Thesis:

Influence of leadership practices on performance of three level 5 hospitals in Kiambu county, Kenya

Effective leadership practices are crucial for fostering organizational commitment, enhancing job satisfaction among healthcare employees, and boosting productivity, all of which contribute to improved hospital performance. Conversely, poor leadership has been linked to low staff commitment, increased strikes, and a decline in health and customer service quality, sometimes resulting in adverse patient outcomes. This study aimed to assess the influence of specific leadership practices—including communication management, diversity inclusiveness, and supervisory skills—on the performance of Level 5 hospitals in Kiambu County, Kenya. Focusing on Thika, Kiambu, and Gatundu hospitals, the study utilized a descriptive cross-sectional survey design, collecting quantitative data through questionnaires administered to a sample of 254 respondents, randomly selected from a target population of 750 healthcare professionals (including medical officers, nurses, clinical officers, pharmacists, HRIOs, and administrative officers). The theoretical foundation of this study is based on Transformational Leadership Theory and Leader-Member Exchange Theory, both of which emphasize the importance of inclusive, communicative, and supportive leadership in healthcare settings. Data analysis involved both descriptive and inferential statistics to examine the relationships between leadership practices and hospital performance. The study’s findings reveal a predominantly female workforce (72.1%), with the most common age groups being 25-29 and over 50 years (each constituting 19.8% of the sample). Nurses formed the largest professional group (67.4%), and the majority of staff held diploma qualifications (43.0%). Key findings highlighted that WhatsApp was the primary communication tool (37.2%), with face-to-face meetings considered the most effective (mean score = 4.13). Diversity Inclusiveness Management emerged as the strongest predictor of hospital performance, showing a strong positive correlation (r = .760, p < .001) and a substantial effect in regression analysis (B = 0.577, p < .001). Supervisory Skills also significantly impacted performance (r = .665, p < .001; B = 0.370, p < .001), while Communication Management showed a moderate positive correlation (r = .440, p < .01) but with a weaker effect in the regression analysis. In conclusion, while the overall performance of these hospitals was found to be satisfactory, key areas for improvement include timely service delivery and diversity training. The study recommends enhancing communication channels, increasing the frequency of diversity training, and investing in supervisory development programs to strengthen leadership capacity and ensure sustainable healthcare excellence. These recommendations align with Kenya’s Vision 2030 and the Sustainable Development Goals (SDGs), aiming to build a resilient healthcare system that prioritizes high-quality service delivery and inclusive leadership.