Factors Influencing The Implementation Of Healthcare Projects
The devolving of national government functions in Kenya especially the implementation of health care is influenced by various factors in the expedition process of these projects. This study investigated the issues that influence the implementation of health care projects under the devolved system of governance. It investigated the influence of: collaborations of communities, distribution of human resources for health, financing of human resources for health and health infrastructure and learning and adoption of best practices. The study was hinged on four theories; Empowerment Theory, Theory of Optimal Resource Allocation, Theory of Fiscal Decentralization and Organizational Learning Theory. The study employed descriptive survey research design. Target population of 703 respondents. The sample size was of 15 (n=15), Meru County Government Department of Health Staff, 224 (n=224) Medical personnel working at public hospitals managed by the Department of Health Meru County and 10 (n=10) Health Civil Societies’ Managers that were selected to participate in the study. Stratified sampling and Simple random sampling were used to pick the respondents. Questionnaires were used to collect data in the study locale. Data was analyzed qualitatively and quantitatively using Statistical Package for the Social Sciences (SPSS) version 22.0, was presented in Frequency and Percentage tables and the regression model Y = β0 + β1X1 + β2X2 + β3X3 + β4X4 + ε was applied. The study established that collaboration of communities, distribution of human resources, financing, learning and adoption all influenced the implementation of health care projects under devolved system of governance in Meru County, Kenya. Many of the respondents as shown by a mean of 3.74 agreed that collaboration of communities significantly influenced the implementation of county funded health care projects’ sustainability. A good number of the respondents as shown by a Mean of 3.77 agreed that the successful implementation of county funded healthcare projects was influenced by the distribution of human resources for health in Meru County. Further, the results of this research as shown by a mean of 3.87 have revealed that health grants are not utilized due existing corruption adversely influencing the implementation of health care projects at the devolved governance level. 65.6% of respondents agreed that there was need to adopt performance appraisals and evaluations on medical personnel to enhance provision of health care services in the county under study. The study concludes that benchmarking is an important learning tool for medical personnel in enhancing of quality standards in health care provision. It can also be concluded that, adequate financial resources disbursed in good time are key drivers of the implementation of health care projects in Meru County. From the findings, the study recommends that an enforcement of Kenya’s Health Policy 2011–2030 on distribution of human resources for health in public health facilities. The study also recommends that the county government should adopt an effective stakeholder mobilization strategy that would help build working collaborations with other health sector players like Non-governmental Organizations, community based organizations and private companies for the realization of health goals in Kenya through devolved units. Studies could be done in other counties in the country for purposes of comparison and generalization.
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