Implementation challenges of under-five health care interventions in western Kenya

Kisumu East sub-County in western Kenya has high under-five mortality rates. In the year 2008 the under-five mortality rate was 220 per 1,000 live births which was almost three times the national figure. The Government of Kenya has initiated interventions targeting the under-fives including immunization, integrated management care for the sick, oral rehydration therapy and care for the HIV positive. The under-five mortality rate in this region has remained high despite the above interventions. This study therefore sought to determine the challenges of implementing under-five health care interventions which could be contributing to poor uptake of health care services among this group in Kisumu East sub-County.

The study applied qualitative methods both in data collection and analysis. Ten health facilities operating in Tier 1 and 2 were sampled to participate in the study. Data was collected through Key Informant Interviews and Focus Group Discussions and theoretical thematic analysis was used in data analysis.

The identified implementation challenges of under-five health care interventions were grouped into three main categories namely; factors in the broader environment including institutional policies, household and community practices and health facility factors such as under-staffing.

Though the government has put in place policies and interventions targeting the under-fives, several challenges prevent the effective implementation of these programmes. The understanding of these challenges may provide direction in designing programmes that address them and thus increase uptake of the interventions targeting this age group.