Level of Community Participation in Rural Health Care and the Associated Factors in Kakuyuni Health Centre, Machakos County

Abstract

Community participation is of paramount importance for the success of any community project. This study aimed at determining the level of community participation in rural health care services and the associated factors in enhancing community participation in Kakuyuni sub-location, in Machakos County. The planning and implementation of rural health care services, is dominated by the individual interests of their leaders or influenced by other local leaders, political leaders and facility in charges rather than the community itself. The objectives of this study were to; To determine at what level the community participates in rural health services, to determine the socio-demographic and community related factors that affect community participation in rural health services and to determine the challenges hindering community participation in rural health care in Kakuyuni Sub location, in Machakos County. An interviewer administered questionnaire which was both closed ended and open ended was used to collect data from 384 participants. A cross-sectional analytical study design was used to conduct this study. The quantitative data obtained was analysed using SPSS software version 24, and Chi square was used to determine significant results. The sociodemographic factors were analysed using descriptive statistics. To analyse the factors, cross tabulation and independent chi square (χ2) tests were used with P values of 0.05 to determine the significant factors. The significant factors were then entered in for Binary Logistic Regression, and finally to multivariate regression. The researcher found out that, 59 (15.4%), of the respondents were involved in needs assessment, 36 (9.4%) at implementation stage, 1.6% at monitoring and evaluation, and 1.3% were involved in all levels of rural health care. However, most 278 (72.4 %) of the respondents reported no involvement at any level of rural health care. The following factors were significantly affecting community participation towards rural health care services; length of stay in the area and community mobilization. Some of the challenges hindering community participation in rural health care facility services included; lack of laws specifically governing implementation of community projects; majority of community members lacked knowledge on community participation 349 (90.9%) on when and where to participate in, lack of community empowerment, poor leadership in the community, lack proper representation and poor infrastructure, poor management systems and poor communication systems. In conclusion, Kakuyuni community members community participation in Kakuyuni Sub-location was low at 106 (27.6%). The study recommends that the community should be enlightened on community participation and their role in rural health care facility services, there is need for increased community mobilization and empowerment to the community members on community participation to ensure increased participation and more so in males and the need for Community leaders to be sensitized on governance, community empowerment and establishing good communication systems. All this together will make the community members to gain control of the program and decisions that shape their health care.