Influence of Devolved Financial Resource Governance Structure on Service Delivery in Public Health Sector in Kenya

Globally, the health sector is an area that any government must focus on since health is a right of every human being. Kenya particularly initiated the idea of devolution and the Big Four Agenda to ensure service delivery to citizens was achieved. Nevertheless, the situation in the public health sector has been encountering challenges due to dissatisfaction of personnel culminating in strikes. The objective of this study was to explore the effect of the working environment on service delivery in the health sector in Nyeri County, Kenya. The study was guided by the person–environment fit theory. The descriptive cross-sectional research design was used. The target population was derived from public hospitals in Nyeri County. Proportionate stratified random sampling was utilized, where 141 respondents were targeted, comprising doctors, clinical officers, and nurses. Data was collected using a closedended questionnaire. A pilot study was conducted at Mukurwe-ini Hospital to enhance the validity and reliability of the data-collection instrument. A Cronbach alpha coefficient of 0.7 was used to ascertain the reliability of the instrument. Data was analyzed using descriptive and inferential statistics from the 78.7% respondents. The findings established that the working environment had positive and significant effects on service delivery (β1 = 0.476, p-value = 0.000) at the 5% level of significance, hence rejecting the null hypothesis. The study further established that the public health sector in Kenya should address the drug shortage, medical staff working hours, and machine maintenance as they would adversely affect quality of service delivery. The study recommends that the public health sector should provide health workers a conducive working environment and all necessary tools and equipment to enable them to discharge their duties effectively with a view to enhance service delivery to patients. Future research should focus on the importance of on–the-job training for effective service delivery in the public health sector.

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Internal control and quality service delivery in a public health sector: A case study of a Local Government in Uganda

AFRICAN JOURNAL OF BUSINESS MANAGEMENT ◽

10.5897/ajbm2019.8819 ◽

2019 ◽

Vol 13 (16) ◽

pp. 557-563

Author(s):

Otieno Ong’unya Gordon ◽

Abbey Kalenzi

Keyword(s):

Public Health ◽

Local Government ◽

Service Delivery ◽

Internal Control ◽

Health Sector ◽

Quality Service ◽

Public Health Sector

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Corrupt Practices in the Public Health Sector: A Focus on Metropolitan Local Government Areas of Kano State, Nigeria

The Nigerian Journal of Sociology and Anthropology ◽

10.36108/njsa/0202/81(0290) ◽

2020 ◽

Vol 18 (2) ◽

pp. 149

Author(s):

Mohammed Mustapha Namadi

Keyword(s):

Public Health ◽

Local Government ◽

Health Sector ◽

Sampling Technique ◽

Healthcare Services ◽

Healthcare Sector ◽

Healthcare Provision ◽

The Public ◽

Public Health Sector ◽

The Government

Corruption is pervasive in Nigeria at all levels. Thus, despite recent gains in healthcare provision, the health sector faces numerous corruption related challenges. This study aims at examining areas of corruption in the health sector with specific focus on its types and nature. A sample size of 480 respondents aged 18 years and above was drawn from the eight Metropolitan Local Government Areas of Kano State, using the multistage sampling technique. The results revealed evidence of corrupt practices including those related to unnecessary-absenteeism, diversion of patients from the public health facilities to the private sector, diverting money meant for the purchase of equipment, fuel and diesel, bribery, stealing of medications, fraud, misappropriation of medications and unjustifiable reimbursement claims. In order to resolve the problem of corrupt practices in the healthcare sector, the study recommended the need for enforcement of appropriate code of ethics guiding the conduct of the health professionals, adoption of anti-corruption strategies, and strengthening the government monitoring system to check corruption in public health sector in order to ensure equitable access to healthcare services among the under-privileged people in the society.

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Interprofessional collaboration among health professionals in cleft lip and palate treatment and care in the public health sector of South Africa

Human Resources for Health ◽

10.1186/s12960-021-00566-3 ◽

2021 ◽

Vol 19 (1) ◽

Author(s):

Phumzile Hlongwa ◽

Laetitia C. Rispel

Keyword(s):

