DEVOLUTION AND HEALTH CARE SERVICE DELIVERY AT BUNGOMA COUNTY REFERRAL HOSPITAL IN BUNGOMA COUNTY, KENYA
Joy Shillah Killong - Student, Master of Arts in Public Policy and Administration, Kenyatta University, Kenya
Edna Moi - Lecturer, Department of Public Policy and Administration, Kenyatta University, Kenya
ABSTRACT
Healthcare services in Bungoma County have been plagued by several challenges ever since the devolution of healthcare services in Kenya. Challenges facing health services include the underfunding of health facilities, inadequate equipment, and lack of adequate staffing, all of which have had a negative impact on the provision of health services. Moreover, poor financial management and low community participation in health services have also contributed to the aforementioned challenges. Though several measures have been put in place to solve these challenges, there is currently very little empirical data regarding the influence of devolved health functions like financial management, human resource management, health infrastructure development, and community participation on health service delivery in the county. The present study intended to examine the influence of devolved health functions on health services in Bungoma County. In particular, the areas that were of interest included the influence of devolved human resource management, healthcare infrastructure development and community participation on health service delivery. Agency Theory was utilized in this study. The research was designed using a descriptive approach and was aimed at a population of 500 health workers, which consisted of 50 healthcare administrators, 300 medical practitioners, and 150 support workers. Using the Cochran formula, the sample size was determined to be 384. Methods of data collection involved the use of questionnaires, interviews, and focus group discussion (FGD). The analysis of quantitative data was carried out using SPSS software, while the qualitative data was subjected to thematic analysis. The results revealed that the study found that the devolution to Bungoma on healthcare delivery has resulted in recruitment and expanded opportunities to train staff which is now more capable for frontier workloads, resulting in more accessible healthcare service. Conversely, there is an ongoing shortage of specialists, work imbalance to restore workloads, and mixed perceptions of motivation and career development to remain substantial barriers. Therefore, the conclusion is to ensure that even as seen to have gained from recruitment, there are strategies for specialists, imbalance in works distributed across health workers, and long-term career development.