Kikuvi, Charlotte Ndunge2026-03-112026-03-112025-06https://ir-library.ku.ac.ke/handle/123456789/32711A Thesis Submitted in Partial Fulfilment of the Requirements for the Award of Degree of Master in Public Health (Epidemiology and Infection Control) in the School of Health Science, Kenyatta University, June 2025. Supervisors 1. Dr. Justus O. S. Osero 2. Dr. Samuel MwangiAccess to healthcare refers to the ability to get the required medical care from the health service providers when needed. Most low- and middle-income countries (LMICs) have limited access to healthcare, especially in urban informal settlements. Informal settlements are characterised by people of low socio-economic status, lack of education, and lack of employment along with substandard housing and overcrowding, poor sanitation, limited water supply, and inadequate or no public infrastructure. Due to the high poverty rate in informal settlements, there is limited access to healthcare, which may cause many health problems. The study assesses determinants of access to healthcare by residents in Kiandutu urban informal settlement, Kiambu County. The study employed a descriptive cross-sectional study design to determine predisposing, enabling and need factors that influence access to healthcare among the residents. A multi-stage sampling approach. Kiandutu urban informal settlement was purposively selected, random sampling was used to select four out of the eight villages and systematic sampling was used to select households. The study covered a total of 318 households. Data collection tools used both quantitative and qualitative approaches. Descriptive statistics were presented using frequency and percentages, tables and graphs. Chi-square and Fisher's exact test statistics were used to evaluate the associations between the variables. Qualitative data were subjected to thematic analysis. The results revealed that religion (ꭙ2=4.193; df=1; p<0.041), education (ꭙ2=7.854; df=2; p<0.020), income (ꭙ2=6.921; df=2; p<0.031), and distance to the facility (ꭙ2=25.818; df=2; p<0.0001) all had an impact on access to healthcare. In conclusion, the seriousness of illness mainly influenced health-seeking behaviour. Education level, religion, income earning and distance to the health facility outside informal settlements influenced access to healthcare. The study recommended, the County Government should carry out health awareness measures to reduce the time gap between symptoms and seeking care. The County Government and Stakeholders should influence and promote the advancement of health services. The County Government and NGOs should ensure health services are affordable and accessible to the residents. The County Government and policy makers to ensure that the health facilities within informal settlements offer specialist clinics.enThesis