title: Perceptions and attitudes of health professionals in kenya on national health care resource allocation mechanisms: a structural equation modeling.
abstract: BACKGROUND
  Health care resource allocation is key towards attaining equity in the health system. However, health professionals' perceived impact and attitude towards health care resource allocation in Sub-Saharan Africa is unknown; furthermore, they occupy a position which makes them notice the impact of different policies in their health system. This study explored perceptions and attitudes of health professionals in Kenya on health care resource allocation mechanism.
  
  
  METHODS
  We conducted a survey of a representative sample of 341 health professionals in Moi Teaching and Referral Hospital from February to April 2012, consisting of over 3000 employees. We assessed health professionals' perceived impact and attitudes on health care resource allocation mechanism in Kenya. We used structural equation modeling and applied a Confirmatory Factor Analysis using Robust Maximum Likelihood estimation procedure to test the hypothesized model.
  
  
  RESULTS
  We found that the allocation mechanism was negatively associated with their perceived positive impact (-1.04, p < .001), health professionals' satisfaction (-0.24, p < .01), and professionals' attitudes (-1.55, p < .001) while it was positively associated with perceived negative impact (1.14, p < .001). Perceived positive impact of the allocation mechanism was negatively associated with their overall satisfaction (-0.08) and attitude (-0.98) at p < .001, respectively. Furthermore, overall satisfaction was negatively associated with attitude (-1.10, p <.001). On the other hand, perceived negative impact of the allocation was positively associated with overall satisfaction (0.29, p <.001) but was not associated with attitude.
  
  
  CONCLUSIONS
  The result suggests that health care resource allocation mechanism has a negative effect towards perceptions, attitudes and overall satisfaction of health professionals who are at the frontline in health care. These findings can serve as a crucial reference for policymakers as the Kenyan health system move towards devolving the system of governance.
authors.affiliation: School of Health Care Administration, Taipei Medical University, Taipei, Taiwan; International Health Program, Institute of Public Health, National Yang Ming University, Taipei, Taiwan.
authors.forename: Patrick Opiyo
authors.initials: PO
authors.lastname: Owili
authors.affiliation: School of Health Care Administration, Taipei Medical University, Taipei, Taiwan.
authors.forename: Yi-Hsin Elsa
authors.initials: YH
authors.lastname: Hsu
authors.affiliation: Department of Health Care Administration, Chang Jung Christian University, Tainan, Taiwan.
authors.forename: Jin-Yuan
authors.initials: JY
authors.lastname: Chern
authors.affiliation: School of Health Care Administration, Taipei Medical University, Taipei, Taiwan.
authors.forename: Chiung-Hsuan Megan
authors.initials: CH
authors.lastname: Chiu
authors.affiliation: Department of Health Care Administration, Asia University, Taichung, Taiwan.
authors.forename: Bill
authors.initials: B
authors.lastname: Wang
authors.affiliation: School of Health Care Administration, Taipei Medical University, Taipei, Taiwan.
authors.forename: Kuo-Cherh
authors.initials: KC
authors.lastname: Huang
authors.affiliation: Institute of Community Health and Development, Great Lakes University of Kisumu, Kisumu, Kenya.
authors.forename: Miriam Adoyo
authors.initials: MA
authors.lastname: Muga
mesh_terms: D000328:Adult; D001291:Attitude of Health Personnel; D003695:Delivery of Health Care; D005260:Female; D015276:Health Care Rationing; D006801:Humans; D007630:Kenya; D008297:Male; D008875:Middle Aged; D008962:Models, Theoretical; D009313:National Health Programs