Dynamics of Devolution and implications In the Implementation of Development Programs on Healthcare Delivery Services In Narok County, Kenya

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Mount Kenya University
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The Constitution of Kenya (CoK), 2010 delegated the management of healthcare service delivery to the County governments. The County governments have been faced with many challenges in managing the health care activities in Kenya since 2013. There has been a lot of outcry from the members of the public about the mismanagement and corruptions in the administration of the healthcare delivery activities. The purpose of this study is to assess the healthcare delivery challenges faced at the County government healthcare department of Narok, by looking at some of the major health care activities which affects the development of the healthcare delivery at the two referral hospitals to the study. The conceptual framework objectives, on procurements practices, seek to establish if the procurements laid down regulations by (PPOA) are being administered in the purchases of goods and services, while on leadership management, it looked at efficiency, motivation and public access towards work schedules, the capital resources allocation, involves examining their availability and consistency trends, and the regulatory framework objective was based on assessing the time factor requirements to carry out medical services. The study development objectives contacted in the two referral hospitals were; to establish the effect of procurements practices, determine the effect of leadership managements, to examine the effect of resources availability to the hospitals and to assess the influence of the continued use of national regulatory frameworks in the county. The target population was 572 Narok County government health workers and in-patients, whereby the researcher used quantitative design method of research through a descriptive stratified random sampling method with a sample size of 57 participants. A questionnaire for the data collection was used as an instrument of data collection. Data was analyzed using SPSS (2013) tool and presented through tables and charts, diagrams and reports. Findings indicated a negative development for healthcare in all the procurements practices of study, in the leadership management, there was a partial positive improvement development in quick decision making and a negative enhancement in the healthcare efficiency and staff motivations, while on capital resources availability, there was an negative improvements towards the healthcare development due to inadequate funding and inconsistency, and on the national regulatory framework, there was a negative improvement towards the achievement of a quick working schedule program development of the health care delivery service. The researcher made the following recommendations; The two hospitals should strictly abide to the laid down Public procurement acts, plans and embrace the E- procurements methods, while in leadership management, involving all the employees in decision contribution in HR policies, initiating rewards and appreciations as well as improvements in channels of communications between health workers and the public should be encouraged which is currently, lacking, and in resources availability, more funds should be channeled to the two hospitals, while on the regulatory frameworks, the county should start enacting their own regulations which are in tandem with their work schedules. The study focused between 2013 when devolution was introduced in Kenya to 2017

Devolution, Procurement, Capacity Building-, Public Participation-