Abstract
IntroductionThere have been worries concerning the preparedness and capacity of the counties to take over health care services. As the current medical students are going into this new system, we sought their opinions on the issue of devolution. The objective is to assess beliefs and attitudes of medical students towards devolution of healthcare services.MethodsA cross sectional survey was conducted at University of Nairobi medical school during the period of February-May 2014. Though a calculated random sample of 384 medical students was powerful enough to fulfill our objectives, all eligible medical students were invited by email to fill in a semi structured online questionnaire. Computed results from Google sheets were reported in frequencies and percentages.ResultsData was collected from 191 respondents with majority of them in their clinical years (levels 3, 4 and 5) of study. More participants considered working in private/ mission health institution (40%) after graduating as compared to public or non health institution (30%). The media provided most of information concerning devolution (77%). Few respondents reported using government documents (36%) or public forums (24%) to get information on healthcare devolution. While most of the respondents were of the opinion that health information system (68%), health finance (63%), procurement of medical products (54%), leadership and governance (73) should be devolved, only 18% wanted health personnel to be devolved. Most of the opinions on healthcare devolution were not in agreement with the goal of devolution: more than 50% thought the process would not result in improved efficiency, resource allocation, disease control programs or maintenance of infrastructure.ConclusionDespite the envisioned benefits of healthcare devolution, there is a low opinion among medical trainees concerning these reforms and their implementation. Nevertheless, it is early to speculate whether such viewpoints will be carried to the future once teething problems are dealt with.
Highlights
There have been worries concerning the preparedness and capacity of the counties to take over health care services
Our findings on perception of medical trainees towards devolution of healthcare concur with other studies that have reported on this matter [10]
We reported a great majority of participants having a low opinion of the current state of public healthcare in their counties
Summary
There have been worries concerning the preparedness and capacity of the counties to take over health care services. The objective is to assess beliefs and attitudes of medical students towards devolution of healthcare services. Few respondents reported using government documents (36%) or public forums (24%) to get information on healthcare devolution. Conclusion: Despite the envisioned benefits of healthcare devolution, there is a low opinion among medical trainees concerning these reforms and their implementation. In countries where devolution has been managed well, there is reported increase in access, utilization and management of the health services [1]. Despite elaborate implementation of devolved health services in some countries, there are existent challenges pertaining to a number of issues. Key among these concerns is expenditure devolution [2, 3]. An allocation formula for health finances that is stringently followed is drawn by independent parties factoring in the population size and geographic size [5]
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