THE INFLUENCE OF INSTITUTIONAL FACTORS IN ACCESS TO HEALTHCARE IN KENYA: A CASE OF NAIROBI COUNTY, KENYA.

Abstract

This study examines the influence of institutional factors on access to public healthcare in Kenya, a case for Nairobi County. It addresses the influences of health policies, leadership and governance, health infrastructure, health facilities, health workers, health finances and health insurance. The objective of the study is to evaluate the influence of institutional variables in access of public healthcare. 
 The study used data from a sample of 1066 households purposively selected from Nairobi County. All households were aged 15 years and above. The households were subjected to interviews that covered a wide range of topics. Descriptive design was chosen for the study. The study adopted multiple sampling methods for the study. These included purposive sampling, systematic sampling, snowball sampling and multi stage cluster sampling frame. 
 The data was collected using various techniques or instruments which included observation, key informant interviews, questionnaires, in-depth interviews, and focus-group discussions. The data was processed using descriptive statistics. Correlation and regression analyses were used to correlate and interpret the data of the study. 
 The findings show access to healthcare is inadequate and unevenly distributed among the households in Nairobi County. The factors attributed to these inequalities were inadequate and poorly implemented health policies, inadequate health facilities, and inadequate health workers, shortage of essential drugs, low level funding and poorly managed health insurance. This study argues that these institutional factors should be made adequate, accessible and quality improved. The focus should be on the lower social classes, who are deprived, and denied capabilities to access healthcare. This is despite the interventions made to access healthcare to the entire population in the County.