dc.description.abstract | The devolving of national government functions in Kenya especially the implementation of
health care is influenced by various factors in the expedition process of these projects. This study
investigated the issues that influence the implementation of health care projects under the
devolved system of governance. It investigated the influence of: collaborations of communities,
distribution of human resources for health, financing of human resources for health and health
infrastructure and learning and adoption of best practices. The study was hinged on four theories;
Empowerment Theory, Theory of Optimal Resource Allocation, Theory of Fiscal
Decentralization and Organizational Learning Theory. The study employed descriptive survey
research design. Target population of 703 respondents. The sample size was of 15 (n=15), Meru
County Government Department of Health Staff, 224 (n=224) Medical personnel working at
public hospitals managed by the Department of Health Meru County and 10 (n=10) Health Civil
Societies’ Managers that were selected to participate in the study. Stratified sampling and Simple
random sampling were used to pick the respondents. Questionnaires were used to collect data in
the study locale. Data was analyzed qualitatively and quantitatively using Statistical Package for
the Social Sciences (SPSS) version 22.0, was presented in Frequency and Percentage tables and
the regression model Y = β0 + β1X1 + β2X2 + β3X3 + β4X4 + ε was applied. The study
established that collaboration of communities, distribution of human resources, financing,
learning and adoption all influenced the implementation of health care projects under devolved
system of governance in Meru County, Kenya. Many of the respondents as shown by a mean of
3.74 agreed that collaboration of communities significantly influenced the implementation of
county funded health care projects’ sustainability. A good number of the respondents as shown
by a Mean of 3.77 agreed that the successful implementation of county funded healthcare
projects was influenced by the distribution of human resources for health in Meru County.
Further, the results of this research as shown by a mean of 3.87 have revealed that health grants
are not utilized due existing corruption adversely influencing the implementation of health care
projects at the devolved governance level. 65.6% of respondents agreed that there was need to
adopt performance appraisals and evaluations on medical personnel to enhance provision of
health care services in the county under study. The study concludes that benchmarking is an
important learning tool for medical personnel in enhancing of quality standards in health care
provision. It can also be concluded that, adequate financial resources disbursed in good time are
key drivers of the implementation of health care projects in Meru County. From the findings, the
study recommends that an enforcement of Kenya’s Health Policy 2011–2030 on distribution of
human resources for health in public health facilities. The study also recommends that the county
government should adopt an effective stakeholder mobilization strategy that would help build
working collaborations with other health sector players like Non-governmental Organizations,
community based organizations and private companies for the realization of health goals in
Kenya through devolved units. Studies could be done in other counties in the country for
purposes of comparison and generalization. | en_US |