Determinants of Quality of Healthcare Delivery in Devolved Systems: Case Study of Lamu County, Kenya

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Date
2023
Authors
Kimani, John Mburu
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Journal ISSN
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Publisher
kenyatta university
Abstract
Devolved government is a form of administration that is permitted by Article 6 of the Kenyan Constitution. Its two political and administrative arms, the Legislature, and the Executive, are divided among the 47 counties. Devolution contributes to this goal by delegating control, authority, and representation to local levels. The passage of numerous bills by Parliament to lay the groundwork for implementation and adoption has aided in the realization of devolution's goals. Kenya's healthcare statistics paint an unsettling picture due to a lack of medical facilities, personnel, equipment, and supplies. In order to receive healthcare, patients may use over-the-counter medications, conventional medical services, or private healthcare facilities, while others may succumb to this circumstance. The purpose of the current study is to identify the variables influencing the provision of medical care services, with particular reference to Lamu County, Kenya. In particular, the study aimed to ascertain how government funding, the degree of service delivery quality, the institutional framework for health services, and the usage of information and communication technologies affect health care delivery in Lamu County. The study was guided by agency theory and stakeholder theory. A descriptive research design was used for this investigation. The 143,920 individuals that comprise the study's target group were both hospitalized patients and hospital-based healthcare workers. To select 399 respondents, a straightforward random sampling approach was used. The necessary sample size was calculated using the Yamane formula and a level of confidence of 95%. The researcher collected data using a semi-structured questionnaire. The researcher used the "Drop and Pick Later" data collection method to allow respondents sufficient time to respond to the study's questions. A pilot study consisting of ten respondents who were not included in the final poll was done. The reliability of the study was determined by calculating Cronbach's alpha, and an alpha of 0.7 or above indicated that the instruments were reliable. The research permits were sought from various authority in order to uphold ethical consideration. A combination of descriptive analysis and content analysis was utilized for analysis of the data collected. Descriptive analysis was used to investigate the quantitative elements, such as the size of the human resource, health facilities, the working hours, and the demographics of the respondents. On the other hand, content analysis was used to examine the theoretical conclusions of the research. The studied data was illustrated using frequency data tables, pie charts, and bar graphs. The study also came to the conclusion that the distribution of resources has a big impact on how well health services are delivered in Kenya. The study recommends that in order to enhance the delivery of healthcare services, both National and County should implement a set of deliberate and proactive processes, rules, and structures that support board size.
Description
A Research Project Submitted to the School of Law Arts And Social Sciences in Partial Fulfilment of the Requirement for the Award of the Degree of Masters of Public Policy and Administration, Kenyatta University.
Keywords
Healthcare Delivery, Devolved Systems, Lamu County, Kenya
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