Nurses’ perceptions of universal health coverage and its implications for the Kenyan health sector

Koon, Adam D.; Smith, Lahra; Ndetei, David M.; Mutiso, Victoria; Mendenhall, Emily

doi:10.1080/09581596.2016.1208362

Cited by 9 publications

(9 citation statements)

References 34 publications

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“…showed that nurses with UHC were completely unfamiliar and offered numerous interpretations that could undermine the move toward UHC. [ 26 ] We design the strategic thinking module to achieve the goals of community coverage by providing nurses with an overview of foresight skills and system dynamics. The UHC can meet its primary goal of better health and is not a new concept, but it requires doctors and nurses to be adequately trained and knowledgeable about the overall health system and ensuring proper access to services.…”

Section: Discussionmentioning

confidence: 99%

Training needs assessment of nursing managers for achieving university health coverage

Tourani

Malmoon

Zaboli

et al. 2020

J Edu Health Promot

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BACKGROUND: University health coverage gives everyone accesses to health services focused on the most important causes of illness and death and ensures that the quality of services is high enough to improve the health of those receiving services. Nurses as the largest group of staff in the health system play an important role in achieving UHC. This study aimed to determine the training needs of nursing managers in universities of medical sciences of Iran in achieving UHC. MATERIALS AND METHODS: This study was a qualitative study conducted in 2019 using the framework method. There were 15 experts in nursing management, health management, and nursing authorities at the national level using the purposive random sampling. Data were collected from the expert panel. We used the Atlas.ti software version 7.2 and using the framework method for the analysis of qualitative data. A set of codes organized into categories that were jointly developed by the researchers involved in the analysis. The UHC framework used to summarize data in a way that could support answering research questions. RESULTS: This study showed that three educational modules leadership and strategic thinking, management, and decision-making, achieving excellence in nursing management to capacity building of nursing managers in the country. CONCLUSION: Training leadership skills and strategic thinking in the nursing empowerment modules illuminate global and national health roadmaps and policies and change attitudes to the model of nursing service delivery. Since nurses are the largest group of professionals in the health system, it facilitated by changes in the role and functions of the hospital and nurses to reach UHC.

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Section: Discussionmentioning

confidence: 99%

Training needs assessment of nursing managers for achieving university health coverage

Tourani

Malmoon

Zaboli

et al. 2020

J Edu Health Promot

View full text Add to dashboard Cite

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“…Addressing inequities in access to and utilization of health services is a major challenge in the Kenyan health system [41], and this study reveals the ways in which health care workers' strikes may further entrench these inequities, both in terms of acute impacts on access to services during strikes as well as overall trust in these services that affect care seeking in the future. The 2017 strikes occurred as the government was rolling out a universal maternal child health policy, Linda Mama, and while health care workers largely support universal health initiatives in Kenya, they feel unsupported and ill-equipped to implement these policies on the ground [42]. Additionally, in this study CHVs articulated their own precarious working conditions in the health system as unpaid but critically important actors when speaking about health care workers' strikes.…”

Section: Discussionmentioning

confidence: 89%

‘It Was Hell in the Community’: A Qualitative Study of Maternal and Child Health Care During Health Care Worker Strikes in Kenya

Scanlon

Maldonado

Ikemeri

et al. 2021

Preprint

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Background: Health care workers in Kenya have launched major strikes in the public health sector in recent years but how strikes by health care workers affect health systems and services is under-explored. We conducted a qualitative study to explore maternal and child health care and services during nationwide strikes by health care workers in 2017 from the perspective of pregnant women, community health volunteers (CHVS), and health facility managers. Methods:We conducted interviews and focus group discussions (FGDs) with three populations: women who were pregnant in 2017, CHVs, and health facility managers. Participants were part of a previous study and recruited using convenience sampling from a single County in western Kenya. Interviews and FGDs were conducted in English or Kiswahili using semi-structured guides that probed women’s pregnancy experiences and maternal and child health services in 2017. Interviews and FGDs were audio-recorded, translated, and transcribed. Content analysis followed a thematic framework approach using deductive and inductive approaches. Data were collected March to July 2019. All participants provided written informed consent.Results:Forty-three women (mean age 28) and 22 CHVs (mean age 47) participated in 4 FGDs and 3 FGDs, respectively, and 8 health facility managers (mean age 38) participated in interviews. CHVs and health facility managers were majority female (80%). Participants reported that strikes by health care workers significantly impacted the availability and quality of maternal and child health services in 2017 and led to indirect economic effects due to households paying for services in the private sector. Participants overwhelmingly felt it was the poor, particularly poor women, who were most affected since they were more likely to rely on public services, while CHVs highlighted their own poor working conditions in response to strikes by other health care workers. Strikes strained relationships and trust between communities and the health system that were identified as particularly important to maternal and child health care. Conclusion: The impacts of strikes by health care workers extend beyond negative health and economic effects and exacerbate fundamental inequities in the health system with important implications for health systems strengthening and universal health coverage in Kenya and other countries.

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“…Doctors interpreted this to be responsible for two subsequent developments. First, in 2013, the newly elected National Rainbow Coalition pushed to increase healthcare utilization through free maternity care and removal of user fees, overwhelming an exasperated health workforce (Koon et al 2017). Second, following devolution, public practitioners would become employees of county health departments, with unclear, politicized mandates (Kimathi 2017).…”

Section: U N E D I T Ementioning

confidence: 99%

When Doctors strike: Making Sense of Professional Organizing in Kenya

Koon

2021

Journal of Health Politics, Policy and Law

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Little is known about how the health professions organize in low- and middle-income countries (LMICs). Recent strikes among health workers in many LMICs have directed interest toward measuring their impacts and understanding their causes. Yet, much of this literature belies a technical understanding of a social problem. By drawing on theoretical developments in organizational studies, this article proposes health sector movements be understood through attendant social processes of sensemaking as organizations seek to expand pragmatic, moral, and cognitive forms of legitimacy. Kenya, a lower middle-income country in sub-Saharan Africa, is an interesting case for such research. The intersubjective construction of meaning among medical doctors fashions narratives to order institutional change in the Kenyan health sector. This analysis shows how the strong legacy of colonial biomedicine shaped medical professionalism and inherent tensions with a deteriorating state following independence. In 2010, a new constitution and devolution of health services caused a fractured medical community to divide and pursue industrial action in its quest for organizational legitimacy. In this way, strike behavior, as a form of legitimation among union doctors in Kenya, is a risky path to universal health coverage.

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Nurses’ perceptions of universal health coverage and its implications for the Kenyan health sector

Abstract: Koon, A.D.;Smith, L.; Ndetei, D.; Mutiso, V.; Mendenhall, E. (2016) [Accepted Manuscript] Nurses perceptions of universal health coverage and its implications for the Kenyan health sector. Critical public health.

Cited by 9 publications

References 34 publications

Training needs assessment of nursing managers for achieving university health coverage

Training needs assessment of nursing managers for achieving university health coverage

‘It Was Hell in the Community’: A Qualitative Study of Maternal and Child Health Care During Health Care Worker Strikes in Kenya

When Doctors strike: Making Sense of Professional Organizing in Kenya

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