Thesis:

Effect of monitoring on the evaluation systems on the Performance of healthcare projects in Homa bay county, Kenya

This study analyzed the influence of Monitoring and Evaluation (M&E) systems on the performance of healthcare projects in Homa Bay County, Kenya, in the context of significant government investments in the healthcare sector. In 2020, the Kenyan government allocated KES 234 billion (US$2,743 million) to healthcare, equating to 7% of the GDP, with further allocations in the 2021/2022 budget. The Homa Bay County government allocated Ksh 1,362,803,518 in the 2020/2021 financial year. The COVID 19 pandemic underscored the importance of robust healthcare systems, driving investments in disease prevention, health education, and emergency preparedness. Kenya's Vision 2030 includes goals for achieving Universal Health Coverage (UHC), with financial allocations aimed at ensuring quality healthcare for all citizens. The study's main objective was to examine the impact of M&E systems on healthcare project performance in Homa Bay County, focusing on M&E staff training, information systems, M&E plans, and costed work plans. A descriptive survey design was used, combining both qualitative and quantitative methods. The study targeted hospital administrators, clinical officers, nurses, and health record officers across three healthcare facilities in each sub-county, with a total sample size of 153 respondents. The analysis revealed very strong positive correlations between the various M&E components and healthcare project performance. Specifically, M&E staff training demonstrated a correlation coefficient of r = .997, M&E information systems also showed a correlation coefficient of r = .997, the structured M&E plan had a correlation coefficient of r = .997, and the costed M&E work plan exhibited a correlation coefficient of r = .994. All correlations were statistically significant at p < .01. These findings emphasized the critical role of well-trained staff, efficient M&E systems, clear planning, and financial management in improving healthcare project outcomes. The study concluded that aligning M&E staff training with organizational goals, enhancing system integration, ensuring consistency in M&E plan implementation, and improving cost estimation accuracy in M&E work plans would optimize healthcare project performance. Recommendations were made to improve M&E staff training, integrate systems across departments, enhance the M&E plan's consistency, and improve financial management practices in M&E work plans.