Browsing by Author "Osuga, Ben"

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    Coordination Mechanisms and Implementation of Public Privatepartnership in Public Health Sector: A Case Study of Isiolo Sub County
    (International Journal of Innovative Research and Knowledge, 2024-07) Wario, Boru Tore; Tenambergen, Mwaura Wanja; Osuga, Ben
    The public health sector has overtime been unable to effectively provide the badly needed health care to the public on its own owing to lack of resources and management challenges. The promise of universal coverage of health services financed through tax revenue has proved untenable in the face of increase in demand for quality health services and other competing demand for the same revenue. The need for properly structured and executed public private partnership has become a necessity. There has been growing concern that despite much presence and effort by public and private health actors over the years, nationally and in Isiolo Sub County, a number of health indicators are either on downward trend or have stagnated. The unacceptably high maternal mortality rate of 448/100,000 live births nationally (KDHS 2008), Isiolo county having the 5th highest maternal mortality in the country at 790/100,000 live births is a case in point. This has put to question how public private partnership in health sector has been conceived, structured, regulated and coordinated. This research therefore sought to establish how coordination mechanisms influence success of public private partnership in health sector in Isiolo Sub County, of Isiolo County. This will be a cross sectional study that involves a census of all health NGOs and health facilities operating in Isiolo Sub County. Health workers in all the twenty one (21) health facilities and workers of nine (9) Nongovernmental organizations supporting health services were the subject of the study. A structured questionnaire will be used to gather data. The questionnaires generated quantitative data, which was analyzed using descriptive and inferential statistics with the help of statistical software known as Statistical Package for Social Sciences (SPSS) version 25 statistical software. Descriptive statistics comprised of frequency distribution, percentages, standard deviation and mean. Inferential data analysis was carried out using Pearson correlation coefficient and multivariate linear regression. The results indicated that coordination mechanisms has a positive and significant effect on implementation of public private partnership in the health sector in Isiolo Sub-County (β2=0.240, p value=0.002). The study concluded that an improvement in coordination mechanisms would lead to an implementation of public private partnership in the health sector. The study also recommends that the government of Kenya should organize workshops and training sessions specifically designed to educate stakeholders on partnership agreements. Further, the management of health sector in Kenya should foster a participatory approach by engaging key stakeholders from the public and private sectors, civil society organizations, and local communities.
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    Health Insurance Plan and Utilization of Health Services: The Case of Tanykina Community Health Plan; Nandi County, Kenya
    (International Journal of Scientific and Research Publications, 2016-03) Terer, Erick; Tenambergen, Mwaura Wanja; Osuga, Ben
    Community Based Health Insurance mechanism of Health financing targets the informal sector and the Rural who cannot access the national social health insurance. Tanykina Community Health Plan was established to help dairy farmers in Nandi North Sub county of Nandi to access quality health services using monthly milk deductions as the premiums. Despite this financial access, there is still low health care utilization by these residences. This study aimed to evaluate the effect of the perceptions of residents and clients on the utilization of health services. A cross-sectional study was conducted on patients attending the contracted health facilities. Of the 336 respondents (84% response rate) 169(50.2%) were enrolled members of TCHP, with most of them being female (95,55%) and over 50 % having at least college level of education. The level of education was highly correlated with increased healthcare utilization (p=0.069) though this was not statistically significant. Increased level of satisfaction correlated positively with increased used of outpatient services and this was statistically significant (p=0.05). The perceived availability of information was however no statistically significantly associated with increased utilization of health services in either outpatient department (p=0.112) or inpatient department (p=0.939). The perception of increased accessed to information increased with additional age of the clients. The belief that the services offered through TCHP target the poor in the society was highly associated with increased education level of the clients (p<0.05) and the duration of membership of the clients (p<0.05). There was also a 15% increase in the outpatient services use and 19% increased likelihood to increased inpatient use with the perception that the services target the poor in the society. Almost all the respondents n=325(97%) perceived that the services of TCHP are highly acceptable. The increased level of perceived acceptance was highly associated with increased utilization of inpatient services (p=0.04). Being male increased the level of perceived acceptance by 10 % compared to the female counterparts. With regard to in-patient health services an additional increase in the level of education of the insured members and the duration of membership significantly increases the utilization of these services by 0.19 and 0.89 respectively. However, the duration of membership was statistically significant (p=0.008) in influencing the level of in-patient utilization. We recommend managers of community based health insurance to continuously evaluate the perceptions that the members have in order to improve utilization of health services.