Factors contributing to patients bypassing the 2nd and 3rd levels of primary health care facilities in Kirinyaga districts Kenya
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Date
2014-03-13
Authors
Kanyora, James Njogu
Journal Title
Journal ISSN
Volume Title
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Abstract
Provision of Primary Health Care moves a country towards a more efficient and higher
quality health care system. Bypassing of 2nd and 3rd levels of Primary Health Care
facilities reveal that the patients understand various measure of quality at the facilities
that they visit and bypass. Patients seek medical services from the facilities that provide
high quality consultations and prescriptions. There must be clear defmed roles for
different levels of health facilities as confusion in service delivery may exist between
District Hospital and Health Centers. There is need to have well defined referral criteria
within the health system /from 2nd to 4th level of PHC facilities to avoid non referred
patients overloading the District Hospital. The main objective of this study was to
determine the factors contributing to patients bypassing the 2nd and 3rd levels of PHC
facilities in Kirinyaga District. The study population involved patients attending both
outpatient and family planning departments. Pretested interview schedules were used as
research tools. In data analysis, Chi-square test was used to test relationships between
variables. Results showed that 96.1% of respondents did not visit their nearest local
facility for medical services but went direct to the district hospital. Significant
relationship (X2 =30.1 df=12 p=0.003 was noted between age of the respondents and visit
to local facilities. Also relationship between sex of respondents and visiting local facility
. (X2=9.6; df=l, p=.OOI) was noted. About 42.1% of respondents believed the District
Hospital had more qualified staff. There is therefore need for District Health
Management Team (DHMT) to asses the requirement of both dispensaries and health
centres in terms of staff and services as well as have defmed referral criterion. Results of
this study may be useful to policy makers within the district to improve the referral
system so as to avoid overloading the district hospital with referral patients.
Description
Department of Community Health, 68p. The RA 427.9 .K3 2010
Keywords
Primary health care --Kirinyaga --Kenya, Health facilities --Kirinyaga --Kenya