Influence of Devolved Human Resource Governance Structure on Service Delivery in the Public Health Sector in Kenya

摘要

The purpose of the study was to establish the influence of devolved human resource governance structure on service delivery in the public health sector in the County government of Trans Nzoia, Kenya. The study was anchored on sequential theory of decentralization and adopted embedded mixed methods research design. The target population was 663 respondents comprising of 15 hospital administrators, 16 doctors, 50 clinical officers, 240 nurses and 342 patient care givers in all the 74 public health care facilities in the County government of Trans Nzoia. Stratified random sampling technique was used to select the study sample. A total of 331 respondents comprising of 8 administrators, 8 doctors, 19 clinical officers 148 nurses and 148 patient care givers were sampled from 74 public health facilities for study. Out of the sample size of 331 of respondents, 281 participated giving a response rate of 85 percent. Data was collected using questionnaires and document analysis guide. Validity of data collection instruments was determined by experts and peers, and the tool modified accordingly after a pilot study in the neighboring Bungoma County. Reliability was established using Cronbach Alpha technique. Both descriptive and inferential statistics were used in data analysis with the help of SPSS program version 21. Descriptive statistics involved frequencies, percentages, means and standard deviation while inferential statistics involved the use of Spearman rank order correlation, simple and multiple regressions. Data was presented using tables. Study findings revealed that health care service delivery was not satisfactory. Devolved human resource governance structure had not been fully implemented. The study established that implementation of devolved human resource significantly influenced service delivery in the health sector. The study recommended that county governments should ensure adequate staffing, motivation and equipping of health facilities to enhance service delivery. Both the medical and support staff should be trained, compensated and equipped appropriately for designated roles.