Landscape analysis of healthcare policy: the instrumental role of governance in HIV/AIDS services integration framework

Abstract

Introduction: low and middle-income countries HIV/AIDS interventions are yet to achieve the desired levels of health outcome due to lack of effectiveness and efficiency in programming, a challenge associated with resource limitations, fragmentated services, complexities in population and disease characteristics including political landscape. The objective of this study was to establish the instrumental role of governance in the implementation of HIV/AIDS services integration policy framework, with focus on organization structure, participation in decision making, collaboration, stakeholder engagement, political commitment as study variables.

Methods: using a mixed method design, a total number of 30 health workers, 5 county AIDS services coordinators (CASCOs), 8 sub-CASCOs and 3 representatives of inter coordinating committee were interviewed in compliance with ethical protocols. Multi-stage sampling techniques was used to select counties in Kenya, health institutions and respondents. Quantitative and qualitative data was generated by administering semi structured questionnaire and key informant interview guide.

Results: generated from excel sheet and NVivo software indicate that organization structures existed and clarity and ease of work varied across the different levels of care. Collaboration efforts, however varied, created synergy in policy framework implementation and political commitment complemented the various leadership actions for successful implementation of integration policy framework.

Conclusion: governance role is indispensable in the implementation of health policy framework. Policy makers need accurate epidemiological and demographic information to implement contextualized policy framework necessary for sustained improvement in health outcomes.