| dc.description.abstract | The focus towards the achievement of Universal health coverage (UHC) has been hampered
by a number of challenges which includes inadequate sensitization and enforcement of set
guidelines, more focus by counties on high-cost interventions rather than on Primary Health
Care (PHC), inadequate staff at national and county levels to offer health care service,
inadequate financing, poor reporting on the quality-of-service delivery among others. The
aim of this study was determinants of access and uptake of universal health coverage among
households of Mwingi West Sub-County- Kitui County. The specific objectives were; to
determine the awareness levels of UHC, determine socio-economic factors influencing
uptake of UHC and determine health systems factors influencing uptake of UHC. Descriptive
cross-sectional study design was employed where quantitative and qualitative data was
collected using a structured questionnaire and Key Informant Interviews. The study
population was households and health workers of Mwingi west. Stratified random sampling
was employed to sample wards while simple random sampling was used to sample 422
respondents in the study area using household registers. Data collection tools were piloted in
Mwingi North of which was not included in the study. The data was managed using SPSS
version 25. Descriptive data was analyzed using measures of central tendency i.e., means,
percentages and standard deviation The chi-square test was carried out to establish
association between social economic, health system factors and uptake of universal health
care. While confidence interval was set at 95%, data was summarized and presented using
graphs, tables and charts. Ethical clearance was obtained from Jaramogi Oginga Odinga
Teaching and Referral Hospital Institutional and Ethics Research committee. The study
targeted 422 participants; however, only 322 of them were accessible. Almost a half, 151
(46.9%) of the participants were aged between 26 to 35 years. More than average, 183
(56.8%) of the respondents were females. Self-employment was the primary mode of
livelihood for a high proportion 194(60.2%) of the participants. Most of the study sample,
183 (56.8%) were aware of Universal Health Coverage (UHC). There was a significant
association between occupation, educational level, belonging to a social welfare group and
awareness of UHC at α ≤ 0.05 (Chi-square: p=0.001, p=0.001, p=0.725, and p=0.0.027)
respectively. There was no association between adequate drug availability in health facilities,
rating of health service received and awareness of UHC (Chi-square: p=0.800, p=0.120)
respectively. An association was found to exist between treatment waiting time, rating of
health care workers and awareness of UHC (Chi-square: p=0.001, p=0.002) respectively.
There is a need to foster patient experiences at facilities offering UHC services through
enhanced quality of service tenable through sustained health care education of health care
workers on emerging disease trends. This will allow provision of adequate evidence-based
care, which meets the patient’s needs. The County Government of Kitui should develop
adequate health promotion strategies aimed at enhancing the awareness of its populace on
matters UHC | en_US |
