Effect of Devolution on Healthcare Administration in Gatanga Sub-County of Murang’a County, Kenya
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This study sought to examine the effect of devolution on healthcare administration in Gatanga Sub-county. The study sought to achieve three key objectives, namely (a) to assess the effects of devolution on healthcare financial planning, (b) to examine the effects of devolution on the management of healthcare facilities; and (c) to evaluate the effects of devolution on healthcare human resource management. A randomly selected sampled of 91 healthcare practitioners, 46 healthcare beneficiaries and 19 healthcare administrators in the county were involved in the study. Data was collected using semi-structured questionnaires and analyzed using descriptive analysis. It was observed that healthcare service is primarily funded by the county government with minor support from grants from the national government and donors. They experienced a range of financial challenges namely unreliable, delayed, and insufficient funding, lack of sufficient equipment. It was also observed that devolution has improved administration through expanding managerial space and improvement in overall service delivery although operational challenges such as poor involvement of stakeholders in day-to-day operations and in decision-making were rampant. Lastly, devolution has allowed healthcare facilities to attract qualified workers, perhaps from local societies although staff challenges such as staff demotivation and inadequacy of CPD opportunities were observed. This study recommends fostering capacity building for local healthcare facilities to help in bolstering the skills of healthcare administrators and the need for the awareness among administrators concerning the welfare of healthcare practitioners.