Influence of Organizational Culture on Public Health Service Delivery in County Governments in Western Kenya Region

Leonard Momos Juma; Shitseswa E. Ayub; Umulkher Ali

doi:10.51867/ajernet4.1.9

Authors

Leonard Momos Juma Masinde Muliro University of Science and Technology [MMUST], Nairobi, Kenya
Shitseswa E. Ayub Masinde Muliro University of Science and Technology [MMUST], Nairobi, Kenya
Umulkher Ali Masinde Muliro University of Science and Technology [MMUST], Nairobi, Kenya

DOI:

https://doi.org/10.51867/ajernet4.1.9

Keywords:

Organisational Culture, Public Health Service Delivery, Western Kenya

Abstract

Poor health service delivery has been linked to the devolution of health services, with some health workers walking off the job due to inadequate pay and unsafe working conditions. This research aimed at establishing the influence of organizational culture on public health service delivery in County Governments in Western Kenya Region, Taking a positivist approach, the study was anchored on Organizational Culture Theory. Descriptive survey and causal-comparative research designs were adopted with a target population of 966 personnel consisting of the CECMs, Chief Officers, Directors and County Nursing Officer for Health, Medical Superintendents, Hospital Administrator, Human Resource Officer, Head of Pharmacy, Head of Nursing, Health Records Information Officer, Head of Laboratory, Head of Clinical Services and number of patients admitted, treated and discharged drawn from all the four Counties of Bungoma, Busia, Kakamega and Vihiga. Primary data was collected using both structured questionnaires and interview schedules. Qualitative data was analysed by content analysis while quantitative data was analysed using both descriptive and inferential statistics. The SPSS Software version 26 was used for statistical analysis which was both descriptive whereby frequencies, percentages, means and standard deviation were clearly shown in the form of both tables, models and charts. The hypothesis tested for significance of the study at 5% significance level. From the regression model, the R² value was 0.761. This shows that organizational culture could explain 76.1 % of variance in public health service delivery. Under regression coefficients, organizational culture could statistically significantly predict public health service delivery in County Governments in Western Kenya Region (t=30.529, p<0.05). Therefore, the hypothesis was rejected. This shows that for one-unit increase in organizational culture, public health service delivery increased by 0.873 units. With regard to organizational culture, it is suggested that policymakers develop policies that encourage a culture wherein all employees and stakeholders are actively engaged in the strategic implementation process. Management of the strategy's implementation should not be the sole purview of change specialists and upper management. The people leading the shift were also responsible for making conditions more amenable to the desired transformation.

References

Acar, Z. A., & Acar, P. (2014). Organizational culture types and their effects on organizational performance in Turkish hospitals. Emerging Market Journals, 3(3), 18-30. https://doi.org/10.5195/emaj.2014.47

Achia, T. N., & Mageto, L. E. (2015). Individual and contextual determinants of adequate maternal health care services in Kenya. Women & health, 55(2), 203-226. https://doi.org/10.1080/03630242.2014.979971

Ahenkan, A., & Osei-Kojo, A. (2014). Achieving sustainable development in Africa: Progress, challenges, and prospects. International Journal of Development and Sustainability, 3(1), 162-176.

Akachi, Y., & Kruk, M. E. (2017). Quality of care: measuring a neglected driver of improved health. Bulletin of the World Health Organization, 95(6), 465. https://doi.org/10.2471/BLT.16.180190

Akokuwebe, M. E., & Adekanbi, D. M. (2017). Corruption in the health sector and implications for service delivery in Oyo State public hospitals. Ilorin Journal of Sociology, 9(1), 200-217.

Al-Otaibi, A., & Common, R. (2018). An assessment of the role of organisational culture in health care provision in Saudi Arabia (Doctoral dissertation, University of Manchester).

Andove, C. M., & Nzulwa, J., (2018). Challenges to Strategic Delivery of Public Health Services in Counties in Kenya: A Study of Machakos County. The Strategic Journal of Business & Change Management. ISSN 2312-9492(Online) 2414-8970(Print). www.strategicjournals.com

Andrews, R., Beynon, M., & Genc, E. (2017). Strategy implementation style and public service effectiveness, efficiency and equity. Administrative Sciences, 7(1), 4. https://doi.org/10.3390/admsci7010004

Assefa, Y., Van Damme, W., Williams, O. D., & Hill, P. S. (2017). Successes and challenges of the millennium development goals in Ethiopia: lessons for the sustainable development goals. BMJ global health, 2(2). https://doi.org/10.1136/bmjgh-2017-000318

Ataguba, J.E., & Goudge, J. 2012. The impact of health insurance on health care utilisation and out-of-pocket payments in South Africa. The Geneva Papers on Risk and Insurance: Issues and Practice, 37(4): 633-654. https://doi.org/10.1057/gpp.2012.35

Bruno, E. E. (2021). Influence of Organizational Culture on Service Delivery Among Private Hospitals in Nairobi City County Kenya (Doctoral dissertation, University of Nairobi).

