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

Abstract

The purpose of the study was to establish the relationship between implementation of devolved financial resource governance structure and service delivery in the public health sector of 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 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. Data was collected using questionnaires, checklist 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 test 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 linear and multiple regressions. Data was presented using tables. The study established that health care service delivery was not satisfactory and that devolved financial resource governance structure had not been fully implemented. The study established a positive relationship between implementation of devolved financial resource governance structure and service delivery in the public health sector. The study recommended for adequate revenue allocation, timely disbursement and own revenue generation by county governments. The study also recommended for annual audits to ensure effective and efficient use of financial resources.

Keywords: Devolved financial governance structure, service delivery in the health sector

DOI: 10.7176/PPAR/11-1-03

Publication date: January 31^st 2021