Operational strategies and enhancement of maternal and child healthcare service delivery in devolved healthcare units in Machakos county

Abstract

The purpose of this study was to establish the influence of operational strategies on enhancement of maternal and child healthcare service delivery in devolved healthcare units in Machakos County. The study objectives included: determining how capacity building mother child care strategy influence enhancement of MCH service delivery in Machakos County; establishing how resource mobilization strategy influence enhancement of MCH service delivery in Machakos County; investigating the influence of community awareness strategy on enhancement of MCH service delivery in Machakos County; establishing how sectoral integration strategy influence enhancement of MCH service delivery in Machakos County. To meet these objectives, the study was carried out in the County referral and sub county hospitals in Machakos County. The department of health services will gain from the study by getting to know whether operating strategies influence enhancement of MCH services delivery and thus affect measures which will inform use of operating strategies that result in effective and timely quality service in the hospitals. The proposed research will give stakeholders better insights into operating strategies and how the same determines MCH service delivery and will help them formulate better strategies for quality healthcare. The study population constituted 600 employees who included County Executive Committee Member, Medical Superintendent, MOH’s, Clinical Officers, Nurses and Subordinates. A sample of 180 employees was selected. Ten employees were used for the pilot study who were randomly selected from county and sub county hospitals in Kitui County. The study utilized descriptive research design. The data was collected using questionnaires mainly and a mixture of cluster and purposive sampling techniques. The data was then analyzed both descriptive and inferential statistics using the Statistical Package for Social Sciences (SPSS) version 24.0 and findings tabulated and presented in form of tables. The study results indicated that capacity building (β1=0.1415; P=0.062<0.05) had a positive insignificant influence on enhancement of MCH service delivery. Findings also show that resource moblization (β2=0.1507; P=0.033<0.05; community awareness (β3=0.9220; P=0.000<0.05; sectoral integration (β4=0.3213; P=0.000<0.05) had a significant positve effect on enhancement of MCH service delivery. The study recommends that the hospital under the county government should increase and strengthen capacity building activities to ensure sustainability of an innovation. Further, there is need for the County Department of Health Services to build permanent community structures and increase training of local communities across the county to strengthen links with wider health system with aim of creating modalities for engaging community base workers and those they serve for improved quality care. The study also recommends increament of domestic resource mobilization through the county’s legislative powers with an aim of improving universal healthcare to the people of Machakos to ensure accessibility and affordability of MCH services thus enhancing quality service in the county. There is also need for the institution to involve all people & organizations interested in decision making process to build commitment towards achieving sustainable goals in delivery of quality service.