Submission ID 130281
| Issue/Objective | Primary Health Care (PHC) underpins universal health coverage, yet inequities in access, quality, and continuity persist, especially for marginalized communities in Kenya. To address these gaps, the Primary Health Care Act of 2023 established Primary Health Care Networks (PCNs) to integrate services across facilities, strengthen community engagement, and promote people-centered care. Piloted in Kisumu and Garissa and scaled nationally, PCNs link health facilities, community units, and stakeholders. In Machakos Sub-County, with 44 facilities and 29 CHUs, this study assesses PCN readiness, functionality, and impact, providing evidence-based guidance to strengthen resilient, equitable health systems and advance equity in action by centering marginalized voices. |
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| Methodology/Approach | The study was conducted in Machakos Sub-County, covering 23 health facilities (Levels 2-4) and all 29 Community Health Units (CHUs). A cross-sectional descriptive design was used, combining primary data, facility assessments, CHU evaluations, and client exit interviews, with secondary data from county health records. Respondents included facility in-charges, clients, and community health actors (CHPs and CHAs/CHOs). Data were collected using standardized assessment tools and analyzed descriptively, with results presented in tables and charts. Ethical clearance was obtained, and collaboration with the Machakos County Health Department and the Ministry of Health PHC Division ensured adherence to ethical standards. The study was conducted within the 2025 planning cycle. |
| Results | In Machakos Sub-County, most facilities were KEPH Level 2 (57%), with 70% government-owned. Quality Improvement Teams were functional in 74% of facilities, and CHUs reported high household coverage (81%) with regular community engagement. Client feedback showed strong communication (94%), efficient service (<30 minutes for 72%), and high satisfaction (72%). Key gaps included inconsistent medicine supply (58%), weak referrals (9%), low community dialogue (19%), and limited supervision. |
| Discussion/Conclusion | The findings show that Primary Health Care Networks (PCNs) in Machakos Sub-County improve service coordination, community engagement, and client satisfaction, supported by active CHUs and Quality Improvement Teams. Despite high household coverage and positive feedback, gaps persist in medicine supply, referral systems, community dialogue, and supervision. In conclusion, strengthening supply chains, governance, and community participation is essential to ensure PCNs deliver equitable, resilient, and people-centered health services, particularly for marginalized populations. |
| Presenters and Affiliations | Anne Ndolo MACHAKOS COUNTY GOVERNMENT ANN MWANIKI MACHAKOS COUNTY GOVERNMENT franscisca kivuva MACHAKOS COUNTY GOVERNMENT Cosmas Musyoki MACHAKOS COUNTY GOVERNMENT ALEX Mwanza MACHAKOS COUNTY GOVERNMENT |
