Kenya’s Health Service Delivery Obligation and the Right to Health: A Case of Machakos County, Kenya
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Date
2025-07
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Kenyatta University
Abstract
The right to access universal healthcare is still pipe dream in Kenya despite government efforts geared towards universal health coverage. This study sought to investigate state obligation on right to universal access to healthcare in Kenya, a case of Machakos County. Specific objectives were; to investigate the effect of state health service delivery policies on the right to health, to assess the effect of state health financing policies on the right to health, to evaluate the effect of state health governance policies on the right to health and to examine the effect of national and county government collaboration on the right to health, in Machakos County, Kenya. This study was guided by egalitarianism and human rights theories. Descriptive cross-sectional research design was used. The target population was Ministry health officials, medical officers, health workers, and patients in the 198 public healthcare facilities published by Machakos County Integrated Development Plan 2023-2027. Yamane sampling formula was used to generate a sample of 100 healthcare facilities in eight sub-counties. Stratified sampling formula was used in grouping the health facilities according to their population in the sub- counties. Purposive and convenience sampling helped in the identification of healthcare officers and patients per each facility sampled and visited. Purposive sampling was also used to enable the selection of eight government officials per each sub-county. Questionnaire and interview were used to collect primary data. Prior to actual study, a pilot study was done in Nairobi County as it is nearer to Machakos County. Validity of the instruments was achieved through expert opinion. Cronbach alpha was used to ensure internal consistency of instruments of data collection. Analysis of data included descriptive and inferential statistics which were presented using tables, figures and charts. This study observed that in the spirit of right to health, all states desire their population to access healthcare services. As such, state finance and supports the nations’ health system to ensure each citizen enjoys the right to health. However, population growth and increasing dynamics within the healthcare such as emerging disease patterns, resource constraints and socio-economic factors have presented challenges to the attainment of universal healthcare and full realization of the right to health in Machakos County, Kenya. Machakos County has a small number of health facilities located in places out of reach for many, majority of patients walk long distances to access health services. The County also has inadequate healthcare workers, and experiences resource challenges and resource misallocation leading to reduced access to healthcare. In conclusion, this study recommends for increased funding for the health sector and adoption of integrative collaborative approach to ensure the right to health is fully realized by all the citizens in Machakos County, Kenya
Description
A Research Project Submitted to the School of Law, Arts and Social Sciences in Partial Fulfillment of the Requirements for the Award of the Degree of Master of Arts in International Relations and Diplomacy of Kenyatta University, July, 2025
Supervisor:
1.Xavier Ichani