Effect of procurement devolution process of medical supplies on the technical efficiency of public health facilities in Nakuru and Baringo Counties of Kenya

Abstract

This study analysed the effect of the procurement devolution process of medical supplies on the technical efficiency of public health facilities in Nakuru and Baringo Counties of Kenya. Although increased government expenditure was expected to improve efficiency and better health outcomes, Kenya's public health sector remains inefficient. The study used a quantitative descriptive research design that targeted 3199 employees in 401 level 2-5 public health facilities (PHFs). Using Slovin’s formula, a sample size of 355 was proportionately sampled. While secondary data was obtained through desk review, primary data was collected through structured questionnaires that were administered to different cadres of employees. Primary data was coded and analysed using STATA/SPSS. To compute the technical efficiency of PHFs, the two-stage Data envelopment analysis (DEA) and multivariate logistic regression were adopted. Study findings show that devolution has improved demand for medical supplies, enhanced procurement efficiency, and promoted ethical procurement. However, complaints from patients have not been reduced, and the training of procurement personnel has not increased. Regression analysis indicates a significant relationship between human capital and technical efficiency. The coefficient of human capital development was 0.199 (T-value= 9.514, p- value= 0.000< 0.05 significant level), implying a positive effect of the procurement devolution process on technical efficiency. This study concludes that despite increased health expenditure in Kenya, public health healthcare services have deteriorated due to the inefficiency of the public health sector. This study recommends increased financial and human resource support for Kenya's public health care.