Impact of health service delivery on quality-of-life outcomes in non-communicable disease management in Mombasa County in Kenya

Abstract

This study investigates the impact of healthcare service delivery on quality-of-life outcomes among patients with hypertension and diabetes in Mombasa County, Kenya, identifying potential barriers and facilitators affecting their management of non-communicable diseases. Using a descriptive cross-sectional design, data was collected through structured surveys from patients at Coast General Teaching and Referral Hospital. The study was guided by the Availability, Accessibility, Acceptability, and Quality (AAAQ – Triple A, Q) framework and the WHOQOL-BREF tool. Findings revealed that patients face multiple barriers to effective care, including inadequate staffing, limited availability of essential drugs, and insufficient diagnostic services. Accessibility challenges such as high transport costs, limited insurance coverage, and geographic distance, especially for rural patients, further hindered timely care. Cultural acceptability also emerged as a concern, with many patients reporting that healthcare providers lacked cultural sensitivity, empathy, and effective communication. These factors not only impacted clinical outcomes but also influenced emotional well-being, social interactions, and environmental satisfaction, which are key aspects of quality of life. While availability and accessibility were prioritized, the study also found that the acceptability and quality of care significantly affected trust, satisfaction, and adherence to treatment. The study calls for targeted, patient-centred interventions such as culturally competent training for healthcare providers, investment in healthcare infrastructure, and policy reforms to promote equitable access. These improvements are essential to strengthening non-communicable disease care and enhancing the quality of life for affected individuals in Mombasa County.