Influence of institutional reorganization on the access to primary care health services in a transition period: A case of IFO camp, Dadaab refugee complex, Kenya

Abstract

The refugee population verification exercise in 2016 indicated the Dadaab Refugee Camp population to be on a declining trend. The declining trend was due to relocations, and voluntary repatriation of the refugees. Health service delivery has transmuted from difficult situations on previous years to serve Dadaab refugee, through soliciting sufficient funds to provide quality essential services like Primary care services for care and protection. With the call for repatriation, it was expected that health service delivery would be affected. Therefore, the study sought to assess the influence of institutional reorganization on the access to primary care services during the transition period in IFO Camp of Dadaab Refugee Complex, Garissa County. The study adopted cross-section descriptive study design that combined both qualitative and quantitative methods of data collection. A total of 384 respondents were included in this study. Random sampling was used to select the respondents. Data collection was face to face using structured questionnaires. In depth interviews were done with camp leaders and institutional managers. Study findings revealed the respondents were aware of the institutional reorganizations that had taken place in the primary care health sector of IFO Camp during the transition period, namely: management process (51.3%), resource re-adjustment (11.7%), structure re-organization (9.9%), and stakeholders’ role (5.5%). The chi-square analysis showed that there was positive correlation between structural adjustment (Χ2=204; P< 0.001), resource adjustment (Χ2 = 67.9, P< .001) and access to primary health care services. Hence it was concluded that there was an association between structural adjustments, resource adjustment, and access to primary health access among the refugees. The study recommends that; i) all stakeholders inside the refugee camp should be involved for effective resource re-adjustments in order to ensure continued access to primary care health services during the transition period and ii) the UNHCR should ensure that there is effective management during the reorganization period in order to ensure efficiency use of resources for better access to health services during the transition.