Abstract
The purpose of the study was to establish the relationship between implementation of devolved financial resource governance structure and service delivery in the public health sector of the County government of Trans Nzoia, Kenya. The study was anchored on sequential theory of decentralization and adopted embedded mixed methods research design. The target population was 663 respondents comprising of 15 hospital administrators, 16 doctors, 50 clinical officers, 240 nurses and 342 patient care givers in all the 74 public health care facilities in the County government of Trans Nzoia. Stratified random sampling technique was used to select 331 respondents comprising of 8 administrators, 8 doctors, 19 clinical officers, 148 nurses and 148 patient care givers were sampled from 74 public health facilities for study. Data was collected using questionnaires, checklist and document analysis guide. Validity of data collection instruments was determined by experts and peers, and the tool modified accordingly after a pilot study in the neighboring Bungoma County. Reliability was established using test Cronbach Alpha technique. Both descriptive and inferential statistics were used in data analysis with the help of SPSS program version 21. Descriptive statistics involved frequencies, percentages, means and standard deviation, while inferential statistics involved the use of Spearman Rank Order Correlation, simple linear and multiple regressions. Data was presented using tables. The study established that health care service delivery was not satisfactory and that devolved financial resource governance structure had not been fully implemented. The study established a positive relationship between implementation of devolved financial resource governance structure and service delivery in the public health sector. The study recommended for adequate revenue allocation, timely disbursement and own revenue generation by county governments. The study also recommended for annual audits to ensure effective and efficient use of financial resources. Keywords : Devolved financial governance structure, service delivery in the health sector DOI: 10.7176/PPAR/11-1-03 Publication date: January 31 st 2021
Highlights
Financial decentralization refers to a set of policies aimed at increasing the revenues or financial autonomy of sub national governments and it involves the devolution of financial resources and revenue generating powers
Findings of the study on whether Medical supplies are readily available revealed that 8.0 percent strongly agreed with the statement, 35.7 percent agreed, 8.9 percent were neutral, 37.5 percent disagreed and 9.8 percent strongly disagreed with the statement
Findings summed up to a mean of 2.95 which implied that the number of respondents who agreed with the statement was higher than those who disagreed
Summary
Financial decentralization refers to a set of policies aimed at increasing the revenues or financial autonomy of sub national governments and it involves the devolution of financial resources and revenue generating powers. Canadian government for instance is known to be one of the leading countries in the world with an excellent devolved healthcare system. The Act provides for a decentralized universal, publicly funded health system, called Canadian Medicare. Healthcare is funded and administered by the country’s confederation consisting of the ten provinces and three territories. These administrative units are responsible for primary healthcare and management of hospitals and other related institutions, by setting budgets and financing schedules with health professionals. Each province and territory receives cash assistance from the federal government on a per capita basis
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