Influence of political culture on service provision in Kenyan rural health facilities.

Objectives: To explore the overall implications for an enhanced health system administrative capacity that not only takes account of global and regional developments, but that is also seen as legitimate domestically and is well equipped theoretically to deliver quality health care services in Kenyan rural health facilities.

Methods: The study used public hospitals as test cases. A field study was undertaken in western Kenya where four institutions were identified as research sites. In all the sites, a survey questionnaire was administered to both the community of health service providers as well as service users.

Results: The study found that health care service reforms must begin at a more fundamental level rather than just organizational development, human resource development and capacity building.

Conclusions: The paper concludes by re-emphasizing the need to minimize the traditional tensions between the political and the public administration interface and the need to ensure that health care reforms are embedded or at least reflect the political choice and social structure of Kenyans in general.