Community health centers in Kenya have faced challenges in maintaining consistent service delivery due to system reliability issues. A systematic literature review was conducted using databases such as PubMed and Google Scholar. The study employed mixed methods including quantitative analysis to assess system performance metrics and qualitative analysis to explore stakeholder perspectives. The findings indicate that a significant proportion (65%) of community health centers experienced reliability issues, particularly in service continuity and resource allocation, which were influenced by the implementation of standardised protocols and regular staff training programmes. While systematic improvements led to notable reductions in system failures, ongoing challenges persist, necessitating further refinements in operational strategies and stakeholder engagement models. Further research should focus on developing adaptive mechanisms for real-time monitoring and feedback loops within the health systems to ensure continuous improvement. Treatment effect was estimated with logit (pᵢ) =₀+^ Xᵢ, and uncertainty reported using confidence-interval based inference.
Gitonga et al. (Tue,) studied this question.