Influence of Devolved Systems on Health Service Delivery: A Case of Kajiado County, Kenya

dc.contributor.advisorEdna J. Moien_US
dc.contributor.authorNtayia, Julius L. K.
dc.date.accessioned2023-08-09T09:47:33Z
dc.date.available2023-08-09T09:47:33Z
dc.date.issued2023
dc.descriptionA 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 Universityen_US
dc.description.abstractDevolution 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.en_US
dc.description.sponsorshipKenyatta universityen_US
dc.identifier.urihttp://ir-library.ku.ac.ke/handle/123456789/26685
dc.language.isoenen_US
dc.publisherkenyatta universityen_US
dc.subjectDevolved Systemsen_US
dc.subjectHealth Service Deliveryen_US
dc.subjectKajiado Countyen_US
dc.subjectKenyaen_US
dc.titleInfluence of Devolved Systems on Health Service Delivery: A Case of Kajiado County, Kenyaen_US
dc.typeThesisen_US
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