| dc.description.abstract | Healthcare financing and resourcing have always been of great concern to low- and
middle-income countries and households. Stakeholders must devise innovative ways to remain in operation amidst reducing
financing and dynamic disease etiology to ensure that there is consistent access to quality healthcare services. The integration
of Human Immunodeficiency Virus (HIV) and non-communicable disease (NCD) services has emerged as a crucial approach
to optimize healthcare delivery and improve health outcomes. NCD and Human HIV programs are currently managed
separately, despite frequent interconnections. The study aimed to conduct a regression analysis of an HIV/NCD integration
model for healthcare providers to improve the performance of healthcare services in Nakuru County. Methods: This study
explains the effect of the explanatory variables - institutional support, health information processes, pooled resources, and
collaboration-on the explained variable- Healthcare System performance-, utilizing a multiple regression model.
Organizational culture was also used to moderate the relationship between the explanatory variables and the explained
variable. Data were collected from a representative sample of 123 healthcare workers drawn from 106 healthcare facilities
providing both HIV/NCD services in Nakuru County, Kenya. The explanatory and moderating variables were selected based
on their potential to influence healthcare system performance. The regression models were adjusted for potential confounding
variables to ensure the robustness of the findings. Results: In the Multivariate analysis, organizational culture was significant
in moderating the relationship between the integration of health services and the performance of the healthcare system, with a
p-value of less than 0.05. Specifically, health facilities that embraced a team-oriented organization culture in delivering
HIV/NCD service treatment and care were 2.142 times more likely to achieve sustainability of the services as compared to
those that did not adopt a team-oriented organization culture. These results were statistically significant at a 95 percent
confidence level. The findings of the study also revealed that institutional support in monitoring outcomes had a positive and
significant influence on the performance of the healthcare system. Health information processes have a significant influence
on healthcare system performance in Nakuru County. Health facilities that utilized functioning information systems during
the provision of HIV/NCD services were 1.987 times more likely to achieve sustainability of the services compared to those
without such systems. The findings also indicate that the performance of the healthcare system in Nakuru County was
significantly influenced by human resources and funding models. Conversely, the findings suggest that there is no significant
association between the collaboration guidelines and the performance of the healthcare system in Nakuru County.
Conclusions: This study highlights the importance of cultivating a team-oriented organizational culture within healthcare
facilities and a need for institutional support. Additionally, the availability and the ability to leverage on available resources
contribute greatly to the sustainability of services, leading to a better-performing healthcare system. These findings can guide
healthcare providers in developing strategies and interventions to enhance the integration of health services and improve
overall healthcare outcomes. | en_US |
