Holistic, Patient-Centered Care: Factors That Shape Providers at a Low-Resource Hospital in Kenya

Kenyan healthcare challenges include lack of personnel, limited resources and delayed treatment, particularly in rural areas. Adequate capacity in orthopedic surgery is paramount to handle the high rates of traumatic injuries and motor vehicle accidents, comprising 59.4% of the orthopedic admissions to the National Hospital in 2024. This study addressed the knowledge and innovative practices of healthcare workers (HCWs) in managing orthopedic conditions. The objective was to determine facilitators and barriers to delivering care in the orthopedic department of a district referral hospital in Kenya.

26 qualitative, semi-structured interviews were conducted with orthopedic-affiliated HCWs to understand their experiences in managing conditions at the Nanyuki Teaching and Referral Hospital in Kenya. Using standard qualitative methods, interviews were recorded and analyzed to identify themes representing key categories, thereby highlighting common HCW perspectives and practices.

Kenyan orthopedic HCWs identified three major themes affecting their role: patient-, HCW-, and hospital-centered care. Several subthemes included financial constraints, limited equipment and resources, the need for teamwork and collaborative care. While institutional challenges hindered HCWs, they developed innovative methods to overcome these barriers. Providers valued holistic approaches and sought out novel work-arounds, actively involving patients.

Despite constrained resources, HCWs at this district hospital were creative and resourceful in providing efficient, quality patient care. HCWs sought work-arounds, improvised, and invested in relationships with other healthcare sectors to create a collaborative environment. This research elucidates the steps to overcome barriers in the Kenyan healthcare system and can serve as a blueprint for other hospitals in LMICs for achieving patient-centered and quality care to obtain optimal outcomes.