Thesis: Effects of devolved governance on health service delivery at Meru teaching and referral hospital in Kenya
dc.contributor.advisor | Dr.Wambui Judy | |
dc.contributor.author | Paul Mutwiri Muthomi | |
dc.date.accessioned | 2025-09-25T09:17:16Z | |
dc.date.graduated | 2025 | |
dc.date.issued | 2025-07 | |
dc.description.abstract | The Kenyan constitution of 2010 established a decentralized structure of government that upholds health as a fundamental right for every individual. Additionally, it specifies the national governments and county governments' responsibilities for providing health services as well as the guidelines that should guide their delivery. It became imperative to address the administration, planning, and management of health services in response to the changes after the first general elections held in accordance with the Kenyan constitution (2010) and the establishment of County Governments. Notably, numerous Counties have been plagued with colossal problems including strikes, corruption, and delayed wages that have contributed to subpar service delivery, among other things. The purpose of this study was to analyze the effects of devolved governance on health care service delivery in Meru teaching and referral hospital in Kenya. The objectives of the study were; to examine the effect of devolved financial planning on health care service delivery in Meru teaching and referral hospital, to assess the effect of devolved heath infrastructure on health care service delivery in Meru teaching and referral hospital, to explore the effect of devolved staffing on health care service delivery in Meru teaching and referral hospital and to examine the effect of Policy Framework on service delivery in Meru teaching and referral hospital. The study was based on tanahashi health model and soufflé theory of 1995, and it employed a descriptive research design with a mixed methods targeting 1996 participants comprising of health care workers, at MTReH, outpatient patients visiting the facility, and members of the Meru County Assembly. The study adopted a stratified sampling forming 10 strata of the respondents, a simple random sampling was subjected to the respondents in their respective Strata to pick the study participant. The study utilized questionnaires for various departments in the hospital and the MCA, interview guide for hospital administrator and CEO and a focus group discussion with the patients for data collection purposes. SPSS version 28 was used to analyze the coded data. The study used both descriptive and inferential statistics for data analysis. Descriptive statistics was presented inform of M, frequencies and SDs while regression and moment correlation were used for inferential statistics, data presentation was done by use of figures and tables. The findings of the descriptive statistics reveal that the participants expressed consensus about the ethical procurement and management procedures used by the county in relation to medical supplies and equipment on healthcare service delivery. The study also revealed uncertainty among respondents regarding the regular monitoring of project implementation by the County Health Management Team (CHMT) on a quarterly basis. The study findings indicated a statistically significant correlation between budgetary planning staffing levels, and the provision of healthcare services at Meru Teaching and Referral Hospital. The study recommended for consideration by policy makers to have a strong representation of the facility’s committees in the county budget committee so as to give their financial plan for the facility. | |
dc.identifier.uri | https://erepository.mku.ac.ke/handle/123456789/7248 | |
dc.language.iso | en | |
dc.publisher | Mount Kenya University | |
dc.subject | Government | |
dc.title | Effects of devolved governance on health service delivery at Meru teaching and referral hospital in Kenya | |
dspace.entity.type | Thesis | en |