Competing Multiple Accountability Mechanisms and Public Administrators’ Responses in the Health Sector in Kenya

Abstract

Accountability in public sector is a complex concept. Public administrators are held accountable by multiple mechanisms of accountability. It is unclear in the public health sector in Kenya which of the four mechanisms of hierarchical, professional, legal and political accountability dominates accountability responses of hospital administrators. The objective of this study was to assess which among the competing multiple accountability mechanism is accorded priority in the health sector in Kenya. The study adopted a case study design targeting hospital administrators from 36 public hospitals in 14 Counties in Kenya. The study found out that professional accountability tend to be given precedence over other forms of public accountability in ordinary conditions and hierarchical accountability under crisis situations. The study concluded that hospital administrators are confronted with all the four mechanisms, but their intensity on accountability vary.