Abstract
The purpose of the study was to establish the influence of devolved human resource governance structure on service delivery in the public health sector in 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 the study sample. A total of 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. Out of the sample size of 331 of respondents, 281 participated giving a response rate of 85 percent. Data was collected using questionnaires 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 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 and multiple regressions. Data was presented using tables. Study findings revealed that health care service delivery was not satisfactory. Devolved human resource governance structure had not been fully implemented. The study established that implementation of devolved human resource significantly influenced service delivery in the health sector. The study recommended that county governments should ensure adequate staffing, motivation and equipping of health facilities to enhance service delivery. Both the medical and support staff should be trained, compensated and equipped appropriately for designated roles. Keywords : Devolved human resource governance structure, service delivery in the health sector DOI: 10.7176/PPAR/11-1-02 Publication date: January 31 st 2021
Highlights
Decentralization is the process by which the activities of a government or an organization are distributed or delegated away from a central authoritative location or group, with regard to authority, planning and decision-making
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
Decentralization is the process by which the activities of a government or an organization are distributed or delegated away from a central authoritative location or group, with regard to authority, planning and decision-making. Decentralization has been recognized as an important subject matter of governance in both developed and developing countries of the world (Dasgupta and Victoria, 2007) It has been advocated as a political response to the ills plaguing fragile and plural societies, including conflicts, inequalities, economic stagnation, corruption and inefficient use of resources (Institute of Economic Affairs (IEA), 2010). The report further pointed out that major provincial government responsibilities had been devolved to districts, the transfer was not accompanied with requisite funding. This hampered devolution and negatively impacted on service delivery in the health sector and other departments
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