Effect of Strategic Management Processes On Service Delivery in Public Level Four Hospitals In Nairobi County, Kenya

Abstract

The Nairobi County hospitals at the public level four have remained inefficient in offering healthcare services even with the strategic management frameworks put in place. Poor resource distribution, ineffective coordination and ineffective implementation mechanisms have led to poor patient care and demoralising staff. The chronic nature of these deficiencies resulted in the need to review the impact of strategic management processes on the service delivery within the public health sector. The aim of the research was to study the impacts of the strategic management processes on service delivery in the public level four hospitals in Nairobi County in Kenya. It had particular objectives to evaluate the impact of environmental scanning, strategy formulation, strategy implementation, strategy control, and strategy communication process on service delivery. The research was based on the Contingency Theory, Resource-Based View Theory, and Stakeholder Theory. The study adopted a descriptive research study and a sample population of 1,012 employees selected in the Nairobi County at the level four of the public hospital. A representative sample of 286 respondents was selected by the stratified and simple random sampling method. The collected data were done by means of structured questionnaires and analysed by means of descriptive as well as inferential statistical methods using SPSS. Descriptive results revealed that environmental scanning, strategy formulation, strategy implementation, strategy control, and strategic communication were practiced to varying extents. Correlation analysis show that environmental scanning (r=0.739; p=0.001), strategy formulation (r=0.851; p=0.002), strategy implementation (r=−0.707; p=0.009), strategy control (r=0.893; p=0.011), and strategy communication (r=0.748; p=0.021) had significant relationships with service delivery. Regression analysis indicated that environmental scanning (β=0.793; p<0.05), strategy formulation (β=0.874; p<0.05), strategy implementation (β=−0.715; p<0.05), strategy control (β=0.872; p<0.05), and strategy communication (β=0.529; p<0.05) significantly influenced service delivery. The study recommended enhanced environmental scanning to anticipate healthcare needs, systematic strategy formulation to align objectives with patient outcomes, better coordination in implementation, robust control systems for monitoring performance, and strengthened communication processes to improve healthcare service delivery in public hospitals.