Health systems research

Jacinta Nzinga

Jacinta Nzinga is a DPhil student at the KEMRI-Wellcome Trust Research Programme in Nairobi, Kenya. She examines how efforts to improve service delivery through adoption of recommended practices in Kenyan hospitals depend on health workers’ responses to improvement efforts, hospital context, actions of unit heads and the interaction between them.

The KEMRI-Wellcome Trust research programme

The KEMRI-Wellcome Trust Research Programme is a major Wellcome Trust’s overseas programmes. Its work has had a major influence on national and international health policy. Research spans a wide variety of topics and disciplines including research on malaria and bacterial and viral infectious diseases, work to map disease risk and intervention coverage and work on research ethics and health systems strengthening.

Jacinta Nzinga: Hospitals, health workers and service delivery in Kenya

My professional background is a social scientist. Actually it stems from my empiric research work and from my studentship. I have an undergraduate degree in environmental health, which is really basic public health, from Kenya. I also have a Masters in global health from Oxford University and I am currently a PhD student in Organisational Studies at Warwick Business School. My current research explores how health workers influence hospital context and how this interacts to influence the service delivery in public hospitals in Kenya. Mainly the focus is on examining the social context in which health care service delivery happens.

It is an important area of study because in health system strengthening the lowest level of the health system is largely ignored and the social context is rarely addressed, or not addressed at all. Looking at health workers, their influences, their perceptions, their attitudes and the structures around them in terms of resources, managers, leadership – those are important things that influence the delivery of service. A lot of focus has been on interventions and quantitative surveys and I feel this area of work that I am doing offers a different perspective in answering this question.

The methods that I use in my research are mainly drawn from social science, psychology and management studies. Therefore I mainly use qualitative methods that include informal interviews, observations, narratives, or stories. I have found that having informal chats with people off the record and outside hospital settings provides even richer data.

For me I feel that it is a new emerging area and there isn’t a lot that has been done in it and because I mainly use qualitative methods there isn’t a lot of statistics. But it is an area that is being increasingly recognised as being an important area of study.

I think gradually people are beginning to appreciate the value of social science research because if for example you have provided a resource of a study that you have conducted and you have graphs and charts then people don’t really understand what is happening in the background. It provides a good comparative way of looking at what’s really happening and people are increasingly starting to listen to the noise behind the numbers.

I’d tell those young people that it is a good place to start if you are genuinely inquisitive about the everyday nature of things and to continue in that line if enjoy being intellectually challenged every day. But I would tell them that it is a very sad place to start if you are looking to get rich.