Influence of Direct Government Funds on Service Delivery in Primary Health Care Facilities in Kenya

Abstract

Introduction: Financing health care services is a global problem for all governments even among the developed countries. The problem is even more magnified in low and middle income countries with struggling economies and competing demands for financial needs; which has adversely affected the delivery of health care services to citizens. In Kenya, research to inform policy development and procedures in healthcare funding has been limited. This research focused to understand the effect of direct government health funds on service delivery in primary health facilities of Meru County, Kenya. Method: This was a cross-sectional study design. A total of 400 respondents from the community, 30 health providers and 30 facility health management team participated in the study using questionnaires and observation. The questionnaire covered five thematic areas. Data was descriptively analyzed using statistical software STATA version 12. Highlighting challenges in health sector funding and facility management and the role of the community in the management of the facility fund. Results: Direct funding at the primary health facilities in Meru County did not have a direct effect on service delivery. Respondents working in the government funding reported that they don’t receive funds regularly and no specific times of receiving funds, other majority indicated that the budget approval request was not acted upon promptly. Furthermore, there was an inadequate audit trail and utilization of funds in most cases was diverted to other expenses believed not to have a direct influence in service delivery. Most funded facilities still experience drug shortage causing delays of service delivery and thus influencing clients to opt for alternative sources of care. The modality of the funds, role played by county health management team (CHMT) and health facility management team (HFMT) are still insignificant in promoting quality of care during service delivery. Conclusion: There has been an overwhelming proof that the funding from the government has helped facilities in Buuri become more effective and serve more people, especially in buying equipment as well develop infrastructure in the facilities and remuneration of human resource (casual labors). Nonetheless, the recipients of the fund feel that there is still more to be done to improve the function of the Health Sector Services Fund (HSSF), in service delivery such as ensuring transparency and facilitating proper planning and timely delivery of the fund. Recommendations: The CHMT should educate the community living around the facilities on their role and functions of the facility management committee through seminars and workshop. The health management committee should also develop an information management system where all the people who use the facility could get information about the facility, its management and the funding sources.