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
Keywords
Devolved Systems, Health Service Delivery, Kajiado County, Kenya