Strategic Management Practices Adoption and Service Delivery by the Health Department of Nairobi City County, Kenya

Abstract

Strategic management has been defined as set of managerial decisions and actions that influences the performance of an organization in the long term and it entails different aspects like scanning of environment, formulation of the organization’s strategy, its implementation, its evaluation and control. It is concerned with the future of the organization and delivery of the organization’s products, and central to understanding of strategic management process is strategic management practices, which is a means through which an organization accomplishes its objectives. The objective of this study was to determine strategic management practices adopted by the Health Department of Nairobi City County and their influence on service delivery. This study employed a case study design and it was carried out in Nairobi City County Health Department, with interview guide used to solicit data on the four elements of strategic management and their influence on service delivery. Senior managers in the Department who are involved in strategic management process in the department where the respondents. To complement data collected during the interviews, the researcher reviewed the strategic plan for the department and other secondary sources. Qualitative data analysis method was used to process collected data, where data from interviews was subjected to content analysis. The responses generated by respondents were recorded and categorized in accordance with the identified themes. The data obtained during interviews from secondary sources was also analyzed using content analysis. The study established that the Health Department of Nairobi City County adopts different strategic management practices which influenced service delivery. The study ascertained that the Department undertakes situation and problem analysis as part of environmental scanning practices. This was undertaken as one of the activities during the development of the current Strategic Plan, during which SWOT analysis was undertaken. This exercise revealed strengths, weaknesses, opportunities and threats in all the key areas. The study also revealed that each year, the Department undertakes analysis of health situation in the County and setting of priorities. In terms of strategy formulation, the study established that the Department has established strategic direction, with clear vision, mission and core values, which influences quality of services. In implementation of the strategy, the Department has well established organization structure, from policy level at County level, down to operational level in Sub Counties and health facilities. The study established that while the Department develops good plans, there are challenges in implementation which affect quality of services, with financial constraints noted as the main challenge. Strategy evaluation is undertaken through monitoring of the performance, with comparison to set targets, with resources being a major challenge in adoption of these practices. The study concludes that the Health Department of Nairobi City County has adopted different strategic management practices in pursuit of its mandate of attainment of the highest possible status of health for the people in the County and beyond, in a way which is responsive to their needs. Adoption of these strategic management practices has contributed to and affects performance of this public sector organization. The study makes the recommendations for the Department based on the findings. These are in improvement of capacity staff in adoption of strategic management practices, in resource mobilization, in partnership management and stakeholder involvement.