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 Dadaab Refugee Camp population to be on a declining trend. The declining trend was due to relocations, and voluntary repatriation of the refugees. 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 health services during the transition period in IFO Camp of Dadaab Refugee Complex, Garissa County. Specific objectives included: to establish the influence of structural re-organization on the access to primary care services; determine the influence of resource re-adjustments on the access to primary care services; investigate stakeholders influence on the access to primary care service; and assess the influence of management processes on the access to primary care services during the transition period. The study adopted cross-section descriptive study design that combined both qualitative and quantitative methods of data collection. 384 sample size was estimated through Krejcie and Morgan formulae. Random, exhaustive and purposive sampling were applied in the selection of the sample. The study used both questionnaires and interviews in collecting primary data and statistical package for social sciences (SPSS) version 23.0 for data analysis of quantitative data. Study findings revealed that four institutional re-organizations had taken place in the primary healthcare sector of Ifo Camp in the last 12 months (transition period), namely; management process (51.3%), resource re-adjustment (11.7%), structure re-organization (9.9%), and stakeholders’ role (5.5%). Structural reorganization and Resource re-adjustments factor had a positive correlation and influence in accessing primary care services at Ifo Camp (Χ2 (1) = 204.0, p < .001) and (Χ2 (1) = 67.9, p < .001) respectively. The two variables had positive and significant correlation to healthcare access. Stakeholder’s involvement in the institution reorganization ((Χ2(2) > = 2.597, p = 0.25) and management processes ((Χ2 (2)> = 2.236, p = 0.157) were found not to have significant correlation with access to primary care services. It was recommended that there should be an effective and proper structural reorganization during the transition period to enhance access to primary service; collaboration with other stakeholders is recommended; and instituting effective and proper management during the reorganization period. Further research needs to be carried out to establish other institutional factors/reorganizations that affect access to primary care services at Ifo Camp in Dadaab Refugee Complex in Garissa and other refugee camps.