POLICY IMPLEMENTATION AND SERVICE DELIVERY IN HOMA BAY COUNTY HEALTH SECTOR, KENYA

Abstract

Kenya lags in various global health sector targets one of them being the implementation of the 2001 Abuja declaration pledge that sought to ringfence 15 percent of government budgets on public healthcare. For the year 2001/02, it only managed a high of 8 percent share, after which the share was at about 5 to 7 percent range from 2013/2014 to 2015/2016. Kenya also performed way below the World Health Organization (WHO) benchmark for annual expenditure on basic healthcare of $64 per person. The goal of this study, therefore, was to look into the impact of policy implementation on service delivery of the healthcare sector in Homa Bay County. Particularly, the study sought to establish the effect of bureaucratic practices and citizen engagement approaches on healthcare service delivery in Homa Bay County. The research was based on the 1921 Bureaucracy Theory of Max Weber and Carole Pateman's Participatory Democratic Theory. A descriptive research design was adopted by the research. Hospital staff, medical record officers and patients were the target population. It will target a total of 1100 respondents.  A 110-sample size was used. The information gathered was then evaluated using inferential and descriptive methods, and the results were presented in figures and tables. A structured questionnaire and interview schedule were used. For this research, a multivariate regression analysis was then adopted. The results revealed that bureaucratic practices and citizen engagement approaches are key determinants of service delivery in the healthcare sector in Homa bay county. The study recommends that the county government should prioritize timely payment of salaries to healthcare workers to enhance the morale to provide quality services to the people. Further, the county should enhance technology in the healthcare facilities to assist both in records management and revenue collection.

Keywords; Policy implementation, service delivery, bureaucratic practices, citizen engagement approaches, public policy