions so as to review past performance, provide regular feedback as it is desired by employees and reward system should be linked to the results of the appraisal which is just and fair. Future studies may replicate this study to lower tiers of the health care system.

Influence of expanded free maternity care programme on delivery of quality health care in maternity units in public health facilities in Kajiado County

Sun, 01 Sep 2019 00:00:00 GMT

Influence of expanded free maternity care programme on delivery of quality health care in maternity units in public health facilities in Kajiado County Magondu, Richard Wachira A well-functioning health system works in harmony among the six pillars; trained and motivated health workers, functional infrastructure, consistent supply of essential medicines and technologies and sufficient funding.Africa is uniquely affected by maternal health challenges with a maternal mortality estimated at 686/100,000 live births. These deaths are avoidable with proper medical intervention.Kenya has high maternal mortality estimated at 360/100,000 live births.This study sought to assess quality of service delivery in maternity units of health facilities currently implementing expanded free maternity care programme in Kajiado County. It was guided by one general objective; to assess the influence of expanded free maternity care programme on delivery of quality health services and four specific objectives which were to establish how essential drugs, medical equipment, health workers and basic amenities influence quality of health services in maternity units of public health facilities in Kajiado County. The study adopted descriptive cross sectional design of survey. All the 44 health workers in labour wards who included midwives, clinical officers and medical officers were sampled. Likert based psychometric construct, self-administered questionnaire was used to collect data. Data analysis was done using Statistical package for social scientist’s software and results tabulated using frequency distribution tables. Descriptive and inferential statistics were used to provide population details and make inferences. The study found that: Health worker factors positively and significantly influenced delivery of quality of healthcare services (r= .655**, P < .001); basic amenities positively and significantly influence delivery of quality healthcare services (r= .350**, P < .020). There was positive association between availability of essential drugs and delivery of quality healthcare services r= .302**, P < .047). However, there was no association between medical equipment and delivery of quality healthcare services r=.338**, P < .006). An improvement in human resource factors and basic amenities would lead to an improvement in delivery of quality services. The study recommends that the County government of Kajiado should a) establish practical modalities for maintenance and replacement of worn-out medical equipments, b) deploy adequate staff to level 2 and 3 health facilities especially those in rural and far-to-reach areas, and c) establish a County fund to enable timely provision of essential drugs, d) prioritize provision of adequate water and reliable power source for all rural health facilities.

Performance of trained clinical officers in reproductive health service delivery through task shifting: opportunities and its challenges in Kenya

