Can patients understand and use regulatory results? Investigating the influence of risk-rating of health facilities on community engagement and accountability mechanisms in two Kenyan counties

Strategies to address poorly implemented regulation of health facilities in developing countries have mainly been supply driven, with risk-based regulatory frameworks responding to performance. However, there has been less emphasis placed on demand-side strategies, with little known about how regulatory innovations have used community accountability and engagement mechanisms to improve quality of care. 

I will investigate how regulatory risk-rating of health facilities feeds into community engagement and accountability mechanisms. I will review the literature to understand links between community engagement and accountability and health facility regulation. I will use a quantitative survey to investigate the association between regulatory performance ratings and patients’ perception of quality of care at healthcare facilities, and in-depth interviews to determine whether regulatory performance rating of facilities is understood and used to influence care through community accountability and engagement mechanisms. 

The study findings will inform policy on how to increase public engagement and involvement in health facility regulation and how to capitalise on community accountability mechanisms to improve services.

This grant was awarded under the scheme’s previous name of Master’s Fellowship in Public Health and Tropical Medicine.