Assessment Of Health Financing Factors Affecting Performance Of Service Delivery At Primary Health Care Facilities In Mombasa County, Kenya

ABSTRACT

The health system in Mombasa County, Kenya, has been experiencing challenges in meeting its primary health care facilities annual targets in service delivery. This could be partly explained by continued skewing of health budget allocation in favour of tertiary and secondary care facilities, which absorb 70% of health expenditures, than the primary care units that provide the bulk of health services. However, there are limited studies that have examined financing factors influencing performance of primary healthcare facilities service delivery. This study therefore sought to assess health financing factors affecting performance of primary health care facilities in Mombasa County. Specifically, the study aimed at determining the financing sources, prioritization in allocations, the financing challenges and the influence of funds allocation on performance of primary health care facilities. The study adopted a cross-sectional research design where the data was collected from 195 of the sampled 214 health workers and 76 of the sampled 81 facility management committee members respectively. Quota sampling method was used to select respondents from 39 primary health care facilities in Mombasa County. A semi-structured questionnaire was used to collect data from the two sample groups. Descriptive analysis involved the use of frequencies, percentages, mean and standard deviation. Inferential analysis involved the use of multiple regression model in order to determine the strength of relationship between the independent variables (sources of health financing, financing challenges, prioritization of funds and allocation of funds) and performance of primary health care facilities in Mombasa. Significance was tested at 5 percent level. Results from the multiple regression analysis indicated that sources of health financing (p = 0.01), and prioritization of funds (p = 0.01) were the main influencers of the performance of Primary healthcare facilities in Mombasa County. The study also established that allocation of funds (p = 0.02) and financing challenges (p = 0.03) were significant predictors of the performance of primary healthcare facilities in Mombasa County. The study concluded that sources of health financing, financing challenges, prioritization of funds and allocation of funds were significant predictors of performance of primary health care facilities in Mombasa County. The study recommends that the county government of Mombasa should put more emphasis on prioritizing funds allocated to primary healthcare facilities in order to improve performance.