Health System Influence on Functionality of Managers in Public Hospitals: A Case of Sub County Hospitals in Bungoma County

Abstract

Healthcare in developing countries is a multi-billion-dollar investment. Health managers tasked with leading and managing the hospitals often have little formal preparation. Various studies have identified challenges in execution of management functions by managers in public hospitals. The study objectives were to establish the influence of management knowledge, organization capacity building systems, internal work environment and hospital finance on the functionality of managers in public Sub County hospitals in Bungoma County. The study was descriptive and purposive sampling was adopted to identify managers in the hospitals. The population target was 170 managers from the 10 Public Sub County hospitals in Bungoma County. A closed ended questionnaire was self-administered. Research ethics was observed with ethical approvals from Kenya Methodist University Scientific Ethics Review Committee and National Commission for Science, Technology, and Innovation. The data was analyzed using SPSS version 24. Descriptive statistics, Bivariate Pearson correlation and univariate regression model were adopted. The results indicated that management knowledge of a manager had a positive and significant influence on manager’s functionality to manage Sub-County Hospitals (β = 0.263; P-value <0.05). This implies that a unit increase in manager’s management knowledge leads to a significant improvement in management of Sub-County Hospitals by 0.263 units it’s an important factor in management of Sub-County Hospitals, managers with higher levels of work experience, qualifications, leadership knowledge and knowledge on overall health systems structure managed public hospitals more effectively. It was established organization capacity building systems had a positive and significant influence on management of Public Hospitals (β = 0.327; P-value < 0.05). This implies that a unit increase in development of organization’s capacity building systems i.e training, mentorship and support supervision leads to a significant improvement in management of Sub-County Hospitals by 0.327 units. Internal work environment had a positive and significant influence on management of Public Hospitals (β = 0.360; P-value < 0.05). This implies that a unit improvement in the hospital’s internal work environment leads to a significant improvement in management of Public Hospitals by 0.360 units, availability of adequate resources for managers such as finance, human resources and information led to effective management of hospitals. It was established health finance had a positive and significant influence on management of Public Hospitals (β = 0.112; P-value < 0.05). This implies that a unit increase in allocation of hospital finance leads to a significant increase in management of the Sub-County hospitals by 0.112 units. The study recommends the county government of Bungoma County to set aside a budget to recruit health workers to address human resource gaps. The county government to enhance their financial commitment towards the running of the hospitals in the county. Increase proportion of their exchequer to the public hospital the current proportion is not adequate. County top leaders to revise the finance accountability frameworks for efficient funds utilization. Furthermore, the local political leaders should collectively rework their conflict resolution mechanisms with the management of the hospitals and look for alternatives problem solving mechanism to reduce interference with the normal operation of hospitals.