Patient experiences and perceptions of home-based versus hospital-based care for acute traumatic wounds in Kenya

BACKGROUND: In Kenya, acute traumatic wounds drive high hospital admissions, yet patient-centered experiences of wound care models remain understudied. This study explores the narrated lived experiences of patients' perceptions of these models at Murang'a County Referral Hospital. Specifically, the study examines patients' perceived benefits of home-based versus hospital-based wound care at Murang'a County Referral Hospital. It also explores patient-identified areas for improvement in wound care services. METHODS: A quasi-experimental study with a qualitative component was conducted to compare hospital-based (control) and home-based (intervention) wound care. Participants with acute traumatic wounds were recruited using consecutive sampling and allocated to either the control or interventional group using a matching criterion of age, cause of wound, and severity of the wound. Data were collected through focus group discussions (June 2024-February 2025) and were analyzed thematically. RESULTS: Home-based care was perceived as cost-effective and convenient, enabling daily routine maintenance. Hospital-based care was valued for clinical expertise but was criticized for long waiting times, inconsistent supplies, and financial barriers. Participants recommended decentralizing services to rural clinics, improving hospital inventory systems, and scaling home-based programs through community health worker training. CONCLUSIONS: The findings highlighted growing patient preference for home-based wound care over traditional hospital-based services, driven primarily by considerations of cost, convenience, and self-efficacy.