| dc.description.abstract | Provision of affordable and quality health care remains an issue of concern in Kenya
just like in any other third world countries. Implementation of cost sharing program in
Kenya then aimed at providing equitable and affordable healthcare at the highest
possible standards for all citizens. Thus, the purpose of this study was to identify the
factors influencing implementation of cost sharing program in public health facilities
in Machakos County, Kenya. The study sought to establish how competence of
employees, assess how internal controls, assess the extent to which attitude of
employees and establish how public awareness influence the implementation of cost
sharing program. The researcher used a descriptive survey research design to enable
her capture attitudes of the respondents, which might otherwise be difficult to
measure using observation method. Main instrument used for data collection was a
questionnaire due to its practicability in reaching a large number of respondents. The
study had a sample size of 263. This included managers, health care workers, clients
and patients as program users and 2 key informants. Simple random sampling was
used as a representation of the whole population. The data collected was analyzed
using SPSS and was presented in tables and figures. The findings of the study showed
that most of employees were not competent in issues related to cost sharing program.
In fact a good number of the implementers did not know what the program entails as
they had not been trained or updated. Their roles in the program were not clear.
Internal control measures put in place-influenced implementation of the program in
that most of them were ineffective, supervision was wanting and there capacity to
detect fraud and corruption was quite low. Staff attitude, which was more of negative
than positive was found to influence the implementation of the program. Most of the
employees did not appreciate the importance of cost sharing and felt that collection
and utilization of the funds was inappropriate. Public awareness about cost sharing
was scarce, as the public knew little or nothing about the program thus influencing its
implementation. The study recommended that the issues of staff incompetence need
to be urgently addressed by ensuring proper training, communication and updates.
Accountability and transparency are key issues that need to be checked through the
financial control measures used. There is need for all concerned parties to address the
need to change the negative attitude of the employees through communication and
ensuring favorable working environment. Public awareness and involvement is key in
implementation and sustainability of projects. There is urgent need for national and
county governments to put in place measures that accommodate long-term awareness
raising campaigns that become part and parcel of normal life of the public | en_US |
