Strategic Orientation and Service Delivery of Level Four Public Hospitals in Kakamega County, Kenya

Abstract

Public health institutions continue to fall short of expectations, despite substantial funding from the government for the health sector. A group in Kenya that represents doctors, pharmacists, and dentists has spoken out against the severe shortage of medical professionals. Claims of severe incompetence, carelessness, malpractice, or abuse of patients made public by members of the public in relation to health care providers constitute instances of subpar service. It is evident from these that the current state of Kenya's public health system does not adhere to the fundamental principles of high quality healthcare, which include the following: confidentiality, respect, autonomy, safety, choice, and fulfillment. The study established the effect of strategic orientation on service delivery of Level Four Public Hospitals in Kakamega County, Kenya. Specifically, the study aimed at determining the effect of customer orientation, resource orientation, and technological orientation on service delivery of Public Level four Hospitals in Kakamega County, Kenya and to establish the moderating effect of organization factors on strategic orientation and service delivery of Public Level four Hospitals in Kakamega County, Kenya. The study adopted a mixed research design comprising of a descriptive and causal research design. The study target population was 304 comprising of 162 nurses, 135 Hospitals office staff and 7 Hospital Administrators. The study sample size was 173. The study applied stratified simple random sampling technique. Structured questionnaires aided in data collection. Closed ended questions were adopted. Pilot study was done at Sabatia District hospital in Vihiga County. Reliability was tested using Cronbach Alpha while the construct and content validity was through supervisor expert opinion. The study analyzed data using both descriptive and inferential statistics. Where descriptive statistics included mean, median, mode, standard deviation, and percentages. Inferential statistics entailed Pearson correlation and regression analysis which helped the researcher to draw future inferences from the study. Data was presented using tables and figures. The study was of importance to medical practitioners, government Authorities, and management of hospitals in managing strategic orientation plans for service delivery. The study found out that Customer orientation had a significant influence on service delivery (t-statistic=7.489, p-value=0.000< 0.05). Resource orientation had a significant influence on service delivery (t-statistic=11.405, p-value=0.000< 0.05). Technological orientation had a significant influence on service delivery (t-statistic=10.882, p-value=0.000< 0.05). Finally, organizational factors moderated the effect of strategic orientation on service delivery among Public Level four Hospitals in Kakamega County, Kenya. (T-statistic=5.961, p value=0.000< 0.05). The study recommends that customers orientation should be prioritized since it enhances service delivery. Hospital management should entrust employees with powers to guard resources available so to fasten development. That hospital should adopt a leadership style that supports employee technology resource based programs. Training on available resources can be availed. Finally, the study recommends that hospital management should increase the scope of firm factors such as culture and structure to streamline strategic orientation and service delivery.