Abstract
Although faith based organizations (FBOs) have had a long presence teaching health personnel and delivering health services to many rural and remote populations in the developing world, their poor visibility for this work can be due to several factors. FBOs may keep a low profile, be confused with non-religious non-governmental organizations (NGOs), or be excluded from surveys because respondents may not know the affiliation of the healthcare facility from which they last received services. It has been argued that their large networks, logistics agreements with governments, and mission-driven stance bring them closer to the communities they serve and that their services have been a higher quality than average.
Kenya has had a long history of established FBOs but there has also been substantial recent health investment by the government. We aimed to find the quantitative and qualitative contributions of FBOs by analyzing two recent data sources: the live web-based nationwide Master Health Facility List and the 2010 nationwide Service Provision Assessment (SPA) survey. Using this information, we found that FBOs contribute to 11% of all health facilities’ presence in the country, doubling to 23% of all available beds, indicating their relative strength in owning mid-level hospitals around the country.
We also constructed an index of “readiness” as a weighted average from services offered, good management practices, and availability of medicines and commodities for 17 items assessed during the SPA survey. We found that FBOs topped the list of managing authorities, with 69 percent of their health facilities achieving such readiness, followed closely by the government at 68 percent, NGOs at 60 percent and lastly a distant private for-profit sector at 51 percent.
These results seem to confirm that FBOs continue to contribute to an important proportion of health care coverage in Kenya and do so with a relatively high quality of care among all actors.
It would be of interest to replicate this analysis with similar databases for other countries in the developing world.