I. An operational study in the outpatient department of Machakos Hospital (1968).

The demand for outpatient services at Government Hospitals in Kenya increased considerably during the period 1962-1967. As a result a discrepancy developed between demand for services and the resources to meet these demands. An operational study, dealing with medical, technical and administrative aspects, was carried out at the outpatient department at Machakos Hospital in 1968. The study comprised: the arrival pattern of patients, work measurement of the activities of the medical assistant, diagnosis, prescriptions, the distribution of patients over the therapeutic units, waiting times and length of queues. Following the study recommendations, expected to improve the efficiency of the clinic and the service to the patients, were put forward to the Ministry of Health. The most important recommendations dealt with: the need for overall leadership; direction of traffic; the position and the role of the medical assistant; the organization procedures, in particular at the medical assistants' units and at the injection room and pharmacy. The present study does not include: the attitude of the staff; expectation and satisfaction of patients; the quality of care provided; the cost of service.