Relationship Between Structural Arrangement and Provision of Primary care Quality: A Case of Health Centers in Nakuru County, Kenya

Abstract

Introduction: Healthcare is a fundamental need, its availability and comprehensiveness helps in making people’s life better and productive. Delivery of quality care requires an efficient system with adequate capacity of well trained and motivated health workforce, good infrastructure, good leadership and governance and effective system for financing primary care. This study aimed at finding out the relationship between structural arrangement and provision of primary care quality in Kenya and majorly focused on the public health centers in Nakuru County. Methods: The study used census research design. A total of 102 respondents comprising technical health workers were included in the study. Data was collected using closed and open ended questionnaire and was analyzed using SPSS. Descriptive analysis was used to profile the characteristic of the respondents. Mean standard deviation and correlation was used to perform analysis of the extent to which each independent variable was considered significant in influencing provision of quality primary care service. Findings: Adequate infrastructure led to an increase in provision of primary care quality in health centers (r=0.453, P<0.001), while increased employee capacity improved provision of primary care quality (r=0.365, P<0.001). Sufficient fund and effective financial management improved provision primary care quality (r=0.567, P<0.001) and effective governance improved provision of primary care quality (r=0.613, P<0.001). Conclusion: The results show that good infrastructure, sufficient funds, high staff capacity, transparency and accountability improved primary care service delivery. Good structures lead to good processes and ultimately good health outcome. Provision of equipment’s to perform the necessary work, adequate allocation and timely release of funds to health centers, career progression and continuous professional development, institute staff retention measures and frequent auditing of assets and liabilities and report made public.