FACTORS INFLUENCING SERVICE DELIVERY IN PUBLIC HEALTH SECTOR IN
KENYA: A CASE STUDY OF MBAGATHI DISTRICT HOSPITAL NAIROBI
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Abstract
The study investigated the factors influencing service delivery in public health sector in Kenya:
A survey of Mbagathi District hospital in Nairobi County. Specifically, the study sought to;
establish the influence of leadership style, leadership culture, staff competences and management
support on the quality of service delivery in public hospitals. The target population for this study
comprised of 273 employees and 10,000 patients in Mbagathi District hospital within Nairobi
County. Simple random sampling was used to select 398 employees and patients while census
was done on the 8 management staff. This study used primary data, both quantitative and
qualitative. Primary data was obtained from the original sources using a structured questionnaire
and captured through a 5-point type Likert scale. A Likert scale questionnaire was preferred as it
makes it possible to convert responses into quantitative format for ease of data analysis using
Statistical Package for Social Sciences (SPSS). Interview guide was also used to obtain
information from the management of the hospital. The questionnaires were self-administered
using the drop and pick later method. A pilot study was undertaken on 10% of the sample
population. Findings indicated that there was a positive and significant relationship between
leadership style, leadership culture, staff competence, management support, work environment
and service delivery in public hospitals in Kenya. Findings of the study indicated that
transformation in service delivery, decision making process, and action oriented decision,
performance appraisal and professionalism influenced service delivery in hospitals. Good
working relationship between the management and staff, members of staff being conversant with
their facility roles and goals, members of staff being well acquainted with their duties and
responsibilities influences service delivery in hospitals. Facility offering training to the staff,
staff trained regularly, staff equipped with adequate and necessary skills are key impetus to
service delivery. Recognition and rewards to members of staff, championing for their
achievement, openness and transparency, management encouraging professionalism, monitoring
and evaluation of the facility performance influences service delivery in hospitals. Conducive
working environment provides a motivating agent for employees to work better and experience
job satisfaction in the hospital. This study shows a relationship on leadership style and decision
making process and action oriented decision, performance appraisal and professionalism in
service delivery in public hospitals. Management that maintains an open and transparent
communication with the staff and offering adequate support (social) to all their staff is an
important element to service delivery in hospitals. Hospital management should acquire,
develop, and retain the qualified resources in order to address the dynamics of ever-changing
technological environment. Management should recognize and reward members of staff and
champion for the achievement of set goals and objectives. This study recommends that
management in public hospitals should promote conscious leadership in a manner that will
strengthen service based culture having emphasis on quality service delivery and at the same
time maintain an open and transparent communication system with the staff and offering
adequate support. It further recommends development of staff competencies and skills as well
promote a good working environment so as to enhance better service delivery in public hospitals.
The findings from the study is useful for dissemination to the hospitals’ management and staff,
Ministry of Health stake holders and policy makers and other academicians for inclusion in
quality management and quality service delivery in hospitals