Strengthening Primary Health Care through Primary Care Networks: Baseline Evidence on Access, Quality, and Care Coordination in Machakos Sub-County, Kenya
1
PUBLIC HEALTH AND COMMUNITY OUTREACH, COUNTY GOVERNMENT OF MACHAKOS, Machakos, Kenya
Popul. Med. 2026;8(Supplement Supplement 1):
ABSTRACT
BACKGROUND:
Primary Care Networks (PCNs) are an innovative approach in Kenya aimed at enhancing access, quality, and coordination of primary healthcare (PHC). In Machakos Sub-County, the establishment of PCNs seeks to strengthen community-facility linkages, improve service delivery, and ensure equitable health outcomes. This study provides a baseline assessment of facility readiness, community functionality, and client experiences within the PCN framework.
METHODS:
A cross-sectional descriptive study was conducted across 23 health facilities and all 29 Community Health Units (CHUs) in Machakos Sub-County. Data were collected through structured facility assessments, community health unit evaluations, and client exit interviews. Quantitative analysis was performed using descriptive statistics to assess infrastructure, human resources, service delivery, community engagement, and patient satisfaction.
RESULTS:
Most facilities were KEPH Level 2 (57%), with 70% government-owned and 30% private. Functional Quality Improvement Teams existed in 74% of facilities, while 35% of MPDSR committees were operational. The majority of Community Health Units (CHUs) reported high household visit coverage (81%) and regular community engagement activities. Client exit interviews revealed good provider communication (94%), efficient turnaround time (<30 minutes for 72% of clients), and high satisfaction with services (72% very satisfied). Key gaps included inconsistent supply of medicines (58% inadequate), weak referral systems (9% effective referrals), low community dialogue participation (19%), and limited supervision at both facility and community levels.
CONCLUSIONS:
PCNs in Machakos Sub-County have established foundational structures that support service delivery and community engagement. However, gaps in governance, supervision, commodity supply, referral systems, and community participation need urgent attention to optimize the impact of PCNs. Strengthening these areas will enhance the accessibility, quality, and coordination of primary healthcare services, contributing to equitable and sustainable health outcomes.
Primary Care Networks (PCNs) are an innovative approach in Kenya aimed at enhancing access, quality, and coordination of primary healthcare (PHC). In Machakos Sub-County, the establishment of PCNs seeks to strengthen community-facility linkages, improve service delivery, and ensure equitable health outcomes. This study provides a baseline assessment of facility readiness, community functionality, and client experiences within the PCN framework.
METHODS:
A cross-sectional descriptive study was conducted across 23 health facilities and all 29 Community Health Units (CHUs) in Machakos Sub-County. Data were collected through structured facility assessments, community health unit evaluations, and client exit interviews. Quantitative analysis was performed using descriptive statistics to assess infrastructure, human resources, service delivery, community engagement, and patient satisfaction.
RESULTS:
Most facilities were KEPH Level 2 (57%), with 70% government-owned and 30% private. Functional Quality Improvement Teams existed in 74% of facilities, while 35% of MPDSR committees were operational. The majority of Community Health Units (CHUs) reported high household visit coverage (81%) and regular community engagement activities. Client exit interviews revealed good provider communication (94%), efficient turnaround time (<30 minutes for 72% of clients), and high satisfaction with services (72% very satisfied). Key gaps included inconsistent supply of medicines (58% inadequate), weak referral systems (9% effective referrals), low community dialogue participation (19%), and limited supervision at both facility and community levels.
CONCLUSIONS:
PCNs in Machakos Sub-County have established foundational structures that support service delivery and community engagement. However, gaps in governance, supervision, commodity supply, referral systems, and community participation need urgent attention to optimize the impact of PCNs. Strengthening these areas will enhance the accessibility, quality, and coordination of primary healthcare services, contributing to equitable and sustainable health outcomes.
| eISSN: | 2654-1459 |
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