Abstract:
Background: The Kenya Quality Model (KQM) was designed by the Department of
Standards Research and Regulatory Services under Ministry of Health (MoH) in
Kenya to provide a conceptual framework for quality improvement in health care.
This model has been used by the National Hospital Insurance Fund (NHIF) to
improve quality in NHIF accredited hospitals. NHIF and MoH have trained health
workers on the use of the KQM. Despite encouraging results after using the Kenya
Quality Model, this document has been poorly adopted by many health facilities.
Barriers associated with the use of the KQM have not been documented locally.
Objective: To determine the barriers associated with the use of the Kenya Quality
Model in St. Francis Community Hospital Kasarani and Igegania Sub-district hospital.
Methodology: A cross sectional study was done at St. Francis Community Hospital
and Igegania Sub District Hospital which have hospital staff trained on using the
Kenya Quality Model. A total of 155 interviews were conducted using questionnaires
with health workers in all departments. A Focus Group Discussion was conducted
with quality improvement team members within the hospital, quality staff from the
Department of Standards Research and Regulatory Services, NHIF quality experts
and other key players in the health sector.
Results: Among the respondents 69% were female and 31% male. Majority (80%) of
the respondents had background medical training. The mean number of years worked
in the health sector was 4.75 ±3.814. Lack of awareness emerged as a barrier to the
use of KQM with 14.8% of respondents aware of the existence of the KQM. Only
10.3% members of staff had been trained. The use of KQM was low with 89.7% of
the respondents reporting none-use. About 37.9% of respondents mentioned that not
all members of the quality improvement team understood the KQM. Other barriers
include that the KQM is too detailed 20.7% and a lack of clear understanding of the
KQM 17.2%. Methods identified by the respondents of increasing awareness on the
existence of the KQM include training 58.3%, facility improvement support 12.5%
and recognition as a centre of excellence 8.3%.
Conclusion: The level of awareness of the Kenya Quality Model is low. In order to
improve the utilization of the Kenya Quality Model awareness level should be
increased and the barriers associated with the use of the Kenya Quality Model
addressed.
Recommendation: The Ministry of Health should aim at scaling-up promotion of
KQM as a tool for quality improvement and assessment among health facilities in
Kenya. More health workers need to be trained on the use of the Kenya Quality
Model.
