Governance and Leadership as Moderators of the Relationship Between Strategic Procurement and Service Delivery in Public Hospitals Kisii County, Kenya

Abstract

Background: Efficient strategic procurement is vital for timely healthcare service delivery, especially in public hospitals facing supply chain constraints. In Kenya, procurement inefficiencies persist despite regulatory reforms, often undermining Universal Health Coverage (UHC) goals.This study examined how governance and leadership moderate the relationship between strategic procurement practices—specifically strategic sourcing, e-procurement, and supplier relationship management—and service delivery in Level 4 and 5 hospitals in Kisii County.  Methods: A descriptive cross-sectional survey design was employed. Using stratified and purposive sampling, 267 hospital staff were selected from five public hospitals. Data were collected via semi-structured questionnaires and analyzed using descriptive statistics, Pearson correlation, and hierarchical regression to test moderating effects. Results: Strategic sourcing (r = 0.575, β = 0.357, p < 0.001) and supplier relationship management (r = 0.598, β = 0.217, p < 0.001) were significantly associated with improved service delivery. E-procurement had a significant correlation (r = 0.653) but was not significant in the combined regression model (β = 0.057, p = 0.159). Governance and leadership significantly moderated the effects of strategic sourcing (β = 0.072, p < 0.001) and supplier relationship management (β = 0.025, p = 0.015), but not e-procurement.  Conclusion: Strategic sourcing and robust supplier engagement are critical to enhancing service delivery in public hospitals. Strong governance and leadership amplify the impact of these practices. Strengthening institutional governance and investing in supplier partnerships are recommended to improve healthcare service delivery.
Keywords: Strategic Procurement, Service Delivery, Public Hospitals, Governance, Kenya, E-procurement, Supplier Relationship Management

DOI: 10.7176/EJBM/17-6-12

Publication date: July 30^th 2025