title: Provision of essential health package in public hospitals: a case of Homabay County hospitals, Kenya.
abstract: BACKGROUND
  Essential Health Packages (EHP) delivery is likely to strengthen service delivery. Healthcare utilization rate is 77% for the sick. 44% and 18% who don't seek care are hindered by cost and distance respectively. The overall child mortality rate in Kenya is 121/1000. In Homabay County, child mortality rate is 91/1000, and maternal mortality rate of 583/100000. The study looked into the provision of EHP in public hospitals in Homabay County.
  
  
  METHODS
  Cross-sectional research design was used. Two hospitals were conveniently due to their municipality location. The study targeted 213 Health workers and 350 patients. Stratified sampling and proportionate sampling was used among different health workers. Sample size was determined by Yamane Formula. The study sampled 138 health workers and 186 patients. Questionnaire and key interview guide were used to collect data.
  
  
  RESULTS
  There are inadequate health workers based on 138 (100%) health workers. Insufficient drugs were reported by 138 (100%) health workers, and 120 (64.5%) patients. 115 (83.3%) health workers say ambulances are not operational. 26 (18.8%) health workers noted lack medical equipment, 138 (100%) are aware of patients referred elsewhere due to lack of medical equipment. 153 (82.3%) and 135 (72.6%) patients' health access is hindered by cost and distance respectively. 159 (85.5%) patients don't always find services needed. 159 (85.5%) patients affected by long waiting time.
  
  
  CONCLUSIONS
  Low service provision/utilization rate in Homabay County results from lack of health workers, inadequate drugs, poor health infrastructure, and lack of access in terms of affordability, availability and distance.
authors: Kenya Methodist University, Kenya.
authors: Shadrack Ochieng
authors: SO
authors: Opon
mesh_terms: D000552:Ambulances / Q000600:supply & distribution; D003430:Cross-Sectional Studies; D003695:Delivery of Health Care / Q000458:organization & administration*; D006282:Health Personnel / Q000458:organization & administration* / Q000706:statistics & numerical data; D006297:Health Services Accessibility; D006779:Hospitals, Public / Q000458:organization & administration*; D006801:Humans; D007630:Kenya; D004364:Pharmaceutical Preparations / Q000600:supply & distribution; D011795:Surveys and Questionnaires; D013997:Time Factors
chemical_list: D004364:Pharmaceutical Preparations
keywords: Health Workers; Health infrastructure; drugs and supplies; organizational practices; patient satisfaction