Telehealth Innovations, Government Policies, and Achievement of Universal Health Coverage among Digital Healthcare Providers in Kenya

Abstract

Telehealth has emerged as a crucial innovation in advancing universal health coverage (UHC) globally by enhancing access to healthcare services, reducing costs, and addressing shortages of medical professionals. However, achieving Universal Health Coverage in Kenya faces significant challenges among telehealth providers, particularly in ensuring services are affordable, accessible, acceptable, and available to all populations. The barriers are exacerbated by socioeconomic disparities, limited infrastructure, and gaps in policy implementation, hindering equitable healthcare delivery. The purpose of the study was to establish the effect of telehealth innovation on the achievement of Universal Health Coverage as moderated by government policies among the telehealth providers in Kenya. The objective of the study was to determine the effect of teleconferencing, store-and-forward, and mHealth on the achievement of UHC by the telehealth providers in Kenya and determine the moderating effect of government policies in the relationship between telehealth innovation and achievement of Universal Health Coverage. Data was collected within a period of three months. The study was founded on positivism philosophy and a mixed method research design. The study was guided by Rostow’s modernization model of development, Resource-Based View, and Unified Theory of Acceptance and Use of Technology. The target population for study incorporated 608 participants, consisting of 114 doctors, 86 medical consultants, and 408 nurses. A sample size of 265 was calculated using Slovin’s Formula. Stratified sampling technique was used to divide the target population into 3 strata (50 doctors, 39 medical consultants, and 176 nurses) while a simple random sampling method was used to select the respondents from each stratum. A pre-test was carried out at Penda Health Medical Center, located in Nairobi. To test for validity and reliability, the researcher used expert reviews and Cronbach’s alpha, respectively. Interviews with doctors and medical consultants in top leadership of the providers were used to collect qualitative data while a questionnaire was used to collect quantitative data from the three strata. Qualitative data was analyzed using thematic analysis while quantitative analysis involved using descriptive statistics and inferential statistics to assess relationships and the moderating effects of government policies. Ethical approval for data collection was obtained from the Daystar University Institutional Scientific and Ethical Review Committee (DU-ISERC), along with a research permit from Kenya’s National Commission for Science, Technology, and Innovation (NACOSTI). Regression analysis demonstrated that teleconferencing (β = .274, p = 0.05), store-and-forward (β = .311, p < 0.05), and mHealth (β = .295, p < 0.05) each significantly contributed to the achievement of Universal Health Coverage (UHC). Government policy itself was also significant (β = .214, p = .007). Importantly, interaction terms were statistically significant: Teleconferencing×Policy (β = .121, p = .038), Store-and-Forward×Policy (β = .139, p = .011), and mHealth×Policy (β = .158, p = .009), confirming that supportive policy amplifies the positive effects of telehealth innovations. The full moderated model explained 22.1% of the variance (R² = .221; F = 14.323, p < 0.05). The study concluded that telehealth innovations alone cannot achieve health equity; their effectiveness depends on government policies that govern, fund, and incorporate them within national health systems. These findings recommend prioritizing and funding robust digital health policies to maximize telehealth’s role in UHC. CHAPTER ONE