Individual characteristics associated with the use of scorecard to improve RMNCAH performance indicators in public primary health facilities in Kenya

Abstract

Purpose: In order to improve RMNCAH (reproductive, maternal, newborn, child, and adolescent health) in Kenyan public primary health facilities, the study assessed the individual characteristics of the healthcare workers using scorecards in Kwale and Kilifi counties.

Materials and Methods: We selected a stratified random sample of healthcare workers (HCWs) from all public primary care health facilities in Kwale and Kilifi counties for a cross-sectional study. We collected quantitative data using a semi-structured questionnaire using kobo collect tool.

Findings: The findings revealed that 62.5% of male healthcare workers used scorecards to measure RMNCAH performance, compared to 37.5% of female healthcare workers. Among married healthcare professionals, 68.8% used scorecards, compared to 25.0% of single and 6.3% of divorced or separated personnel. Only 6.3% of HCWs aged 20-29 years used scorecards, in contrast to 68.8% of those aged 30-39 years and 18.8% of those aged 40-49 years. Additionally, 62.5% of nurses used scorecards, compared to 37.5% of registered clinical officers (RCOs). A significant majority (75.0%) of healthcare professionals with a diploma used scorecards, compared to those with other educational levels. Less experienced HCWs (0-4 years and 5-9 years) were more likely to use scorecards than those with 10–14 years and 15 years or more of experience. The relationship between years of experience and scorecard use was statistically significant (p= 0.029, <0.05). The study concludes that scorecard use was more prevalent among male healthcare workers, married professionals, and those aged 30–39 years, compared to their female, single, and younger or older counterparts. Less experienced healthcare staff were more likely to use scorecards than those with longer tenures.

Implications to Theory, Practice and Policy: The study recommends that healthcare facilities and policymakers promote scorecard use for RMNCAH performance monitoring, focusing on female healthcare workers, single or divorced professionals, RCOs, and those with higher education levels. It emphasizes developing targeted training programs to meet the specific needs of underrepresented groups and creating supportive environments that provide necessary resources and training for scorecard adoption. Additionally, policies should prioritize gender diversity and age inclusivity in training initiatives to ensure all healthcare workers are equipped with the skills needed for effective scorecard utilization.