Competing Multiple Accountability Mechanisms and Public Administrators’ Responses in the Health Sector in Kenya
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Date
2018Author
Karumba, Kenneth K
Type
ThesisLanguage
enMetadata
Show full item recordAbstract
The concept of accountability in the public sector is complex and has generated debate in the
history of public administration. This study focused on accountability of public
administrators under normal conditions and crisis situations where it is unclear which of the
four mechanisms of hierarchical, professional, legal and political accountability dominates
responses of hospital administrators in the public health sector in Kenya. Literature has
pointed to existence of complex and competing multiple accountability mechanisms that
often creates cross-pressure in public administration leading to negative consequences.
However, these studies have been conducted in other public service jurisdictions outside
Kenya. Besides, these studies have not conducted empirical research targeting hospital
administrators. This research project, adopted the Principal-Agent theory and Romzek and
Dubnick (1987) and a case study design to assess the multiple accountability mechanisms and
responses of hospital administrators in Kenya. The study targeted hospital administrators
from 36 public hospitals in 14 Counties in Kenya. Primary data was collected using a selfadministered
questionnaire posted through email. Secondary data was obtained through desk
review of relevant documents in the Kenya’s public service and the health sector. Study
findings demonstrated the existence of the four mechanisms of accountability and how they
operate in ensuring hospital administrators are held accountable. Additionally, findings
showed that professional accountability seem to be given precedence over the other forms of
public accountability in ordinary conditions and hierarchical accountability under crisis
situations. The study concluded that the four mechanisms of accountability exist and operate
distinctively in the health sector and as result hospital administrators are confronted by all the
four mechanisms, but their intensity on accountability vary.
Publisher
University of Nairobi
Rights
Attribution-NonCommercial-NoDerivs 3.0 United StatesUsage Rights
http://creativecommons.org/licenses/by-nc-nd/3.0/us/Collections
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