Public Health ◽

Health Professionals ◽

Cleft Lip ◽

Cleft Lip And Palate ◽

Interprofessional Collaboration ◽

Collaborative Leadership ◽

Health Sector ◽

Group Function ◽

Public Health Sector ◽

Effective Group

Abstract Background Collaboration among different categories of health professionals is essential for quality patient care, especially for individuals with cleft lip and palate (CLP). This study examined interprofessional collaboration (IPC) among health professionals in all CLP specialised centres in South Africa’s public health sector. Methods During 2017, a survey was conducted among health professionals at all the specialised CLP centres in South Africa’s public health sector. Following informed consent, each member of the CLP team completed a self-administered questionnaire on IPC, using the Interprofessional Competency Framework Self-Assessment Tool. The IPC questionnaire consists of seven domains with 51 items: care expertise (8 items); shared power (4 items); collaborative leadership (10 items); shared decision-making (2 items); optimising professional role and scope (10 items); effective group function (9 items); and competent communication (8 items). STATA®13 was used to analyse the data. Descriptive analysis of participants and overall mean scores were computed for each domain and analysed using ANOVA. All statistical tests were conducted at 5% significance level. Results We obtained an 87% response rate, and 52 participants completed the questionnaire. The majority of participants were female 52% (n = 27); with a mean age of 41.9 years (range 22–72). Plastic surgeons accounted for 38.5% of all study participants, followed by speech therapists (23.1%), and professional nurses (9.6%). The lowest mean score of 2.55 was obtained for effective group function (SD + -0.50), and the highest mean score of 2.92 for care expertise (SD + -0.37). Explanatory factor analysis showed that gender did not influence IPC, but category of health professional predicted scores on the five categories of shared power (p = 0.01), collaborative leadership (p = 0.04), optimising professional role and scope (p = 0.03), effective group function (p = 0.01) and effective communication (p = 0.04). Conclusion The seven IPC categories could be used as a guide to develop specific strategies to enhance IPC among CLP teams. Institutional support and leadership combined with patient-centred, continuing professional development in multi-disciplinary meetings will also enrich IPC.

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Identifying and bridging the knowledge-to-practice gaps in rehabilitation professionals working with at-risk infants in the public health sector of South Africa: a multimethod study protocol

BMJ Open ◽

10.1136/bmjopen-2020-039242 ◽

2021 ◽

Vol 11 (5) ◽

pp. e039242

Author(s):

Pragashnie Govender

Keyword(s):

Public Health ◽

South Africa ◽

At Risk ◽

Neonatal Intensive Care ◽

Qualitative Data ◽

Health Sector ◽

Critical Time ◽

Reliability And Validity ◽

The Public ◽

Public Health Sector

IntroductionEarly childhood is a critical time when the benefits of early interventions are intensified, and the adverse effects of risk can be reduced. For the optimal provision of early intervention, professionals in the field are required to have specialised knowledge and skills in implementing these programmes. In the context of South Africa, there is evidence to suggest that therapists are ill-prepared to handle the unique challenges posed in neonatal intensive care units and wards with at-risk infants in the first few weeks of life. This is attributed to several reasons; however, irrespective of the causative factors, the need to bridge this knowledge-to-practice gap remains essential.Methods and analysisThis study is a multimethod stakeholder-driven study using a scoping review followed by an appreciative inquiry and Delphi process that will aid in the development, implementation and evaluation of a knowledge translation intervention to bridge knowledge-gaps in occupational and physiotherapists working in the field. Therapists currently working in the public health sector will be recruited for participation in the various stages of the study. The analysis will occur via thematic analysis for qualitative data and percentages and frequencies for descriptive quantitative data. Issues around trustworthiness and rigour, and reliability and validity, will be ensured within each of the phases, by use of a content validity index and inter-rater reliability for the Delphi survey; thick descriptions, peer debriefing, member checking and an audit trail for the qualitative data.Ethics and disseminationThe study has received full ethical approval from the Health Research and Knowledge Management Directorate of the Department of Health and a Biomedical Research Ethics Committee. The results will be published in peer-reviewed academic journals and disseminated to the relevant stakeholders within this study.

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Who manages health workforce in the States of India: Profile, knowledge and perceptions of the team

European Journal of Public Health ◽

10.1093/eurpub/ckaa166.664 ◽

2020 ◽

Vol 30 (Supplement_5) ◽

Author(s):

S Khurana ◽

S Roy ◽

M Gupta

Keyword(s):

Public Health ◽

Capacity Building ◽

Human Resource ◽

Health Workforce ◽

Health Sector ◽

Limited Resource ◽

Role Clarity ◽

Public Health Sector ◽

Hrm Practices ◽

Significant Difference

Abstract Problem Human resources in the public health sector is of prime importance in a limited resource setting country, who at times work in a high-pressure, limited resource environment and where skilled staff continue to remain in short supply. The role of Human Resource for Health (HRH) team responsible for managing this health workforce is crucial. They play an important role in improving the human resource practices and creating an enabling organizational culture for optimal resource utilization. The paper explores the profile of the HRH teams of the states of India, their knowledge levels, and perceptions of their role. Methods The participants were HR Managers from 29 states of India who look after HRH in National Health Mission and State Health Departments. Cross-sectional survey tool was used for data collection. Quantitative data analysis included univariate and bivariate analysis. One Way ANOVA test of significance and post-hoc tests using Tukey's method was used to ascertain the groups with significant difference. Results Most of the HRH team members are postgraduates or have management background. Their experience varies from <1year to > 25 years. Mostly of them perceive their role to be limited to implementing bare essential HRM practices, mostly administrative. The educational qualification of the members did not have any significant bearing on their technical knowledge related to HRM practices; but their experience in public health sector showed a significant association. Lessons This study lends evidence to the principle that professionals who have been in the system for long, know about HRH and the associated policies better, and hence may be better equipped to handle HRH and establish good HR Management (HRM) systems. Better role clarity among the HRH teams, expansion of their current scope of work to include advanced practices of HRM and continuous capacity building mechanisms are needed to help strengthen the development and management of HRH. Key messages This study, a first of its kind in the country, lend evidence related to the principle for deciding the profile of team who should be entrusted with managing and development of HRH. The Study gives evidence to focus on the role clarity of HRH to zero down their knowledge and skills gaps and enhance their competencies through better capacity building.

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