Reproducibility package for Management Of Healthcare Facilities And Patient Attendance During Major Disruptions: Evidence From Kenya

We measure and analyze management practices in the Kenyan healthcare sector, drawing on a nationally representative survey and linked administrative data. We make two main contributions. First, we adapted the World Management Survey (WMS) to measure the quality of management practices in primary health care facilities as well as hospitals, surveying 429 PHCs and 73 hospitals, representative at the national level. PHCs are the primary point of contact for most patients, providing treatment for common infectious diseases and chronic conditions, as well as services related to maternal and child health. The survey indicates low management practice quality on average on the WMS scale and a highly compressed distribution. Second, we utilized administrative data to test the association between management quality and PHC performance, measured by outpatient attendance, during a period of disruption that included the onset of the COVID-19 pandemic and a public health workers' strike. Overall attendance fell during this period. However, private facilities with better management quality suffered a smaller decline in attendance than public facilities, primarily driven by better operations management. These results underscore the resilience of well-managed private facilities in the face of healthcare crises, pointing towards the complementarity of the public and private sectors.