Browsing by Author "Muiruri, Lillian"

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    Implementation of User Fee Policy in Psychiatric Hospitals in Kenya: A Case of Mathari Hospital, Nairobi
    (EdinBurg Peer Reviewed Journals and Books Publishers, 2024-08) Munene, Winnie Kanana; Tenambergen, Mwaura Wanja; Muiruri, Lillian
    In Kenya, user fees were implemented as a form of cost-sharing to lessen the financial burden of health financing on Kenyan patients. This occurred in 2004. The Kenyan Ministry of Health offers a financing mechanism through risk pooling to the greatest extent possible to achieve universal coverage for mental health care. The use of services is based solely on need for care, with no additional tax funding or required health insurance; contributions are determined by ability to pay. Diseases such as mental health have been on the rise in Kenya due to a change in lifestyle and as a result of other emerging diseases. In Kenya, the high expense of healthcare continues to be a major obstacle to receiving timely, high-quality medical care. Despite the increase in prevalence of diseases related to mental health, the government’s user fee policy has not been able to keep up with inflation. The purpose of this study was to assess the implementation of user fee policy in psychiatric hospitals in Kenya: A Case of Mathari Hospital, Nairobi. The study was guided by objectives that were seeking to determine the utilization of user fee policy at Mathari Hospital and to establish how hospital policies influence user fee policy implementation at Mathari Hospital. A cross-sectional study design was used. Findings from this study established that utilization of the user fee policy at Mathari Hospital was aligned with the existing hospital policies. The management of Mathari Hospital should streamline user fee collection by constantly providing on the job training to the employees.
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    Patient Satisfaction with Emergency Care Services Accessed at Selected Health Facilities in Nairobi City County: Patients’ Perspective
    (Journal of Health, Medicine and Nursing, 2019) Osiyel, Daniel Edwin; Tenambergen, Mwaura Wanja; Muiruri, Lillian
    Purpose: The main aim of the study was to study the factors influencing patient satisfaction with emergency care services accessed at selected health facilities in Nairobi City County. Methodology: In this study, descriptive research design was adapted. The target population of the study included patients seeking emergency healthcare from five public health facilities in in Nairobi County. Stratified proportion and simple random sampling technique were used to select 304 respondents among patients in emergency department. Data collection tool was used to obtain quantitative data. Nairobi City County referral facilities were purposely selected because of the high number of patient throughput. Systematic sampling was done to identify the respondents. Descriptive cross-sectional study design was used where quantitative approach was used for data collection. Findings: The results showed that there is a positive and significant influence of the physician service factors on access and patient’s perspective to emergency healthcare services in public hospitals in Nairobi County (r = .596**, P = .001). On waiting time factor, findings show that there is a positive and significant influence access and patients’ perspective to emergency healthcare services in public hospitals in Nairobi County (r=.407**, P = 0.001) on quality of care, findings show that there is a positive and significant influence access and patients’ perspective to emergency healthcare services in public hospitals in Nairobi County (r=.255**, P = 0.001). Lastly, results showed that there is a positive and significant influence of the health facility type factor on access to emergency healthcare services in public hospitals in Nairobi County (r = .257**, P = .001). This implies that the four factors are important and significant determinants of access and use of emergency healthcare services in public hospitals in Nairobi County. Unique contribution to theory, policy and practice: The researcher brings in a wealth of new knowledge to the field of emergency healthcare, where the health sector can adopt a strong pillar of health service delivery by introducing a physician specialty course on emergency healthcare and medicine, further, proper mechanisms can be put to reduce waiting times before a patient seeking emergency healthcare is attended to. This would rely on the quality of care the patient receives when in need.
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    Utilization of Service Charters in Public Hospitals in Kenya: A Case of Thika Level 5 Hospital, Kiambu County
    (International Journal of Scientific and Research Publications, 2016-06) Masese, Charles Onyambu; Tenambergen, Mwaura Wanja; Muiruri, Lillian
    Service delivery in government health facilities in Kenya still faces multiple challenges. These challenges can still be identified ten years down the line since the introduction of Service Charter. The objective of the study was to assess how the service charter utilization would influence health service delivery in Thika Level 5 Hospital (TL5H) in Kiambu County. Cross sectional study design was employed. Quantitative data was collected using questionnaires. A sample size of 156 technical employees of TL5H and patients participated in this study. Collected data was edited, coded, and entered into the computer using the Statistical Package for Social Scientists (SPSS v 23). The respondents strongly agreed that the hospital charter content is not viewed annually creating unfriendly services (mean 1.73, SD 0.97), (mean 1.74, SD 0.997) indicated the respondents strongly agreed that the service charter is not clearly understood by the majority of patients informing them of their rights when seeking services. The respondents disagreed that the hospital management is always active in monitoring performance and playing the oversight duty according to the SC (mean 2.19, SD 1.20) on whether failure to utilize the service charter may lead to deterioration of quality and equity of healthcare, the respondents agreed (mean 2.05, SD 1.54). Most of the respondents strongly agreed there is availability of support for the service charter (Mean 1.72, SD 0.93), while the respondents also indicated that the waiting time has not improved despite the availability of service charter (Mean 2.98, SD 1.09). The study also established that there was uncertainty in the amount of waiting time in TL5H (Mean 1.775, SD 0.91). The channels used for communication were not clear (Mean 1.993, SD 1.12) while the communication at TL5H does not ensure clarity on issues (Mean 1.9, SD 1.07) while the respondent agreed on communication at TL5H was not always done to get commitment from staff (Mean 1.923, SD 1.047) and there was inadequate open communication of most issues at TL5H (Mean 1.846, SD 1.075). The study recommends that 1) TL5H should improve the contents of the service charter to make it clear, to ensure that the patients fully understand the contents, 2) there should be proper monitoring of the members of staff to ensure that the service charter is fully implemented to minimize the amount of complaints by patients, 3) the service charter contents should be embedded in the organization culture to ensure that is fully and properly implemented to the satisfaction of the service users.