Challenges to Implementation of Human Resource for Health Strategy in the Health Sector of Mombasa County

Abstract

Strategy implementation is one side of strategic management. Effective strategy implementation in organizations has been seen to lead to superior performance and competitive advantage. Public organisations that have implemented strategies effectively has been able to deliver quality services and achieve satisfaction of its stakeholders. Unlike development, strategy implementation is much more difficult. Only 10-30% of well-developed strategies are effectively implemented. This low success rate is attributed to numerous challenges encountered during implementation. Organizations that are able to overcome strategy implementation challenges satisfy stakeholders by delivering value and providing quality services, and achieve a competitive advantage. Health is one of the key economy drivers. The sector thus requires not only development of strategies but effective implementation. In Kenya, Health sector was decentralized to the county level of government. This study sought to find out the challenges to strategy implementation of the HRH strategy in Mombasa County and the measures put in place to overcome these challenges. The study adopted the case study research design as the focus was a single County. Data was collected through in-depth interviews with County and sub-county health management teams, and facility level managers. Data was analysed using content analysis. Insufficient financial and human resources, ineffective communication, competing priorities, lack of a monitoring and evaluation framework and poor infrastructure were found to be the main challenges to strategy implementation. The study also found that the county overcame challenges through public private partnerships, increased financial allocations to the health department, utilization of different modes of communication and continuous medical education at facility level. Effective leadership, decentralization of power and clear structures and systems were success factors to strategy implementation. The recommendation of the study is that the National government increased allocation to Health to 15% of its GDP and the County department disburse funds to the sub-counties and facilities in a timely manner. This will ensure availability of financial resources for strategy implementation. Development of attraction and retention packages and proper planning for staff replacements to reduce staff shortages is another recommendation. Development of a monitoring and evaluation framework to allow for evaluation of the strategy implementation was also recommended.