Buong, J. A. B., &Ayugi, M. E. (2017). Uptake of community health strategy on service delivery and utilization in Kenya. https://core.ac.uk/download/pdf/ 236412185.pdf

Carlopio, J., & Harvey, M. (2012). The Development of a Social Psychological Model of Strategy Implementation. International Journal of Management, 29 (3), 75 - 86

Carney, M. (2018). Influence of organizational culture on quality healthcare delivery. International journal of health care quality assurance.

Chepkonga, P., & Nyaga, J. (2019). Leadership Style, Culture and Service Delivery in Public Health Sector: A Case Study of Mbagathi District Hospital, Nairobi City County. Journal of Human Resource & Leadership, 3(1), 24-40.

Chi, H., & Chia, H. J. (2018). The influence of hospital organizational culture on organizational commitment among nursing executives. African Journal of Business Management, 6(44), 10888-10895. https://doi.org/10.5897/AJBM11.1510

Childress, J. R. (2013). Leverage: The CEO's guide to corporate culture [Kindle

Demirkaya, Y. (2015). Strategic planning in the Turkish public sector. Transylvanian Review of Administrative Sciences, SI, 15. Gale Academic OneFile,

Dixon-Woods, M., McNicol, S., & Martin, G. (2012). Ten challenges in improving quality in healthcare: lessons from the Health Foundation's programme evaluations and relevant literature. BMJ Quality & Safety, 21(10), 876-884. DOI: 10.1136/bmjqs-2011-000760. PMID: 22543475; PMCID: PMC3461644.

https://doi.org/10.1136/bmjqs-2011-000760

Ghafoor, M. M. (2013). Role of demographic characteristics on job satisfaction. Far East Research Centre, 6(1), 30-45.

Gibson, C. B. (2017). Elaboration, generalization, triangulation, and interpretation: On enhancing the value of mixed method research. Organizational Research Methods, 20(2), 193-223. https://doi.org/10.1177/1094428116639133

Gilles, I., Burnand, B., & Peytremann-bridevaux, I. (2014). Factors associated with healthcare professionals ' intent to stay in hospital : a comparison across five occupational categories. International journal for quality in health care, 26(2), 158-166. https://doi.org/10.1093/intqhc/mzu006

Gitonga, Z., & Keiyoro, P. (2017). Factors influencing the implementation of healthcare projects: The case of Meru County, Kenya. International Academic Journal of Information Sciences and Project Management, 5(1), 259-280.

Govindarajan, V. (2016). A contingency approach to strategy implementation at the business-unit level: integrating administrative mechanisms with strategy. Academy of management Journal, 31(4). https://doi.org/10.2307/256341

Gupta, J.N.D., Sharma, S.K. and Hsu, J. (2004), "An overview of knowledge management", in Gupta, J.N.D. and Sharma, S.K. (Eds), Creating Knowledge Based Organizations, Idea Group, Southfield, MI. https://doi.org/10.4018/978-1-59140-162-9.ch001

Hill, C.W.L., & Jones, G. R. (2013). Theory of Strategic Management. (10th ed). U.S.A: South -Western, Cengage Learning.

Holtz, C., & Elsawy, I. (2013). Developing Countries: Egypt, China, Indian, and South Africa. In Holtz, C. (Ed.). Global health care: Issues and policies (2nd Ed). Burlington: Jones and Bartlett Learning.

Hussein, N., Omara, S., Noordina, F., & Ishaka, N. A. (2016). Learning organization culture, organizational performance and organizational innovativeness in a public institution of higher education in Malaysia: A preliminary study. Procedia Economics and Finance, 37, 512-519. https://doi.org/10.1016/S2212-5671(16)30159-9

Jaques, E. (1951). The changing culture of a factory. Tavistock.

Kariuki, E.G. (2021). An Analysis of service differentiation strategies adopted by top law firms in Kenya [Thesis, Strathmore University].

Kaur, J. (2015). Techniques Used in Hypothesis Testing in Research Methodology-A Review. International Journal of Science and Research (IJSR), 4(5), 2319-7064.

Kenya, B.O. (2016). Factors influencing service delivery in public hospitals: A case of Nairobi County, Kenya. Doctoral dissertation, University of Nairobi.

Kiana, D. (2016).Evaluation of Determinants of Strategy Implementation in Government Hospitals in Nairobi County. Unpublished.

Kim, W.G. & Cha, Y. (2002).Antecedents and consequences of relationship quality in hotel industry. Hospitality Management, 21, 321-338. https://doi.org/10.1016/S0278-4319(02)00011-7

Kimani, E. M. (2015). Effect of Government Regulations on Factors Hindering Financing Of Small Scale Water Investments in Kenya. (Degree of Doctor of Philosophy in Business Administration), Jomo Kenyatta. University of Agriculture and Technology.

