NAIROBI COUNTY, KENYA.

Embracing modern technology is one among very many ways of improving efficiency and reducing costs within Health care organizations. While the integration of information and health services potential benefits cannot be disputed, there are many challenges which affect its adoption, in fact, majority of organizations have abandoned their newly acquired system only to go back to their old manual system. This study sought to review the design, implementation and operation of Health Management Information System (HMIS) in Kenyatta National Hospital (KNH) Nairobi County. Specific objectives were a) to determine the design criteria phase of HMIS at KNH, b) to assess the implementation of HMIS at KNH, and c) to evaluate the operation of HMIS at KNH. This was a descriptive cross-sectional study. The study sample was 263 respondents who filled a structured questionnaire and 40 key informant interviewees. Data collected from the field was analyzed through the use of univariate and bivariate statistics. The study revealed that in the design phase, there was significant stakeholder involvement and this manifested through definition and identification of the KNH's HMIS, clear understanding of the purpose and process in the design requirements and thus an indication that the design criteria was observed during the HMIS implementation. In the implementation phase, the fmdings indicated that while the other attributes had a significance, gender did not have a significant association with HMIS implementation p=0.901. The fmdings indicated that the level of management and duration of employment were significantly associated with HMIS implementation at KNH. In the operation phase, respondents said the benefits of electronic HMIS were improved efficiency and reduced workload. More than half (53.1%) of health workers felt that the electronic HMIS in KNH had achieved its objectives which will lead to effective utilization of HMIS and better healthcare service delivery. Overall KNH had successfully implemented HMIS. In recommendation KNH in collaboration with the MOH need to come up with a standardized policy for implementing interventions, improve the current infrastructure, and develop a plan for monitoring and evaluation of the HMIS

Transformational Leadership, Work Engagement and Performance Among Public Service Employees in Uganda

This study aims at examining the relationship between transformational leadership, work engagement and performance among employees of the public service in Uganda. The study also reports an investigation into the mediating effect of work engagement on the relationship between transformational leadership and performance. To test the relationships between transformational leadership, work engagement and performance, the author applied the Pearson’s product moment correlation coefficient. The mediating effect was tested using the three step regression analysis proposed by Baron and Kenny (1986). Data was collected from 132 employees of Ministry of Gender, Labor and Social Development in Uganda. The results show a positive and significant relationship between transformational leadership, work engagement and employee performance. Though, the inspirational motivation component of transformational leadership is not related to overall work engagement. And the transformational leadership component of individualised consideration is not related to overall performance. Work engagement is found to fully mediate the relationship between transformational leadership and employees’ performance. So even when the results of this study to a certain extent are explained by the social exchange theory, emphasis should be on creating an environment of work engagement by management because this has shown to increase employee performance. However, a possible limitation could be arising from the use of self-report questionnaires. That is, responses generated from the “employees only” could have been biased because they might have expected chastisement for negative responses. Keywords Transformational leadership, Work engagement, Performance DOI: 10.7176/EJBM/12-23-03 Publication date:August 31st 202

Gender, Organizational Commitment and Job Performance in the Ugandan Local Government

The purpose of this paper was to establish the association between gender, organizational commitment and job performance of sub-county chiefs in the Ugandan local government. Most of the literature review indicates the effect of gender on organizational commitment, the effect of gender on job performance and the relationship between organizational commitment and job performance. A total of 320 sub-county chiefs were involved in the study and were selected using multi-stage stratified random sampling. A self-administered questionnaire used to collect data measured the following variables: Organizational commitment, job performance, and demographic variables of gender, age, educational level and tenure (years of experience). Data was entered into the computer using SPSS program. Factor analysis was carried out to establish different components of job performance, which were: cooperation, time consciousness, organization citizenship behavior (OCB), and communication. The already established components of organizational commitment that were used were: affective, continuance and normative commitment. A t-test, Pearson correlation and regression analyses were carried out to test the hypotheses. Results indicated that: gender does not significantly influence organizational commitment as well as it components of affective, continuance and normative commitment; males and females do not significantly differ on their levels of job performance and its components of cooperation, time consciousness, organization citizenship behavior and communication; there was a positive significant relationship between overall job performance and affective commitment as well as normative commitment; and only affective commitment was a significant predictor of job performance. Employees who value hard work, and are committed and highly participate in organizational activities are likely to be outstanding (good) performers. However, targeting one employee attitude in order to improve performance may not be enough. It is very important to focus on a combined pattern of work attitudes to obtain the desired goals. Keywords: Gender, Organizational commitment, Job performance DOI: 10.7176/EJBM/12-14-03 Publication date:May 31st 202

