FACTORS THAT DETERMINE ACCESS TO HEALTH CARE
SERVICES IN PUBLIC HEALTH INSTITUTIONS IN KAJIADO
DISTRICT.
RESEARCH PROPOSAL IN PART FULFILLMENT
FOR THE
AWARD OF THE DEGREE OF BACHELOR OF SCIENCE IN
NURSING,
UNIVERSITY OF NAIROBI.
BY:
MURITHI LYDIA WAMBOGO.
H32/9508/2002.
SUPERVISED BY:
MRS. LUCY KIVUTI-BITOK,
LECTURER,
SCHOOL OF NURSING SCIENCES,
COLLEGE OF HEALTH SCIENCES, UNIVERSITY OF NAIROBI.
MARCH 2006
HF,('1,ARATION
I, Lydia Wambogo Murithi hereby declare that this research proposal is my original
work and has not been presented for the award of any degree or diploma in any
university.
Signature
Date
11
ACKNOWLEDGEMENTS
The completion of this proposal would have been a more difficult task without the
support, encouragement,
and suggestions made to me by my lecturers especially
Mrs. Lucy-Kivuti-Bitok,
friends and most of all my family.
iii
CERTIFICATE OF APPROVAL
This research approval has been submitted for the degree of the Bachelor of Science
in Nursing, University of Nairobi with my approval as the university supervisor.
Signature;
_
Date:
Mrs. Lucy Kivuti-Bitok
Lecturer,
School of Nursing Sciences,
University of Nairobi.
IV
TABLE OF CONTENTS
+ Title page
• Declaration
11
+ Acknowledgements
111
• Certificate of Approval
IV
+ Operational defmitions
V11
• List of abbreviations
IX
+ Executive summary
X
CHAPTER ONE: INTRODUCTION
1.0
Introduction
1.1
Statement of the problem
1.2
Background information
1.3
Theoretical framework
.
5
1.4
Study Justification
.
5
1.5
Hypothesis
.
5
1.6
Broad objectives
1.7
Specific objectives
.
6
1.8
Research Questions
.
6
1.9
Expected Benefits
.
6
3
.
.
.
v
4
5
6
CHAPTER TWO : LITERATURE REVIEW
2.0
Introduction
2.1
Studies done Globally and their findings
2.2
7
.
.
7
.
8
African Perspective
CHAPTER THREE: MEmODS
AND MATERIALS
3.0
Study Design
.
12
3.1
Study Variables
.
12
3.2
Study area
3.3
Sampling
.
.
12
13
3.3.0
Sample size Calculation
.
13
3.3.1
Inclusion and Exclusion criteria
.
14
3.3.2
Sampling Method
.
14
3.4
Data Collection
3.5
Data Cleaning
.
15
3.6
Data Analysis
.
15
3.7
Presentation of results
.
15
3.8
Control of Biases and Errors
.
16
3.9
Ethical considerations
.
16
3.10
Limitations
.
17
.
REFERENCES
.
VI
15
18
OPERATIONAL DEFINITIONS
Acceptability
- Degree to which the heath service meets the cultural needs and standards
of a community. This will affect utilization of that service.
Accessibility of health care:
A measure of the proportion of a population that reaches appropriate health
services; in terms of financial, geographical and cultural access.
Affordability: Extent to which the intended clients of a health care service can pay for it.
It depends on income distribution, cost of services and financing mechanisms.
Appropriateness: If an expected heath benefit exceeds the expected negative
consequences by a large enough margin to justify it; rather than other
alternatives.
Availability: Identifies the presence or absence of needed heath care services.
Health care Provider: An individual or institution that provides medical services
(E.g. physician, hospital, lab)
Vlll
APPENDICES
20
Appendix
I
Schedule of activities
Appendix
II
Research Budget.
Appendix
III
Authority Application Letter
Appendix
IV
Interview consent form
.
23
Appendix
V
Data Collection instrument-Questionnaire
.
24
lX
.
.
21
.
22
ABBREVIATIONS
G.O.K - Government of Kenya
M.O.E - Ministry of Education
M.O.H - Ministry of Health
S.P.S.S - Statistical Package of Social Sciences
W.H.O - World Health Organization
EXECUTIVE
SUMMARY
The study is a descriptive quantitative and qualitative type whose main objective is to
establish factors that determine access to health care services in public health institutions in
Kajiado District, Rift Valley Province-Kenya.
The sample population will consist of three hundred and eighty four adult residents aged
between 18 and 65 years.
Study participants will be selected via stratified random sampling method.
The main Data collection tool will be a questionnaire designed by the principal researcher.
Research assistants will be involved to assist in implementation of the study tool and data
collection.
The study is expected to take 13 weeks with an estimated cost of one hundred and sixty-two
thousand, four hundred and ten shillings.
The S.P.S.S will be used for data analysis.
Findings and expected benefits of the study will be communicated to the health centers,
dispensaries in the district, the district health management team.
2