Assessment of factors influencing service delivery at rural health centers in Uganda: a case study of Wakiso District

Abstract

Integrated and people-centered health services are essential to achieving universal health coverage. This can only be achieved through the provision of efficient and effective health services. Service delivery is one of the key building blocks of any health system; it is a direct output of health system inputs such as the health workforce, procurement and supplies, infrastructure and financing. The rising burden of disease and weak health systems are exacerbated by poor health service delivery. The aim of the study was to identify factors influencing service delivery in sub-county hospitals in Wakiso, Uganda. The objectives of the study was to determine the influence of staff on service delivery in hospitals in Wakiso district, to assess the influence of facilities on service delivery in hospitals in Wakiso district, to establish the influence of management practices on service delivery in hospitals in Wakiso district. The study adopted a descriptive cross-sectional design. The target population consisted of five officers from each of the twenty-three sub-county hospitals, making a total of one hundred and fifteen. Open and closed ended questions were used to collect data. Data were analysed using Epidata and SPSS version 26. Correlation and multi linear regression analysis were used respectively to determine the strength and direction of the relationship between the variables and the extent of the independent variable on service delivery, while descriptive statistics were used to generate means and standard deviation from the collected data. There was a positive significant relationship between staff, facilities, management practices and drug procurement (staff r= 0.892, p=.000; facilities r= 0.969, p=.000; management practices r= 0.891, p=.000; and drug procurement r=0.930, p=.000 respectively) and service delivery in Wakiso hospitals. It is concluded that human resources, facilities, management practices and drug procurement have positive and significant effect on service delivery in Wakiso hospitals. This study recommends that the management of Wakiso hospitals should motivate and have the required number of staff, have adequate and usable facilities, engage in management practices that add value to hospital operations and procure drugs on time, in the right quality and quantity.