Influence of Devolved Systems on Health Service Delivery: A Case of Kajiado County, Kenya
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Date
2023
Authors
Ntayia, Julius L. K.
Journal Title
Journal ISSN
Volume Title
Publisher
Kenyatta University
Abstract
Devolution was introduced by the 2010 Constitution, providing services such as
Healthcare, Agriculture, Transport, and Cultural through county governments. The
County governments have endeavoured to undertake these functions, albeit with a few
difficulties. This study aimed at assessing devolved governance’s influence on health
services in Level Five hospitals in Kajiado County. The study examined the influence
of the devolution of healthcare finance, healthcare management, and human healthcare
resources on healthcare services in the County. The study also examined the policies
that could enhance the healthcare services delivery subject if enacted. The study was
underpinned by Stakeholder theory because of its assertions regarding the role of
Stakeholders in promoting efficacy and organisational performance. Qualitative and
quantitative research methods were used to actualise the study. The study was
conducted in Kajiado Level Five Hospital Kajiado County with a target population of
500 participants from various sectors in Kajiado County. A sample of 100 participants
selected from the total population representing twenty per cent was in the study. Data
was collected by the use of questionnaires and scheduled interviews. Both primary and
secondary data were used in the study. Inferential data was analysed through Pearson’s
correlation and regression analysis, powered by the Statistical Package for Social
Sciences (SPSS) program. Visual tools such as figures and tabular presentations were
used for the results of this study. During data collection, ethical considerations were
respected and adhered to in full. The study observed that funding for healthcare
services in the sub-county is mostly provided by the county administration, with a
modest contribution from national and donor grants. This has resulted in inconsistent,
delayed, and inadequate funding; healthcare facilities have been unable to deliver
certain treatments, such as dental and optical services, and have been unable to
purchase necessary equipment. The study has also observed that the County’s
devolution gave healthcare administrators room to make localised decisions. However,
this room was not extended to all stakeholders in day-to-day operations through
regular communication and participation in decision-making. Lastly, the study found
that devolution facilitated the recruitment of qualified personnel by the hospital,
especially from local communities. The study recommends the promotion of capacity
building to enhance the overarching management of county hospitals besides
developing a framework to undergird the professional development of healthcare
personnel in these hospitals.
Description
A Research Project Submitted to the School of Humanities and Social Sciences in Partial Fulfillment of the Requirements for the Award of the Degree of Master of Arts in Leadership and Governance at Kenyatta University, March 2023.
Keywords
Devolved Systems, Health Service Delivery, Kajiado County, Kenya