Sun, 01 Sep 2019 00:00:00 GMT

Performance of trained clinical officers in reproductive health service delivery through task shifting: opportunities and its challenges in Kenya Kishasha, Meshack Kijungu The world is experiencing a chronic shortage of well-trained health workers with a global deficit of doctors, nurses and midwives being approximately 2.4 million, and with low- and middle income countries having acute human resource crisis. Human workforce Health crisis in Sub-Saharan Africa has been due to the critical shortage especially of the doctors, nurses and mid-wives. To alleviate this shortages, task shifting was recommended in 2004 and approved by the World Health Organization in 2008 in Addis Ababa. In Kenya, under the policy of skills transfer, clinical officers, were trained and task shifted as from 2002 to perform emergency obstetrical and gynecological procedures in order to fill the gaps left by the doctors. The purpose of this study was to determine the performance, challenges and the opportunities in task shifting for the trained clinical officers in reproductive health. The specific objectives of the study was to determine the level of competence, motivational challenges, regulatory, working and policy environment. This was a cross-sectional study design that used both quantitative and qualitative approaches for data collection. Seven selected counties of Muranga, Nairobi, Kakamega, Kisii, Mombasa, Machakos and Nakuru were used for study. To trace the respondents, purposive, snowballing sampling technique was employed. Structured questionnaires were administered and triangulated by both focus group discussions and key informant interviews. Qualitative data was analyzed through content analysis. Performance was measured by observing how well the officer performed a particular procedure besides record retrieval of previously performed operations. The researcher reviewed literature from previous records on trends in reproductive health services since the inception of task shifted clinical officers in 2004. One hundred and fifty clinical officers were targeted for study. A sample of 45 reproductive health clinical officers was captured for study calculated as 30% of the target population for cluster group surveys. The study found out that motivation builds a better, more satisfied and better performing workforce as evidenced by response of further training (66%), provision of housing at facility (53.33%), recognition as specialist (66.66%), increase in service utilization such as ANC (53.34%, deliveries (86.67%), good outcomes in deliveries (80%) and obstetrical operations (93.33%). There was significant statistical evidence of competence in performing task shifted obstetrical and gynecological procedures at p-value 0.05, computed chi-square value of 7.134 against the critical value of 9.488. Sixty six respondents agreed that there was reduced maternal mortality rate as reflected in 2014 Kenya demographic Health survey, increased number of hospital deliveries and good delivery outcomes. Analysis of Variance with a computed value of 95.7, p-value 0.05 and critical value of 2.45 indicated that responses from despondence differed significantly while response for anew act of parliament for the practice of new skills was 100%. The study concluded that the performance level of competence for clinical officers was high and that there existed reasonable degree of motivation and career opportunities for the cadre. The study recommended for the development of task shifting policy framework for the cadre, sensitization of workforce at health facilities on the concept of task shifting and enactment of act of parliament to cater and allow for the independent practice of new skills.

Use of district health information system data to facilitate decision making in Uasin- gishu sub county hospitals, Kenya

Sun, 01 Sep 2019 00:00:00 GMT

Use of district health information system data to facilitate decision making in Uasin- gishu sub county hospitals, Kenya Kuyo, Richard Ole Comprehensive and dependable information is basis for making decisions. WHO building blocks: services delivery, health information, products and technologies, health workforce, financing and governance. Aim of study was to assess use of DHIS2 data to facilitate decision making in Uasin Gishu Sub County Hospitals. Specific objectives were to determine level of knowledge, organizational, technical and individual factors prompting District Health Information System2 data use in Uasin Gishu Sub Hospitals. Study was conducted in Uasin Gishu-Sub County Hospitals (Kapseret, Kesses, Ainabkoi, Moiben, Turbo and Ziwa). Study used quantitative and qualitative methods using cross-sectional design. Questionnaire was administered to gather quantitative data from 283 providers who were selected randomly while 10 key informers were purposively selected for in-depth interviews. Quantitative data was analyzed using R Software for descriptive, bivariate and multivariate logistic regression. Thematic analysis was used to analyze qualitative data using Qualitative Data Analysis (QDA) software. Bivariate association comparing independent variables and dependent was calculated using Pearson’s Chi Square test and fishers exact test where chi square assumptions were violated. Multivariate analysis was done using logistic regression to measure for predictors. A P value of 0.05 was considered as significant. Findings of numerical variables were depicted in graphs, charts and tables. Results for qualitative data were summarized in form of themes. Approval was got from KeMU SERC and NACOSTI. Consent was sought from participants of the study. Study found that 68.4% respondents reported good, very good or excellent competence levels in data management using DHIS2, DHIS2 information application to inform policy and operational planning was reported as good, very good, and excellent by 37.3%, 18.9%, and 8.0% respectively. Half of the participants (50.0%) acknowledged availability of funds to support DHIS2, champions promoting use of DHIS2 information were records officers (56.2%). Moreover, 61.7% of participants agreed or strongly agreed age influences health workers adoption and use DHIS2 while 65.4% of participants were dissatisfied with IT Support from MOH. Although 80.9% of respondents had log in credentials, only 24.2% had difficulty with logging into DHIS2. Furthermore, 79.5% had low or moderate level of training in DHIS2, 15.0% had never trained and this is why only a third of participants had some confidence in handling tasks using DHIS2. Inferential results show Kapseret, Moiben, and Turbo were associated with higher odds of rating as moderate vs. low or high vs. low users of DHIS2 data compared to Ainabkoi, OR: 4.15 (95% CI), 3.07 (95% CI) and 5.51 (95% CI) respectively. In addition, there is significant associations between level of knowledge, organizational, technical, individual factors and level of DHIS2 data use (p<0.05). Study concludes that level of knowledge on DHIS2 information use is fair across six Sub County Hospitals in Uasin Gishu but utilization of DHIS2 information by CHMT is low. Additionally, main funder of DHIS2 system is County Government while support from National Government is minimal; age influences users’ adoption of DHIS2 data. Level of training on DHIS2 is generally low while utilization of information on DHIS2 to facilitate decisions range from moderate to low. Consequently, study recommends that County scales up utilization of DHIS2 information and generate policy measures to facilitate decision making.

