Can patients understand and use regulatory results? Investigating the influence of risk-rating of health facilities on community engagement and accountability mechanisms in two Kenyan counties.
Wellcome Trust
Strathmore University
Strategies to address poor implementation of health facility regulation in developing countries have mainly been supply driven, with the emergence of innovative risk-based regulatory frameworks that respond to facility performance. However, there has been less emphasis placed on demand side strategies, with little known about how such regulatory innovations have utilized community accountability and engagement mechanisms to improve quality of care. This study seeks to investigate how regulatory risk-rating of health facilities feeds into community engagement and accountability mechanisms. It will involve: (i) a review of literature to understand links between community engagement and accountability, and health facility regulation; (ii) a quantitative survey to investigate the association between regulatory performance ratings and patients’ perception of quality of care at healthcare facilities; and (iii) in-depth interviews to determine whether and how regulatory performance rating of facilities is understood and used to influence care through community accountability and engagement mechanisms. The study findings will inform policy on how to increase public engagement/involvement in health facility regulation and how to capitalize on community accountability mechanisms to improve services
8.1 Organisation and delivery of services