Health professional regulation and provision of quality health services; cross sectional analysis of private health care providers in Wajir County, Kenya

Authors

  • Ali Ahmed Mohamed Qadar Department of Health Systems Management, Kenya Methodist University, Kenya
  • Wanja Mwaura-Tenambergen Department of Academics, Riara University, Kenya
  • Eunice Muthoni Mwangi Department of Population Health, Medical College, Aga Khan University, East Africa
  • Luke Wahome Kinyua Department of Economics, Mount Kenya University, Kenya

DOI:

https://doi.org/10.18203/2394-6040.ijcmph20242537

Keywords:

LMICs, Kenya, Professional regulation, Regulatory bodies

Abstract

Background: Health professional regulatory bodies oversee and enforce standards in healthcare to safeguard patient safety and prevent harm. However, international consistency in these regulations remains limited. The Kenya health sector relies on various bodies to enforce standards among professionals and institutions, albeit constrained by financial and human resources that hinder effective oversight. This study aimed to assess how regulatory practices- such as licensing, training oversight, inspection of practice, and quality assurance mechanisms- affect the quality of healthcare provided by private providers.

Methods: The study targeted 108 healthcare providers from 36 private health facilities, primarily nurses and clinical officers. A sample of 86 participants was drawn using purposive sampling. The data were collected using a structured questionnaire.

Results: The licensing of health professionals, training, inspection of practice, and quality assurance mechanisms collectively influenced 47.9% of the variation in service quality. Statistical analysis revealed significant associations between licensing (p=0.003), practice inspections (p=0.01), quality assurance (p=0.001), and service quality.

Conclusions: Regulatory bodies play a crucial role in ensuring healthcare standards; however, their effectiveness hinges on tailored strategies that address local challenges and foster collaborative efforts towards sustainable quality improvement in healthcare services. Routine inspections, conducted in a supportive manner, are likely to ensure ongoing adherence to standards. Moreover, adequate resource allocation for regulatory compliance and continuous quality improvement activities, including the formation of internal quality improvement (QI) teams and the maintenance of regular QI meetings and assessments, was deemed essential.

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References

World Health Organization. The World health report: 2000. health systems: improving performance. World Health Organization; 2000.

World Health Organization. Everybody’s business--strengthening health systems to improve health outcomes: WHO’s framework for action. 2007. Available from: https://www.who.int/publications/ i/item/everybody-s-business----strengthening-health-systems-to-improve-health-outcomes. Accessed on 2 June 2024.

Browne J, Bullock A, Poletti C, Cserző D. Recent research into healthcare professions regulation: a rapid evidence assessment. BMC Health Serv Res. 2021;21:1-12.

Risso-Gill I, Legido-Quigley H, Panteli D, McKee M. Assessing the role of regulatory bodies in managing health professional issues and errors in Europe. Int J Qual Health Care. 2014;26(4):348-57.

McCarthy CF, Riley PL. The African health profession regulatory collaborative for nurses and midwives. Hum Res Health. 2012;10:1-5.

Ndomondo-Sigonda M, Miot J, Naidoo S, Dodoo A, Kaale E. Medicines regulation in Africa: current state and opportunities. Pharm Med. 2017;31:383-97.

Mulaki A, Wachira S. Kenya Health System Assessment. 2019. Available from: http://www.healthpolicyplus.com/ns/pubs/11328-11600_KenyaHSAReport.pdf. Accessed on 2 June 2024.

Ministry of Health. Kenya Health Workforce Report: The Status of Healthcare Professionals in Kenya, 2015. 2015. Available from: https://taskforce.org/wp-content/uploads/2019/09/ KHWF_2017Report_Fullreport_042317-MR-comments.pdf. Accessed on 2 June 2024.

Muthaka DI, Kimani DN, Mwaura S, Manda DK. A review of the regulatory framework for private health care services in Kenya. Kenya Institute for Public Policy Research and Analysis. 2004.

