An assessment of elements influencing implementation of Universal Health coverage among Counties in Kenya: A case of Makueni County

Abstract

Universal Health Coverage (UHC) is an initiative which promotes access to quality healthcare service, equitably and to everybody regardless of their financial capabilities. The aim of UHC was to ensure that people can get quality, adequate and timely health care services they need without being exposed to any financial risks (WHO, 2010). The aim of this study was to assess the elements influencing the implementation of Universal Health Coverage among Counties in Kenya. The specific objectives were to investigate the effect of funding; infrastructure, technology and human resource capacity on implementation of Universal Health Coverage among Counties in Kenya.This study adopted the descriptive research design targeting 291respondents made up of 7 specialist doctors, 22 medical officers, 201 nurses and 61 clinical officers in county and sub-county hospitals in the county. The study conducted a census of the entire target population responding to the data collection instrument which was a questionnaire. The study carried out a descriptive analysis to measure the effects of the independent variables on the dependent variables. Regression analysis was used to measure the relationship between the independent and dependent variables. The findings from this study will be of significance to national and county governments in identifying the most critical pillars for the achievement of the overall success of the Universal Health Coverage. The research would further add knowledge to the existing body of literature by providing empirical findings that can be used as a useful reference point for other scholars. From the study key findings, it was concluded that infrastructure was the key driver of success in the implementation of Universal Health Coverage in Makueni County in Kenya. The success realised in the implementation of Universal Health Coverage in Makueni County in Kenya was as a result of the county’s investment in availing and maintaining a vigorous infrastructure. The human resource capacity was one of the major determinants of success behind the implementation of Universal Health Coverage. Funding had a greatest and positive effect on implementation of UHC among Counties in terms of adequacy of funds, prudent and efficient use of funds, timely disbursement of funds and accountability and prioritization in financial resources. Technology too was identified as critical element explaining success of implementation of Universal Health Coverage. Technology helped to improve the efficiency and productivity in the hospitals in the Makueni County. Government policies and regulations had a significant moderating effect on implementation of universal health coverage. The study recommends that the Makueni County management should continuously upgrade its infrastructure to meet the increasing and emerging needs of UHC implementation. The Makueni County management should ensure that all the human resources are retrained on UHC requirements to endure their competence was aligned with UHC components. The management of Makueni County should institute stringent measures to curb pilferage and ensure that UHC implementation funds are utilised accordingly. The management of Makueni County should continue to invest in emerging medical technology to enhance the UHC implementation. Finally, the management of Makueni County should continuously seek to comply and work closely with National government policies and regulations on UHC to achieve the best standards and quality in provision of healthcare.