Patient satisfaction with emergency care services accessed at selected public health facilities in Nairobi City County: patients’ perspective

Thu, 01 Aug 2019 00:00:00 GMT

Patient satisfaction with emergency care services accessed at selected public health facilities in Nairobi City County: patients’ perspective Osiyel, Daniel Edwin Access to emergency medical services is portrayed in the light of the truth as the capacity of the affected individual to get the perfect health attention from the wellbeing pro associations once they need it. It is an extensive length of access to medical care that requires an effective evaluation of genuine, financial and socio insightful get right of access to organizations. The aim of the study was to examine the patient satisfaction with emergency care services accessed at selected public health facilities in Nairobi City County, the purpose was to generate knowledge about improving efficiency in the delivery of emergency care in public healthcare facilities. Nairobi City County public health facilities were conveniently selected because of the high volume of patient throughput. Systematic sampling was done to identify the respondents. Descriptive cross-sectional assessment configuration was utilized where quantitative method was utilized for information gathering. Information was collected, recorded for a fourth of a year, and analyzed at p ≤ 0.05 primer of significance utilizing SPSS quantifiable gathering. The relationship between variables was tried utilizing Cronbach’s alpha values and the outcome appeared in diagrams and tables. Purposive sampling was utilized to pick the domain. The main data collection tool was the questionnaire, which included the background information, as well as a structured questionnaire enquiring about the participants’ perception of the emergency care activities. Information was gotten from a sum of 304 respondents utilizing data collection administered audit and the information obtained from them formed the basis of research data, the analysis was done using SPSS V27 and presented utilizing tables and charts. In context on the assessment exposures, it was established that crisis care patients were normally disappointed with emergency care services delivered. This was attributable to low activity by the physicians during emergency care delivery; lack of timely access to emergency healthcare due to long waiting times, low quality of care during emergencies and; lack of guaranteed healthcare facilities that could provide immediate emergency care as, and when needed, which could thwart access to emergency healthcare and therefore, satisfaction of patients with emergency healthcare. There was also low acceptability of emergency healthcare by patients, poor infrastructure therefor no ease of access. Pearson correlation shows that there was statistically significant relationship between X1 physician’s action (r=.257**, p<0.001), X3 quality of care (r=.235**, p<0.001) and X4 access to emergency healthcare facility (r=.268, p<0.001) and patients’ satisfaction with EHC. However, X2 waiting time had no significant relationship to patients’ satisfaction with EHC services (r=304, p>0.001). These findings show that physician’s action was the strongest factor that could enhance patients’ satisfaction to emergency healthcare services according to the emergency care patients. Conversely, quality of healthcare and emergency healthcare facility was equally strong. Based on the findings, several recommendations can be made; Physicians should be specifically trained to enhance patient experience during the emergency care delivery and supported by being given enough equipment enhance access to EHC; There should be a proper Management support framework in the emergency care to enhance quick access of patients so as to boost faster access to EHC; there should be adequate dissemination of required information to the physicians in order to improve quality of care and finally, There should also be effort to increase access to EHC services through provision of enough transport such as ambulances, and comfortable healthcare facilities to handle all types of emergencies, whether of medical or trauma nature.