| dc.description.abstract | Every organization’s aim is to reaAliBzSe TaRnAd CuTph old great performance in service
delivery, which leads to progression and growth for the organization. In order to
improve effectiveness and safeguard higher performance, organizations have
enhanced their strategy implementation process. There have been complaints about
poor service delivery in public hospitals in devolved units from its citizenry; this is in
spite of the reality that county governments obligate themselves to offering these
services in their strategic plans, county integrated development plans, as well as in
their service delivery charters. This study sought to establish the extent to which
strategy implementation determinants influence public health facilities service
delivery in county governments in the Western Region of Kenya. In order to achieve
this purpose, it was hypothesized that public health facilities service delivery in
county governments is determined by participative leadership style, human resource
capacity and organizational culture. It was also hypothesized that this relationship
was moderated by external environmental factors. Taking a positivist approach, the
study was anchored on the McKinsey 7-S Model Framework, participative leadership
theory, human capital theory, and organizational culture theory. Descriptive survey
and explanatory research designs were adopted with a target population of 966
respondents, consisting of the 16 top management leaders in the Ministry of Health,
264 medical personnel and 686 patients admitted, treated, and discharged who had
been selected to form the study sample through stratified and simple random
sampling techniques. Structured questionnaires and interview schedules were the
main tools for data collection. The validity and reliability of these instruments were
established through conducting a pilot study, conducting Cronbach alpha tests, and
getting expert opinions. The questionnaires for medical personnel gave Cronbach
alpha coefficients of α = 0.807, an indication of a high level of reliability. The
collected data was then coded and analyzed using the SPSS version 26 computer
program. Data was analyzed using descriptive statistics such as frequencies,
percentages, means, and standard deviations and inferential statistics such as
Pearson’s correlation coefficient test, simple, multiple, and hierarchical regression
analysis, analysis of variance (ANOVA), and exploratory factor analysis. Multiple
regression analysis results showed that strategy implementation determinants
significantly influenced public health facilities service delivery. From the results,
participative leadership explains 62.4% (R2 =0.624), human resource capacity
explains 51.2% (R2 =0.512) and organizational culture explains 80.1% (R2 =0.801) of
the variance in public health facilities service delivery. Therefore, the hypotheses
were rejected. The external environment moderated the relationship between strategy
implementation determinants and public health facilities service delivery in the
Western Region of Kenya. The study concluded that strategy implementation
determinants influenced public health facilities service delivery in the Western
Region of Kenya. Participative leadership style, human resource capacity and
organizational culture were the major determinants of public health facilities service
delivery. External environmental factors did not moderate the relationship between
participative leadership style and public health facilities service delivery. However,
external environmental factors moderated the relationship between human resource
capacity, organizational culture and public health facilities service delivery. The study
recommends that the county governments in the Western Region of Kenya should
enhance the operation of strategy implementation determinants for better public
health facilities service delivery. | en_US |
