Publication: Dynamics of Devolution and implications In the Implementation of Development Programs on Healthcare Delivery Services In Narok County, Kenya
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2021-03
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Mount Kenya University
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Abstract
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
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Keywords
Devolution, Procurement, Capacity Building-, Public Participation-