Effects of Accessibility on Health Service Delivery in Public Hospitals in Kilifi County, Kenya

Abstract

Achieving UHC has remained a severe challenge globally, with countries experiencing severe gaps in the healthcare delivery system. Therefore, this research intends to bridge the gap by investigating UHC's effects on healthcare services in Kilifi County. The study aims to establish how accessibility affects health service delivery in public hospitals in Kilifi County. Institutional and new public management theories guided the study. The study adopted a descriptive research design and targeted a total of 2875 participants comprising both healthcare workers and patients attending the healthcare facilities and senior healthcare management team. The researcher adopted stratified random and convenience sampling to select 288 subjects for the study. A pilot study was undertaken to establish the validity and reliability of data collection instruments. The data were collected using a structured questionnaire for quantitative data and an interview guide for qualitative data, and the results were presented using percentages and frequency tables. Descriptive statistics and a regression model were used to analyze quantitative data, while qualitative data utilized thematic analysis. The results from the study showed that there was a significant association between accessibility factors for the patients where availability of services was associated with increased service delivery OR =1.25,95% CI=0.90-1.74, p=0.190) while staying further away from the facility is associated with decreased service delivery (OR) =0.76,95% CI=0.34-1.67, p=0.49). Similarly, easy accessibility was associated with improved service delivery on healthcare workers' factors OR =1.09,95% CI=0.21-5.68, p=0.9180). Thematic analysis revealed similar findings where increased accessibility was associated with increased service delivery. The results of the study were used to make recommendations for improving accessibility through integrating healthcare services within different departments and healthcare facilities using ICT. Finally, the study recommends further research on how technology in healthcare will increase accessibility.