Characterising Kenyan hospitals’ suitability for medical officer internship training: a secondary data analysis of a cross-sectional study
Objective To characterise the capacity of Kenya internship hospitals to understand whether they are suitable to provide internship training for medical doctors.Design A secondary data analysis of a cross-sectional health facility assessment (Kenya Harmonized Health Facility Assessment (KHFA) 2018).S...
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BMJ Publishing Group
2022-05-01
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| Series: | BMJ Open |
| Online Access: | https://bmjopen.bmj.com/content/12/5/e056426.full |
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| author | David Gathara Mike English Helen Kiarie Yingxi Zhao Fred Were Catia Nicodemo Boniface Osano |
| author_facet | David Gathara Mike English Helen Kiarie Yingxi Zhao Fred Were Catia Nicodemo Boniface Osano |
| author_sort | David Gathara |
| collection | DOAJ |
| description | Objective To characterise the capacity of Kenya internship hospitals to understand whether they are suitable to provide internship training for medical doctors.Design A secondary data analysis of a cross-sectional health facility assessment (Kenya Harmonized Health Facility Assessment (KHFA) 2018).Setting and population We analysed 61 out of all 74 Kenyan hospitals that provide internship training for medical doctors.Outcome measures Comparing against the minimum requirement outlined in the national guidelines for medical officer interns, we filtered and identified 166 indicators from the KHFA survey questionnaire and grouped them into 12 domains. An overall capacity index was calculated as the mean of 12 domain-specific scores for each facility.Results The average overall capacity index is 69% (95% CI 66% to 72%) for all internship training centres. Hospitals have moderate capacity (over 60%) for most of the general domains, although there is huge variation between hospitals and only 29 out of 61 hospitals have five or more specialists assigned, employed, seconded or part-time—as required by the national guideline. Quality and safety score was low across all hospitals with an average score of 40%. As for major specialties, all hospitals have good capacity for surgery and obstetrics-gynaecology, while mental health was poorest in comparison. Level 5 and 6 facilities (provincial and national hospitals) have higher capacity scores in all domains when compared with level 4 hospitals (equivalent to district hospitals).Conclusion Major gaps exist in staffing, equipment and service availability of Kenya internship hospitals. Level 4 hospitals (equivalent to district hospitals) are more likely to have a lower capacity index, leading to low quality of care, and should be reviewed and improved to provide appropriate and well-resourced training for interns and to use appropriate resources to avoid improvising. |
| format | Article |
| id | doaj-art-b40eba589de3475e84a0ac2cae720ae3 |
| institution | OA Journals |
| issn | 2044-6055 |
| language | English |
| publishDate | 2022-05-01 |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | BMJ Open |
| spelling | doaj-art-b40eba589de3475e84a0ac2cae720ae32025-08-20T01:47:55ZengBMJ Publishing GroupBMJ Open2044-60552022-05-0112510.1136/bmjopen-2021-056426Characterising Kenyan hospitals’ suitability for medical officer internship training: a secondary data analysis of a cross-sectional studyDavid Gathara0Mike English1Helen Kiarie2Yingxi Zhao3Fred Were4Catia Nicodemo5Boniface Osano63 MARCH Centre, London School of Hygiene and Tropical Medicine, London, UK2 Health Services Unit, KEMRI-Wellcome Trust Research Programme, Nairobi, Kenya4 Division of Monitoring & Evaluation, Ministry of Health, Nairobi, KenyaNuffield Department of Medicine, Oxford University, Oxford, Oxfordshire, UK11 Department of Paediatrics and Child Health, University of Nairobi, Nairobi, Kenya3 Nuffield Department of Primary Care and Health Science, University of Oxford, Oxford, UK2 Department of Paediatrics and Child Health, University of Nairobi, Nairobi, KenyaObjective To characterise the capacity of Kenya internship hospitals to understand whether they are suitable to provide internship training for medical doctors.Design A secondary data analysis of a cross-sectional health facility assessment (Kenya Harmonized Health Facility Assessment (KHFA) 2018).Setting and population We analysed 61 out of all 74 Kenyan hospitals that provide internship training for medical doctors.Outcome measures Comparing against the minimum requirement outlined in the national guidelines for medical officer interns, we filtered and identified 166 indicators from the KHFA survey questionnaire and grouped them into 12 domains. An overall capacity index was calculated as the mean of 12 domain-specific scores for each facility.Results The average overall capacity index is 69% (95% CI 66% to 72%) for all internship training centres. Hospitals have moderate capacity (over 60%) for most of the general domains, although there is huge variation between hospitals and only 29 out of 61 hospitals have five or more specialists assigned, employed, seconded or part-time—as required by the national guideline. Quality and safety score was low across all hospitals with an average score of 40%. As for major specialties, all hospitals have good capacity for surgery and obstetrics-gynaecology, while mental health was poorest in comparison. Level 5 and 6 facilities (provincial and national hospitals) have higher capacity scores in all domains when compared with level 4 hospitals (equivalent to district hospitals).Conclusion Major gaps exist in staffing, equipment and service availability of Kenya internship hospitals. Level 4 hospitals (equivalent to district hospitals) are more likely to have a lower capacity index, leading to low quality of care, and should be reviewed and improved to provide appropriate and well-resourced training for interns and to use appropriate resources to avoid improvising.https://bmjopen.bmj.com/content/12/5/e056426.full |
| spellingShingle | David Gathara Mike English Helen Kiarie Yingxi Zhao Fred Were Catia Nicodemo Boniface Osano Characterising Kenyan hospitals’ suitability for medical officer internship training: a secondary data analysis of a cross-sectional study BMJ Open |
| title | Characterising Kenyan hospitals’ suitability for medical officer internship training: a secondary data analysis of a cross-sectional study |
| title_full | Characterising Kenyan hospitals’ suitability for medical officer internship training: a secondary data analysis of a cross-sectional study |
| title_fullStr | Characterising Kenyan hospitals’ suitability for medical officer internship training: a secondary data analysis of a cross-sectional study |
| title_full_unstemmed | Characterising Kenyan hospitals’ suitability for medical officer internship training: a secondary data analysis of a cross-sectional study |
| title_short | Characterising Kenyan hospitals’ suitability for medical officer internship training: a secondary data analysis of a cross-sectional study |
| title_sort | characterising kenyan hospitals suitability for medical officer internship training a secondary data analysis of a cross sectional study |
| url | https://bmjopen.bmj.com/content/12/5/e056426.full |
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