Intergovernmental Relations Effect on the Health Care Sector in Nairobi City County, Kenya
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Date
2025-06
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Kenyatta University
Abstract
Since the beginning of health devolution in Kenya in 2013, there have been several concerns regarding the ineffectiveness of service delivery in the health sector, which have been attributed to strained ties between the national government and county administrations. There have been issues with service delivery and medical supply shortages in Nairobi City County's healthcare sector. This study sought to investigate how intergovernmental interactions have an effect on the healthcare industry. The study's specific objectives were to examine how intergovernmental relations affect the distribution of financial resources, human resources, and medical equipment for the Nairobi City County healthcare sector. The study was anchored on the General system theory and resource-based vision theory to analyze the study. The study adopted a descriptive research design and conducted a census for all the 7 administrators working at level 4 and level 5 health facilities in Nairobi City County as well as 78 employees working in the health department of Nairobi City County Government. The annual health care reports for the County used to gather secondary data. Semi-structured questionnaires were used to gather the main data. To evaluate the validity and reliability of the research instrument, a pilot study was carried out at Kiambu County's health department. Both qualitative and quantitative data were gathered using a semi-structured questionnaire. Qualitative data was analyzed thematically, while quantitative data was analyzed using descriptive and inferential statistics. Descriptive statistics included mean and standard deviation, while inferential statistics were analyzed using the F-test and ANOVA. The analyzed data was provided as frequency tables, percentages, and charts. Before the survey could begin, respondents were asked to provide informed consent, and anonymity and secrecy were assured to boost the response rate. The most critical relationship was between intergovernmental relations and financial resource allocation for the healthcare sector in Nairobi City County accounting to 39.4%. This was followed by the r-squared for the relationship between intergovernmental relations and human resource allocation as well as for medical equipment for the Nairobi City County healthcare sector each accounting to 22.7% of variation. The study recommends that the National government and County government of Nairobi City County should ensure an improvement in intergovernmental relations so as to ensure that financial resources are adequately allocated. This will also help in ensuring timely release of financial resources to health facilities by the national government. In addition, the two levels of government should work in collaboration to ensure adequacy and training of healthcare professionals in Nairobi County. Specifically, they should ensure the healthcare professionals such as doctors and nurses are increased to meet the needs of the population of Nairobi City County.
Description
A Research Project Submitted to School of Law, Arts and Social Sciences in Partial Fulfillment of the Requirements for the Award of the Degree of Master of Arts in Public Policy and Administration of Kenyatta University, June, 2025
Supervisor;
1.Felix Kiruthu