Factors influencing service delivery in public hospitals: a case of nairobi county, kenya

Abstract

This research project was conducted on ‘Factors influencing service delivery in Public Hospitals: a case of Nairobi County, Kenya’. The study was conducted at Kenyatta National Hospital, Mbagathi Hospital and Mama Lucy Kibaki Hospital in Nairobi County. This study was initiated because of recent labour unrest due to dissatisfaction by staff presenting as refusal to offer services due to delayed or refusal to pay dues, poor working environment, inadequate infrastructure and lack of commitment by management to engage with employees. The study focused on four areas, which were Management Style, implementation of ICT services, Training and frequency of drug supply. Descriptive survey was used for generating needed information. The target population was respondents in management position in administration, wards, pharmacy, procurement offices, finance and ICT Departments. Simple random method was used to get respondents in this study. The 96 respondents included 34 respondents from KNH, 31 respondents from Mbagathi Hospital and 31 respondents from Mama Lucy Kibaki Hospital. An approval for data collection was obtained from NACOSTI, Kenyatta National Hospital, Mbagathi Hospital, Mama Lucy Kibaki Hospital and Nairobi City County. Questionnaires were used for data collection. Pretesting done at Makadara Health Centre after which appropriate adjustments were made. A total of 34 respondents from Kenyatta National Hospital, 27 respondents from Mbagathi Hospital and 31 respondents from Mama Lucy Kibaki Hospital were involved in the study. 92 respondents returned questionnaires and this represented 95% rate of response. Data analysis was done using SPSS and Microsoft excels computer applications. It was found out that management of these hospitals had a greater influence on how services are delivered and decision making process, a view given by 38% of the respondents, less assignment is delegated and there could be a positive improvement if the management was changed as given by 42% of the respondents. The findings showed that information systems have not been fully integrated in the hospitals operation as given by 57% of the respondents while the level of training was a factor considered while offering services, an opinion given by 97% of the respondents. The results of the study show that drug supply was not adequate mainly due to procurement bureaucracies within the hospitals according to responses given by 61% of the respondents. The information obtained in the study is useful for dissemination to the hospitals’ management and staff, Ministry of Health stake holders and policy makers and other stakeholders in Public Health sector for inclusion in quality management and quality improvement of services