Type | Thesis or Dissertation - Master of Arts |
Title | Factors influencing effectiveness of Kenya's community health strategy in the fight against HIV/AIDS: a case of Transmara West sub County, Narok County, Kenya |
Author(s) | |
Publication (Day/Month/Year) | 2014 |
URL | http://erepository.uonbi.ac.ke/bitstream/handle/11295/90301/Kiprono_Factors influencingeffectiveness of Kenya s Community health strategy.pdf?sequence=3 |
Abstract | The purpose of this study was to explore the factors that influence effectiveness of Kenya’s Community Health Strategy in the fight against HIV/AIDS. Specifically, the study sought to establish the influence of resource allocation, cultural attitudes and practices, supportive supervision, and existing referral systems and linkages or networks on community health strategy in the fight against HIV/AIDS, in Transmara West Sub-county of Narok County. The research design used was descriptive in nature. Simple random sampling was used to select a sample size of 168 respondents from a population of 290 CHWs, using Cochran’s 1977 formula. Census approach was used to sample all the 10 CHEWs while purposive sampling was employed to identify KIs. The respondents were males and females between 30 years and 50 years of age. Information was collected using a questionnaire by the researcher and administered by two trained research assistants under the researcher’s guidance. Data was analyzed using descriptive summaries, and findings presented by the aid of tables. For quantitative data, analysis was done using SPSS and findings presented using tables, too. The study concluded that among the four factors namely; cultural attitudes and practices, resource allocation, supportive supervision and referrals, linkages and networks; resource allocation had the greatest influence on the effectiveness of the Kenya’s Community Health Strategy in the fight against HIV/AIDS. This was followed by cultural attitudes and practices and then supportive supervision. Lastly, referrals, linkages and networks indicated a positive relationship with effectiveness of community strategy, but one which was weaker than the first three factors. The CHWs rated amount of funds allocated to Community Strategy as very high determinant as shown by a mean of 1.262 and a standard deviation of 0.839. Also, consistency of funding and availability of CHWs kit/IEC material and logistical support were rated as moderate determining factors at a mean of 3.114 and standard deviation of 0.984 and 1.050 respectively. Additionally, the respondents rated staffing levels of health centers as a moderate determining factor at a mean of 3.262 and a standard deviation of 0.911. At a mean of 2.465 and a standard deviation of 0.376 the CHWs agreed that cultural practices have high influence on effectiveness of community services in HIV/AIDs fight, and indicated at a mean of 2.537 and standard deviation of 0.674 that cultural beliefs and practices hindered access to proper care for HIV clients. Regular support supervision was rated as moderately influential at a mean of 3.032 and a standard deviation of 0.893 just as extensive coverage of indicators during supervision was rated at a mean of 3.078 and a standard deviation of 0.675 as moderately influential. CHWs further conceded with a mean of 2.993 and a standard deviation of 1.777 that completeness of referral process was a high determinant of effectiveness of the community health strategy in the fight against HIV/AIDS. The study recommends that issues around resource allocation be streamlined by the government to ensure a smooth implementation of the program. Resource allocation determined whether effective support supervision was achieved or not and the study thus recommends a dedicated budget to the strategy. On cultural practices, the study recommends that communities be empowered through more targeted community mobilizations by use of IEC materials that would bring out the real HIV issues for better understanding. Appreciating that supportive supervision at the Community Units increases quality of service and contribute to the uptake of community-based HIV services, there was need to ensure consistent and adequate supply of resources to the CHEWs and SCHMT to conduct this activity regularly and in a predetermined manner. Regular monitoring, guidance and mentorship visits by program officials help boost morale and motivation of the beneficiaries. Communities should be empowered and prepared to take up the responsibility of taking care of their own health through mainstreaming of community participation in all health and development projects. Finally, for fairly observable and measurable change on indicators, project or program implementation support period should be longer, say 3-5 yrs. The government should strive to have all partners commit to funding and/or technical support for periods not less than 3 years. |
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