Abstract:
A strong healthcare system forms the foundation of national development by sustaining a healthy, productive
population. In Kenya, public hospitals continue to face service quality concerns despite reform efforts. Anchored
in the Gap Theory of Service Quality, this study examined how physical infrastructure specifically cleanliness,
signage, space and comfort, lighting, ventilation, and accessibility influences patient satisfaction in Narok
County, a region experiencing rapid population growth and serving both urban and remote pastoralist
communities as a referral hub. Using a cross‑sectional survey design with stratified random sampling, data were
collected from 1,203 patients across maternity, casualty, and outpatient units. Analysis in SPSS 27 revealed that
private hospitals reported higher mean satisfaction (4.136) than public hospitals (3.680), a significant difference
confirmed by ANOVA (F = 41.375, p < 0.05). The 0.456‑point gap, equating to a 12.4% advantage, was largely
associated with superior performance in the identified infrastructure sub‑variables. The study recommends
targeted upgrades to public hospital facilities to improve service delivery and restore public confidence. It further
calls for longitudinal research to track the sustained effects of such improvements and to examine inter‑county
disparities for guiding equitable healthcare reforms.
