Perceptions of medical students towards healthcare devolution: an online cross-sectional study

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.

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The Relationship between Student Safety Practices and Retention in Public Secondary Schools in Kisii County, Kenya

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Effects of Devolution on Maternal Health Care: The Case of Level Four Hospitals in Nairobi City County, Kenya

“…In addition, Mabonga (2017) observed that in the last two decades, health sector devolution policies have been implemented on a broad scale throughout the developing world, usually as part of a broader process of political, economic, and technical reform. Devolution of health services is widely practiced throughout the world especially in the developing countries to ensure improvement in the performance of the health system, increase population access to service and the efficiency of the delivered services (Noory, 2016;Muchomba & Karanja, 2015). The devolution of health system structure and management has been and continues to be a key issue for many countries in the achievement of health for all, and development of primary health care (Mwatsuma & Nyamu, 2014).…”