Social accountability of health facility committees in delivery of primary health care services in Nyandarua County, Kenya
Date
2024
Authors
Muriithi, B. M.
Journal Title
Journal ISSN
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Publisher
Strathmore University
Abstract
Despite Health Facility Committees being recognized as a useful mechanism of social accountability, they remain inherently unprepared for their role. The study sought to determine the social accountability of health facility committees in the delivery of primary health care services in Nyandarua County, Kenya. Specifically, the study sought to document sources of information used by HFMCs, the role of existing formal and informal guidelines on the functioning of HFMCs, the influence HFMCs community participatory processes and to assess the decision-making processes regarding primary health care service delivery in Nyandarua County. The study adopted the social contract theory, stakeholder theory and Bove Model. The researcher adopted a mixed-method correlational research design. First, the study adopted a descriptive quantitative approach to determine the relationship between variables using dispensaries and health centers in Nyandarua County as the unit of analysis A total of 32 Health Facility Management committees and 32 health administrators were sampled and included in the study using a stratified random sampling approach. The study collected primary data using questionnaires and focused group discussions. Participants for the focus group discussions were purposively sampled from each of the 32 health facility committees using a criterion that ensured heterogeneity in terms of gender, age, and years of working experience. Data analysis included descriptive analysis of means frequency and percentages using Statistical Package for Social Sciences for the survey data and manual thematic coding for the qualitative interview data. The findings revealed that HFMCs get information on the status of healthcare provision from the management, medical staff, subordinate staff, and the county government. In addition, the findings revealed that HFMCs are usually guided by formal and informal guidelines. Furthermore, the findings revealed that one on one community meetings are the most helpful participatory mechanism. One-on-one meetings allow HFMC members to engage directly with community members on a personal level. Finally, the findings revealed that among decisions that HFMCs are involved in are income-generating activities decisions and hiring and firing of facility support staff. Regarding sources of information used by HFMCs, the researcher concluded that the main source of information is from the member’s community. Concerning the existing guidelines on the functions of HFMCs, the study concluded that the majority of the guidelines used by the committee are informal. The study also concluded that one one-on-one community meetings are the most commonly used participatory mechanism. Regarding the decision making process the study concluded that HFMCs are involved in various decision making however they are mostly involved in advocating and mobilizing resources on behalf of the health facilities they represent. From the conclusion the study recommended that the County Government of Nyandarua should ensure that there is training of the committees and availing of guidelines for the HFMC on various issues including information gathering, community participation, and decision making.
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Citation
Muriithi, B. M. (2024). Social accountability of health facility committees in delivery of primary health care services in Nyandarua County, Kenya [Strathmore University]. http://hdl.handle.net/11071/15555