Kimathi, L. (2017). Challenges of the devolved health sector in Kenya; Teething problems or systemic contradictions? Africa development, XLII (1), 55-77. https://www.ajol.info/index.php/ad/article/view/163620

King, M. (2012). Deep culture. Journal of Popular Culture, 45, 687-694. doi:10.1111/j.1540-5931.2012.00952.x

Leslie, H., Malata A., & Ndiaye, Y. et al. (2017). Effective coverage of primary care services in eight high-mortality countries. BMJ Glob Health, 2, e000424. doi:10.1136/bmjgh-2017-000424

Lu, T.P., Shih, J.T., Kittipittayakorn, C., & Lian, G.F. (2013). "Improving outpatient service quality in department of orthopedic surgery by using collaborative approaches," Proceedings of the 2013 IEEE 17th International Conference on Computer Supported Cooperative Work in Design (CSCWD), Whistler, BC, Canada, 515-520. DOI: 10.1109/CSCWD.2013.6581015.

Lynch, R. (2012). Strategic Management (6th ed). Cape Town: Pearson Education Limited.

Magee, K.C. (2002). The impact of organizational culture on the implementation of performance management (Doctoral dissertation). Available from Dissertations and Theses database (UMI No. 3047909).

Mithanti, T. S. (2012).The impact of effectuation on the performance of South African medium and high technology firms (Doctoral dissertation). University of the Witwatersrand.

Mohanan, M., Hay, K., & Mor, N. (. (2016). Quality of health care in India: challenges, priorities, and the road ahead. Health Affairs, 35(10), 1753-1758. https://doi.org/10.1377/hlthaff.2016.0676

Mwendo, L. (2009). Retirement age increased to 60 years. Retrieved from http://www.kenyaweeklypost.com/modules.phd

Ochola, A., (2016). Determinants of Strategy Implementation in the Public Health Facilities in Mombasa County, Kenya. Master's Thesis. University of Nairobi.

Ortega, A., Ángel P. M., & Castillo, S. (2013). Impact of perceived corporate culture on organisational commitment. Management Decision, 51 (5), 1071 - 1083. https://doi.org/10.1108/MD-08-2012-0599

Papanicolas, I., Woskie, L. R., & Jha, A. K. (2018). Health Care Spending in the United States and Other High-Income Countries. JAMA, 319(10), 1024-1039. https://doi.org/10.1001/jama.2018.1150

Prenestini, A., & Lega, F. (2013). Do senior management cultures affect performance? Evidence from Italian public healthcare organizations. Journal of Healthcare Management, 58(5), 336-351. https://doi.org/10.1097/00115514-201309000-00007

Robbins, S., Judge, T.A., Millett, B., & Boyle, M. (2013). Organisational behaviour. Melbourne, VI: Pearson Higher Education.

Schein, H. E. (2005). Organizational Culture and Leadership. (2nd ed). San Francisco, California: Jossey-Bass Publishers.

Schneider, B., & Barbera, K. M. (2014). Oxford handbook of organizational climate and culture. New York: Oxford University Press. https://doi.org/10.1093/oxfordhb/9780199860715.001.0001

Simoneaux, S., & Stroud, C. (2014). A strong corporate culture is key to success. Journal of Pension Benefits, 22(1), 51-53. Retrieved from http://www.aspenpublishers.com

Thuku, J.M. (2020). Effects of Devolved Governance on Health Service Delivery at Thika Level Five Hospital in Kiambu County, Kenya. Master's Thesis. Africa Nazarene University

Wahome, C. W. (2019). Impact of Devolved Health on Maternal Healthcare in Kenya: the Case of Nyandarua County. Doctoral dissertation, University of Nairobi.

Waithaka, D., Tsofa, B., Kabia, E., & Barasa, E. (2018). Describing and evaluating healthcare priority setting practices at the county level in Kenya. The International journal of health planning and management, 33(3), e733-e750. https://doi.org/10.1002/hpm.2527

Wang, X., Birch, S., Zhu, W., Embrett, M., & Meng, Q. (2016). Coordination of care in the Chinese health care systems: a gap analysis of service delivery from a provider perspective. BMC health services research, 16(1), 1-11. https://doi.org/10.1186/s12913-016-1813-8

World Bank, (2018). Annual Report. Washington, D.C.

World Health Organization. (2016). World health statistics 2016: monitoring health for the SDGs sustainable development goals. World Health Organization.

Zodpey, S., Lumbiganon, P., Evans, T., Yang, K., Ha, B. T., Negandhi, H., & Al-Kabir, A. (2018). Assessment of health professional education across five Asian countries-a protocol. Human resources for health, 52. https://doi.org/10.1186/s12960-018-0316-6