McGivern G, Seruwagi G, Wafula F, Kiefer T, Nakidde C, Museiga A, et al. Strengthening health professional regulation in Kenya and Uganda: research findings policy brief. Available from: https://www.chasei.org/wp-content/uploads/ 2021/12/11a_Policy_Brief_Strengthening-Health-Professional-Regulation_in-Kenya_and_Uganda.pdf. Accessed on 2 June 2024.

Njiru JW, Mwangi EM, Oluoch M. Determinants of adverse drug reactions reporting in retail chemists in Nairobi County, Kenya. Int J Community Med Public Health. 2020;7(10):3847-54.

Ministry of Health. Kenya Master Health Facility List: Find all the health facilities in Kenya. 2021.

Krejcie RV, Morgan DW. Determining sample size for research activities. Educ Psychol Measure. 1970;30(3):607-10.

Sutherland K, Leatherman S. Regulation and quality improvement: a review of the evidence. Health Foundation; 2006.

McGivern G, Wafula F, Seruwagi G, Kiefer T, Musiega A, Nakidde C, et al. Deconcentrating regulation in low- and middle-income country health systems: a proposed ambidextrous solution to problems with professional regulation for doctors and nurses in Kenya and Uganda. Hum Res Health. 2024;22(1):13.

Gross J, Mccarthy C, Kelley M. Strengthening nursing and midwifery regulations and standards in Africa. Afr J Midwife Women’s Health. 2011;5(4):185-8.

Schwendimann R, Blatter C, Dhaini S, Simon M, Ausserhofer D. The occurrence, types, consequences and preventability of in-hospital adverse events- a scoping review. BMC Health Serv Res. 2018;18(1):521.

Busse R, Klazinga N, Panteli D, Quentin W. Improving healthcare quality in Europe: characteristics, effectiveness and implementation of different strategies. Health Policy Series: 53. World Health Organization. Regional Office for Europe; 2019.

Slawomirski L, Auraaen A, Klazinga NS. The economics of patient safety: strengthening a value-based approach to reducing patient harm at national level. OECD Health Working Papers, No. 96, OECD Publishing, Paris; 2017.

World Health Organization. Global patient safety action plan 2021-2030: towards eliminating avoidable harm in health care. World Health Organization; 2021.

O'Neill N. The eight principles of patient-centered care. Oneview Healthcare; 2022.

Aftab W, Khan M, Rego S, Chavan N, Rahman-Shepherd A, Sharma I, et al. Variations in regulations to control standards for training and licensing of physicians: a multi-country comparison. Hum Res Health. 2021;19:1-0.

Keshri VR, Sriram V, Baru R. Reforming the regulation of medical education, professionals and practice in India. BMJ Glob Health. 2020;5(8):e002765.

Grimm N. Healthcare regulations: Who does what? Footprints- Training and Etracking Solutions Blog; 2014.

Mwangi E, Mwaura-Tenambergen W. Healthcare providers’ engagement in strategic purchasing of outpatient services: a cross-sectional analysis of the National Health Scheme in Kenya. Pan-Afr J Health Environ Sci. 2024;3(1):137-58.

Henker H, Fox-Lewis S, Tep N, Vanna D, Pol S, Turner C. Healthcare workers’ perceptions of an organizational quality assurance program implemented in a resource-limited setting: a qualitative study. Health Promot Perspect. 2018;8(3):179.

Kohn LT, Corrigan JM, Donaldson MS. Setting performance Standards and expectations for patient safety. To Err is Human: Building a Safer Health System. National Academies Press (US); 2000.

Ministry of Health. Republic of Kenya. Quality of Care Certification Manual for the Kenyan Health Sector. 2020. Available from: http://guidelines.health.go.ke:8000/media/Quality_of_Care_Certification_Manual_for_the_Kenyan_Health_Sector-March2020.pdf. Accessed on 2 June 2024.

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Published

2024-08-30

How to Cite

Qadar, A. A. M., Mwaura-Tenambergen, W., Mwangi, E. M., & Kinyua, L. W. (2024). Health professional regulation and provision of quality health services; cross sectional analysis of private health care providers in Wajir County, Kenya. International Journal Of Community Medicine And Public Health, 11(9), 3404–3412. https://doi.org/10.18203/2394-6040.ijcmph20242537

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Section

Original Research Articles