EFFECT OF TRAINING HEALTH WORKERS ON IMPROVING HEALTH SYSTEM RESPONSIVENESS AMONG CHRONIC CARE CENTERS IN TIER THREE HOSPITALS, KENYA

This study determined the effect of training health workers in improving health systems responsiveness within diabetic and hypertensive clinics in tier three hospitals in Kenya. Responsiveness, defined as meeting non-health improving expectations, is fundamental to a well-functioning health system. The study used a quasi-experimental design with baseline survey, a training intervention on responsiveness and client interaction skills for health workers, and an end-line survey. A sample of 323 respondents was selected from a sampling frame of 853 using fisher's formula. The end-line survey included 258 participants. Data were collected using an interviewer-assisted structured questionnaire, with responses rated on a five-point likert scale and then dichotomized into favorable and unfavorable categories using a demarcation threshold formula. Responsiveness levels increased from 63.7% to 67.4%, while proportion of favorable responsiveness rose from 38.3% to 52.7% between baseline and end line. The odds of favorable responsiveness nearly doubled from 0.620 to 1.114 between baseline and end line. A paired samples t-test indicated significant (p<0.05) positive deviations across all responsiveness domains. In conclusion, responsiveness, improved following the training intervention. We recommend that health systems managers and Training institutions and hospital management should integrate responsiveness training across all levels from training to practice to enhance sensitivity to client needs in healthcare. Keywords: Health System Responsiveness, Training, Intervention, Chronic Conditions, Diabetes Mellitus, Hypertension, Kenya