Thesis:

Influence of strategic management practices on Performance of national health insurance fund in Eastern region, Kenya

The current business environment has forced organizations to ensure strategic management practices to gain a competitive advantage and enhance performance. The National Health Insurance Fund (NHIF) has installed strategic management methods to enhance value addition, deliveries and organizational performance. These steps did not yield results as they ought to, and the results were seen to correlate with them regarding increased comprehensiveness coverage and quality provision of services. This paper discusses how strategic management practices contribute to the performance of NHIF in Kenya, the eastern region. This study's research had specific objectives of finding out how strategic planning practices, strategic designing practices, strategic implementation practices, and practices of strategic evaluation practices determine the performance of NHIF. The current paper was based on the Dynamic Capability Theory, the Theory of Management by Objectives and the Congruence Model Theory, which assisted in analyzing the variables of concern. The study used a longitudinal descriptive research design, which is suitable for researching the activity of a particular organization. The experiment was conducted among 64 workers in various East Region NHIF office departments, including human resources, research and development, marketing, and financial departments. A census of the departments was distributed to all the 64 employees who were respondents. Secondary sources and primary sources of data have been employed. Structured and close-ended questionnaires of a 5-point Likert scale of the primary-source data were used. Before the study, the questionnaire was piloted to gain validity and reliability of the research tool on the six respondents of the NHIF office in Nanyuki within the County of Laikipia. Data analysis was provided with descriptive and inferential statistics and demonstrated in tables and graphs. The findings showed that all four strategic management practices positively and significantly affected the performance of NHIF. Strategic planning showed a moderate positive correlation with performance (r = 0.424; β = 0.258, p < 0.001), indicating that structured environmental scanning, goal setting, and alignment with national health priorities enhanced strategic alignment and effectiveness. Strategic formulation was also significantly associated with performance (r = 0.349; β = 0.245, p < 0.001), emphasizing the importance of participatory policy development and alignment with NHIF’s mission and vision. The study concluded that strategic management practices collectively foster performance improvements in NHIF. However, implementation was identified as the most influential determinant, suggesting that effective execution mechanisms are indispensable to achieving strategic objectives. While planning, formulation, and evaluation practices were positively rated, areas such as inclusivity, interdepartmental communication, and real-time data feedback required improvement. Based on the findings, several recommendations were proposed. First, NHIF should enhance strategic evaluation mechanisms by investing in digital performance dashboards and real-time analytics to enable adaptive management. Second, execution excellence should be prioritized by strengthening resource tracking and implementation accountability frameworks. Lastly, the organization should institutionalize participatory strategy development, particularly by engaging county-level staff, to improve ownership, coherence, and contextual relevance of strategic plans.