Exploring the perceptions of pediatric health care workers on audit and performance feedback in Kenyan County Hospitals
Poor service delivery in the Kenyan public healthcare institutions can be attributed to non-compliance to evidence based practises and clinical guidelines by the health providers. This has resulted to drug dose errors, poor compliance with evidence‐based standards and high mortality rates from avoidable and treatable illnesses in children. It is through audit that intervention approaches and processes are developed and implemented in a healthcare system to improve service delivery. Health systems must be improved if continued and sustained gains in health outcomes are to be made particularly in low and middle income countries. Through an exploratory qualitative research design using semi-structured interviews and focus group discussions, the perceptions of the healthcare workers on audit and feedback were explored. A total of 53 paediatric healthcare workers from were purposively sampled through 10 focus group discussions and 10 semi structured interviews. Data were transcribed, themes explored, and revised in two rounds of coding and analysis in Microsoft Excel, subjected to a layered analysis, and reviewed. Eight major themes of the perceptions and behaviour of the healthcare workers to A&F were identified: commitment to improve care; opportunity to reflect on quality of care delivered; understand hospital morbidity and mortality; reinforced standards on care; used data for planning; enhanced teamwork, A&F as an incentive; and enhanced supportive supervision. The reporting and the data within the hospitals were accurate and reliable and used for decision making. The audit and performance feedback reports positively influenced the behavioural attributes and the leaderships and management skills of the health workers. The hospitals appreciated the feedback reports which elicited reactions they were never aware about their performance. There was general perception in the improvement of paediatric care and reduction in variation in practice and documentation process in the hospitals.