Monitoring and Evaluation, Contextual and Behavioural Determinants and Performance of Maternal Health Programmes in Kenyan County Governments

Abstract

Maternal Health is a significant and central human right and a vital element of sustainable development. Inefficiency in M&E is among the significant management stages have significantly contributed to operations failure in government institutions. Inefficiency in M&E is among the significant management stages have significantly contributed to operations failure in government institutions institutions. The study therefore purposes to the relationship between monitoring and evaluation, contextual and behavioural determinants1 and performance of maternal health programmes (MHP) in Kenyan County Governments. The objectives of the study were to; establish how planning for M&E, stakeholder engagement, capacity building for M&E, contextual determinants and behavioral determinants influence performance of MHP in Kenyan County Governments, examine the moderating influence of contextual determinants and behavioral determinants on link amid practices for monitoring and evaluation and performance of MHP in Kenyan County Governments and assess the combined moderating influence of contextual determinants and behavioral determinants on link of practices for monitoring and evaluation and performance of MHP in Kenyan County Governments. This study was1 anchored on the program theory, contingency theory, stewardship theory principal agent theory and the theory of constraints. Pragmatism served as the study's paradigm. A mixed method research design was used in this study. The study targeted 388 hospitals from nine counties (Appendix IV). The unit of analysis was 1165 people, including employees from level 4 and 5 hospitals. Stratified random sampling was used to obtain 282 respondents. The research instruments for the study included a self-administered structured questionnaire, interview guides and an observation guide. Using descriptive narratives, qualitative data was evaluated within specific topics. Measures of central tendencies and measures of dispersion were used to descriptively assess quantitative1 data. The study hypotheses were tested using regression. Frequency tables were used to present the data. The qualitative data revealed that resources were allocated by gathering information and assessment in order to meet the desired goals, through use of indicators of tracking processes and progress within each public sector departments, and efficiency in delivery and performance is the policy statement. The study discovered a high relationship between county maternal health program success and M&E planning (r=0.859, p=0.000<0.05); stakeholder participation in M&E (r=0.838 and p=0.000<0.05); capacity building for M&E (r=0.796, p=0.000<0.05); data management for M&E(r=0.855, p=0.001<0.05); contextual determinants1 (r=0.877, p=0.002<0.05) and behavioral determinants (r=0.843, p=0.012<0.05). The study discovered that when contextual determinants were introduced into the relationship and the interaction terms in model 3 rised the R square by 0.141. This means that the interaction amid contextual determinants and combined M&E practices describes 14.1% alterations in performance of CMHP. The research found that after introduction of behavioural determinants into the link, and the interaction term in model 3 rose the R square by 0.066. This denotes that the collaboration between behavioral determinants and combined M&E practices describes 6.6% variations in performance of CMHP. The study concluded that planning for M&E had the greatest influence on the performance of MHP, followed by data management for M&E, then stakeholder’s engagement in M&E, while capacity building for M&E had the least influence. For the program's effectiveness, the study suggests that management develop an effective methodology as well as raise awareness of M&E activities.