Factors affecting Implementation of Primary Health Care Services among Nurses in Level 3 Health Facilities in Kiambu County, Kenya

Abstract

Primary health care is instrumental to delivery of quality basic health care services in communities. Its significance lies in ensuring that appropriate basic healthcare services are offered to all who need them competently, fairly and efficiently based on a people-centered approach. The study therefore sought to assess the factors affecting implementation of primary health care services among nurses in level 3 health facilities in Kiambu County, Kenya. This was an analytical cross-sectional study conducted among 141 nurses who worked in level 3 health facilities in Kiambu County and recruited using simple random sampling technique. They responded to a self-administered questionnaire. Data was probed descriptively with measures including proportions along with counts utilizing SPSS version 25.0. Relationships in study attributes were probed with chi-square test at 95% CI with outcomes shown in tables and figures. From the findings, majority (91.5%, n = 129) of the nurses rated the level of implementation of primary health care services in their work stations as sub-optimal. The factors found to strongly correlate with the poor implementation of the primary health care services were inadequate number of available healthcare personnel (p = 0.002); poor or low remuneration of health care providers (p = < 0.000); poor supply of essential medicine/drugs (p = 0.011); unavailability of essential medical equipment (p = 0.000); poor planning of the PHC programs (p = 0.024); lack of or inadequate support to HCPs from the hospital management (p = 0.013) and significant underfunding of the primary health care services (p = 0.001). Efforts are therefore required on the part of relevant stakeholders in Kiambu County to address the various factors that impede effective delivery of primary health care services