Effects of management practices on hospital outcomes in Kenya

Management in hospitals just like any other organization is very important as nothing moves without it. Kenyan public hospitals have not been doing well in their service delivery and the management’s role in hospital performance has not been evident.Objective: The objective of this study was to analyze the effect of hospital management practices on hospital outcomes Design: The study employed a mixed method research design where both qualitative and quantitative data were collected from all the 25 hospitals in central Kenya. The qualitative data was analysed thematically while quantitative data was analysed statistically. Setting: 25 hospitals in central Kenya. Subjects: Patients, next of kin, health workers and hospital managers. Interventions: There was no intervention measures taken. Results: The study identified eleven management practices in Kenya public hospitals with regular supervision being practiced widely. The results further showed that hospitals practicing motivation and inspiration of staff, effective communication, delegation, work plan, work plan implementation and, staff empowerment had an increase in total live births. At the same time the results also indicate that hospitals that practiced empowerment, delegation and managers residing in hospitals had a reduction in fresh still births. All management practices identified in this study improved overall inpatient and outpatient satisfaction though not statistically significant.Conclusion: This study concluded that better management of hospitals translates to improved hospital outcomes and general health improvement of population served. This results in reduction of fresh still births, increase in total live births, and overall satisfaction in both inpatient and outpatient services

Voluntary Medical Male Circumcision: Modeling the Impact and Cost of Expanding Male Circumcision for HIV Prevention in Eastern and Southern Africa

Emmanuel Njeuhmeli and colleagues estimate the impact and cost of scaling up adult medical male circumcision in 13 priority countries in eastern and southern Africa, finding that reaching 80% coverage and maintaining it until 2025 would avert 3.36 million new HIV infections

Track E Implementation Science, Health Systems and Economics

Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/138412/1/jia218443.pd

A facility-based study of women' satisfaction and perceived quality of reproductive and maternal health services in the Kenya output-based approach voucher program

Background: This is a facility-based study designed to assess perceived quality of care and satisfaction of reproductive health services under the output-based approach (OBA) services in Kenya from clients’ perspective. Method: An exit interview was conducted on 254 clients in public health facilities, non-governmental organizations, faith-based organizations and private facilities in Kitui, Kilifi, Kiambu, and Kisumu counties as well as in the Korogocho and Viwandani slums in Nairobi, Kenya using a 23-item scale questionnaire on quality of reproductive health services. Descriptive analysis, exploratory factor analysis, reliability test, and subgroup analysis using linear regression were performed. Results: Clients generally had a positive view on staff conduct and healthcare delivery but were neutral on hospital physical facilities, resources, and access to healthcare services. There was a high overall level of satisfaction among the clients with quick service, good handling of complications, and clean hospital stated as some of the reasons that enhanced satisfaction. The County of residence was shown to impact the perception of quality greatly with other social demographic characteristics showing low impact. Conclusion: Majority of the women perceived the quality of OBA services to be high and were happy with the way healthcare providers were handling birth related complications. The conduct and practice of healthcare workers is an important determinant of client’s perception of quality of reproductive and maternal health services. Findings can be used by health care managers as a guide to evaluate different areas of healthcare delivery and to improve resources and physical facilities that are crucial in elevating clients’ level of satisfaction

Camera‐trap data do not indicate scaling of diel activity and cathemerality with body mass in an East African mammal assemblage

Diel activity patterns of animal species reflect constraints imposed by morphological, physiological, and behavioral trade-offs, but these trade-offs are rarely quantified for multispecies assemblages. Based on a systematic year-long camera-trap study in the species-rich mammal assemblage of Lake Manyara National Park (Tanzania), we estimated activity levels (hours active per day) and circadian rhythms of 17 herbivore and 11 faunivore species to determine the effects of body mass and trophic level on activity levels and cathemerality (the degree to which species are active throughout the day and night). Using generalized least squares and phylogenetic generalized least squares analyses, we found no support for the hypothesis that trophic level is positively associated with activity levels. We found no support for activity levels to scale positively with body mass in herbivores or to differ between ruminants and nonruminants; in faunivores, we also did not detect relationships between body mass and activity levels. Cathemerality was positively associated with activity levels but did not scale significantly with body mass. Overall, our findings caution against trophic level or body mass-associated generalized conclusions with regard to diel activity patterns