Evaluating Quality of Services in Community Differentiated Service Delivery Model. A case of Kakamega county

Abstract

BACKGROUND The provision of high-quality services is a prerequisite for the successful implementation of community-differentiated service delivery. The service quality influences the clients' satisfaction, perceived value trust in the model and eventual utilization. Evaluating the quality of services in community differentiated service delivery will inform policymakers of existing quality gaps and in turn, this will assist in formulating strategies that will improve service quality and increase utilization. METHODOLOGY This was a cross-sectional study conducted in Kakamega County between September and December 2021 involving 402 participants. using purposive sampling, clients already established on ART were selected and data was collected through a structured questionnaire. Descriptive and inferential statistics were used to analyze data using SPSS version 25. RESULTS The results on dimensions of service quality established a high mean score (4.27) related to client literacy and a low score (2.64) on the package of services. There was a moderate positive relationship between client literacy and package of services (0.641) and a strong positive relationship between package of services and competence of the service provider (0.894). On the package of services (79.9%) of participants reported that ART refill and referral services were available, (12.7%) adherence and psychosocial support, 11.7% and 5% viral load sample collection. Regarding quality, the Freidman test ranged from client literacy (7.84), cost of services (7.79), accessibility (5.71), competence of the provider (4/06) and comprehensive package (2.54). CONCLUSION The study established a service quality gap in the package of services and the competence of the provider. The package of service provided is not comprehensive enough to address the needs of the clients. RECOMMENDATION Policymakers and leaders should re-distribute resources to allow for the training of providers using the differentiated service delivery manual 2023. The dimensions of quality can be reorganized to prioritize the appropriate package of services followed by the competence of lay health providers and lastly client literacy.