From A-Level Success to College Achievement: The Mediating Effect of Academic Engagement on Cumulative Grade Point Average (CGPA) and Persistence among undergraduate students at Makerere University

The transition from high school to university is an important phase in the educational journey of many students. This stage not only serves as an access for university enrollment but also equips students to handle the challenges at university. This study investigates the influence of prior academic performance, as measured by A-level grades, on university cumulative grade point average (CGPA) and persistence to graduation while also exploring how academic engagement mediates this relationship. Using a post-positivist lens, sequential explanatory mixed-methods research design was applied, with emphasis on quantitative analysis of data and followed up by a qualitative analysis of data to explain the statistically significant results. The targeted population included final-year students from four participating schools at Makerere University, totaling 1,273 students. The study utilized a simple random sampling technique, allowing all final-year students from the four schools an equal chance to participate, which caused the realization of the final sample of 754. SPSS V26 was utilized to conduct correlation and regression analyses to explore the relationships and predictive power of A-level grades on college CGPA and persistence. Additionally, a mediation analysis was performed to assess the indirect effect of academic engagement on the link between A-level performance and university CGPA. The correlation findings indicated that A-level grades have a significant impact on students' cumulative grade point average (CGPA) but do not significantly affect their persistence in university. Consistent with prior research, academic involvement was found to significantly influence both CGPA and persistence. Additionally, the analysis showed no significant correlation between A-level grades and academic engagement, as well as an insignificant indirect effect of academic engagement on the relationship between A-level points and CGPA. To gain further insight into these statistically significant results, qualitative data collection and analysis were conducted using a purposive sampling method. Fourteen students voluntarily shared their experiences to elucidate the relationships, leading to the emergence of several key themes. For example, strong study skills, motivation, and intellectual ability were identified as reasons why students with higher A-level grades tend to achieve higher CGPA in university. Additionally, a solid grasp of concepts and increased confidence were highlighted as factors explaining why academic engagement positively predicts both CGPA and graduation persistence. Based on the findings, the study concluded that both A-level grades and academic engagement were critical factors toward university success. Therefore, the study recommended that Makerere University and other higher education institutions uphold the current A-Level cut-off requirements for admission into different university programs as may be deemed so. Besides, faculty members should prioritize creating an engaging learning environment that promotes interactive and meaningful experiences, utilizing methods such as collaborative learning sessions, projects, peer-to-peer interactions, and class presentations. By fostering this culture, students are more likely to excel academically and persist in their studies until graduation, as they will perceive their learning as both meaningful and rewarding

The Design Criteria in Implementation of a Health Management Information System: a Case of Kenyatta National Hospital

