Thesis:

Influence of monitoring and evaluation practices on the performance of managed equipment service projects in public referral hospitals in Nairobi city county, Kenya

Managed Equipment Service projects often face issues such as inadequate maintenance, leading to equipment downtime and operational inefficiencies. Additionally, challenges include insufficient training for healthcare staff and poor coordination between stakeholders, which impact the overall effectiveness and sustainability of the projects. This study aimed to evaluate the effect of monitoring and evaluation practices on the performance of Managed Equipment Service projects in public referral hospitals within Nairobi City County, Kenya. The specific objectives were: to examine how M&E planning influenced the performance of MES projects in these hospitals; to assess the effect of M&E technical expertise on the performance of MES projects in public referral hospitals; to establish the influence of resource allocation for monitoring and evaluation on the performance of MES projects; and to explore the influence of M&E data management on the performance of MES projects in public referral hospitals in Nairobi City County. The research was guided by three theories: the Logical Framework Theory, Human Capital Theory, and Stakeholder Theory. A descriptive research design was employed to provide a comprehensive understanding of these variables. The study involved 172 key stakeholders, including members of the Ministry of Health Implementation Committee, project managers, medical engineers, and various healthcare professionals who were directly engaged in MES projects in Nairobi County. For the pilot phase, 10 respondents were drawn from Kenyatta National Hospital and Mbagathi Hospital. Data were analyzed using a combination of quantitative and qualitative methods. Quantitative data collected through questionnaires were analyzed descriptively using SPSS Version 26, with the results presented through tables, graphs, and charts. Inferential statistics, including multivariate regression and correlational analysis, were conducted to determine the strength and significance of relationships among variables. Qualitative data were subjected to content and thematic analysis to identify and interpret key themes and patterns. The study concluded that effective Monitoring and Evaluation (M&E) planning significantly enhances the performance of Managed Equipment Service (MES) projects, although challenges such as delayed implementation, weak risk assessments, and inadequate stakeholder involvement persist. It also established that M&E technical expertise, resource allocation, and data management positively influence MES outcomes, though issues like inconsistent staff training, underfunding, and weak data utilization limit full potential. Inferential statistics supported these conclusions, revealing strong positive correlations between all four M&E variables and project performance— most notably M&E planning (r = 0.682, p < 0.01), with the model explaining 52.2% of performance variance (R² = 0.522). Based on these findings, the study recommended that the Ministry of Health and allied agencies institutionalize inclusive M&E planning, strengthen continuous staff training, increase funding for M&E activities, and promote better data use in decision-making to improve the sustainability and impact of MES projects. The study contributes to existing knowledge by offering sector-specific empirical evidence on how structured M&E enhances MES outcomes, addressing gaps in training, coordination, and data utilization.