Gitahi, Eunice2026-03-132026-03-132025-11https://ir-library.ku.ac.ke/handle/123456789/32738A Research Thesis Submitted in Partial Fulfillment of the Requirements for the Award of the Degree of Master of Community Health in the School of Health Sciences of Kenyatta University, November 2025. Supervisors 1. Dr. Priscilla Kabue 2. Mrs Elizabeth AmbaniPrimary health care (PHC) is the foremost interaction instance where necessary medical care is offered to individuals. It dwells on health promotion, curbing illnesses as well as the inherent behavioral and societal factors that contribute to people’s poor health in addition to treating illness and caring for the sick among individuals, families and communities. It is an approach to health that promotes people-centred care guided by the tenets of empowering, community collaboration as well as fairness and equality in the society. The study’s core aim was to evaluate the implementation of PHC services by nurses working in level 3 health facilities in Kiambu County. The study’s precise aims were to ascertain the nurses’ rating of the level of implementation of PHC services in these facilities, to determine their attitude towards implementing PHC services, to establish factors affecting the implementation of PHC services in the said health facilities and to identify perceived areas of improvement in execution of PHC services within the said health facilities. This was an analytical cross-sectional study conducted among 148 nurses working in level 3 health facilities in Kiambu County who were chosen utilizing simple random sampling technique. Using a self-reporting questionnaire, data was gathered. SPSS version 25 was used in probing the data descriptively including varied measures like percentages and frequencies. The chi-square test at 95% CI was utilized for assessing association between predictor and outcome research variables. Results are shown in figures and tables. Appropriate ethical principles were adhered to. The study achieved a response rate of 95.3%. From the findings, majority (91.5%, n = 129) of the nurses rated the level of implementation of PHC services in their work stations as sub-optimal. The nurses had positive attitude towards the implementation of PHC services given that all (100%, n=141) concurred that they perceived provision of PHC services as being critical to attainment of quality healthcare services for all in the country while 99.3% (n = 140) agreed that PHC services constituted an essential foundation for a sustainable health system and health programs in the country. Leading factors that hindered the nurses’ implementation of PHC services included inadequate number of available healthcare personnel - 99.3%; poor or low remuneration of health care providers - 99.3%; poor supply of essential medicine/drugs - 97.2%; unavailability of essential medical equipment - 98.6%; non-functional status of existing medical equipment - 98.6%; poor planning of the PHC programs - 95.7%; lack of or inadequate support to HCPs from the hospital management - 94.3%; significant underfunding of the primary health services - 98.6% and lack of or poor information systems - 98.6%. Nurses working in level 3 health facilities in Kiambu County had positive attitude towards the implementation of PHC services. Several factors, institutional based in nature, did influence the nurses’ implementation of PHC services within the level 3 health facilities in Kiambu County. To further enhance the implementation of PHC services in the county, the leadership of Kiambu County needs to invest on PHC system and programs in the county particularly in the areas of funding of these services, health care personnel staffing and support and ensuring adequate supply of essential medications and adequate availability of essential medical equipment within the health facilities.enThesis