The study utilized an in-depth interview schedule for 33 respondents in the design phase who were selected using snow-ball, the data collected from the field was analyzed through the use of univariete and bivariete statistics. Data presentation was in form of descriptive statistics such as frequency distribution, percentages, pie charts, bar graphs and tables. The data from the design phase were summarized in three main evaluation areas targeting the perception of the HMIS, purposes and processes From the findings, in the design stage although the respondents did not show systematic ordering there was evidence to the effect that the steps were followed during the design phase. From the findings majority of the key informants were able to define HMIS and distinguish the key features of the HMIS. Out of the 33 participants, 13 (33.4%) reported that they knew the persons who originated the idea of the electronic HMIS in KNH, a similar number were involved in the conceptualization of the system, while 4 (12.2%) indicated that they were involved in designing the HMIS and 18 (54.6%) were involved in implementation. Despite the general lack of knowledge on HMIS policy the informants demonstrated adequate understanding of the objectives of the electronic HMIS in KNH. Based on the responses obtained during interviews there were multiple problems related to the manual system that existed in KNH during the pre-implementation stage and these issues served as the basis for objective setting for the current HMIS in the hospital. Most key informants felt that the hypothesized benefits of the current HMIS were being realized including improved efficiency while four key informants felt that the benefits had been partially realized. An evaluation of the manual HMIS was done during which deficiencies of the HMIS were identified through consultations involving HMIS users and stakeholder. A HMIS needs assessment was conducted and formed the basis of the electronic system requirements with specific proposals for improvement of the deficiencies identified in the manual HMIS. An evaluation of the manual HMIS was done during which deficiencies of the HMIS were identified through consultations involving HMIS users and stakeholder. During the interviews the participants were able to highlight various aspects of the IS development cycle and there was evidence to the effect that the steps were followed during the design phase plus an evaluation of the manual system was done during which deficiencies of the system were identified through consultations involving HMIS users and stakeholders. Based on the results and discussions, among the main problems that key informants described during the design phase was major inefficiencies characterized by evident mismatching of resources input and output which spanned several areas including time, human resources and finances however, participants were able to highlight various aspects of the IS development cycle and there was evidence to the effect that the steps were followed during the design phase, planning plus an evaluation of the manual system was done during which deficiencies of the system were identified through consultations involving HMIS users and stakeholders. As a recommendation we can say that NH and the MOH needs to come up with an established standardized policy for implementing interventions. Embracing modern technology is one among very many ways of improving efficiency and reducing costs within healthcare organizations. While the integration of information and health services potential benefits cannot be disputed, there are many challenges which affect its adoption, in fact, majority of organizations have abandoned their newly acquired systems only to go back to their old manual systems. The objective of this study was to determine the design phase of the implemented Health Management Information System at Kenyatta National Hospital. This study was a cross-sectional descriptive study, the targeted population of the study were 35 healthcare workers who were involved in the designing of the Health Management Information System at Kenyatta National Hospital, and the sample technique used was snowball sampling

DATA INTEGRITY AND EVIDENCE-INFORMED GUIDANCE ASSOCIATED WITH THE IMPLEMENTATION OF A HEALTH MANAGEMENT INFORMATION SYSTEM AT KENYATTA NATIONAL HOSPITAL

<p><strong><em><span>Objective</span></em></strong><strong><span>: </span></strong><span>The main objective for carrying out the project was to ascertain the </span><span>factors </span><span>associated with the implementation of a health management information system at Kenyatta national hospital.</span><span> The objective of this study was to determine </span><span>Data Integrity and Evidence-informed guidance</span><span> associated with the implementation of a Health Management Information System at Kenyatta National Hospital. </span></p> <p><strong><em><span>Design setting</span></em></strong><strong><span>: </span></strong><span>The investigation deployed an analytical cross-sectional study. </span></p> <p><strong><em><span>Subjects or participants</span></em></strong><strong><span>:</span></strong><span> A sample total of 263 respondents was calculated using the Krecie and Morgan formula for the quantitative study. A strict inclusion criterion was followed to select the respondents from all trained health personnel in Kenyatta National Hospital. The study utilized an interview schedule. Data were analyzed using SPSS version 21 while qualitative data was analyzed on themes developed. Data presentation was in form of quantitative statistics such as frequency distribution, percentages, and tables. Qualitative results were presented in verbatim form. </span></p> <p><strong><em><span>Results</span></em></strong><strong><span>: </span></strong><span>The results depicted that </span><span>the hospital uses HMIS in its day-to-day activities/roles in delivering health care services, (p-value 0.006 and OR 6.844). The sex of the study population showed a significant association and also agreed strongly that there was an effective and fair distribution of computers in the hospital (OR 3.67). The study observed that the age of the study population strongly agreed and had a statistically significant association with the fact that there was proper HMIS advocacy by the management in KNH, p-value 0.05. </span></p> <p><strong><em><span>Conclusion</span></em></strong><strong><span>: </span></strong><span>Modern medicine’s best practice holds that health information systems empower the patient by putting them in the center of their own healthcare story.</span></p&gt