Abstract
Sub-Saharan Africa lags other regions in the adoption of both Patient-Centered (PC) and Facility Centered (FC) mobile health (m-health) applications. Transformational Leadership Style (TLS) of Hospital Management Boards (HMBs) is catalytic for the adoption of disruptive technologies such as m-health by hospitals. There is limited evidence on the effect of TLS of HMBs in the adoption of innovations in Low- and Middle-Income Countries (LMICS). This study investigated the moderating role of TLS of HMBs on the adoption of PC and FC m-health by hospitals in Kenya. It used the Logit Regression Model to test null hypotheses that the four constructs of TLS (Idealized Influence (II), Individualized Consideration (IC), Inspirational Motivation (IM), Intellectual Stimulation (IS)) individually or combined had no significant moderating effect on adoption of PC and FC m-health applications. Primary data was collected from a representative sample size of 211 Top Executives (TEs) of level 4 to 6 hospitals who evaluated the TLS of their HMBs on m-health adoption. At a 5% level of significance, the study found that only the combined application of the four constructs (II, IC, IM, IS) significantly moderated the adoption of PC m-health (p=0.046) but did not moderate FC m-health (p=0.345). Each incremental application of TLS would increase the odds of adopting PC m-health by 1.002 but not for FC. Therefore, this study recommends the capacity strengthening of HMBs in TLS to scale up PC m-health adoption in Kenya and other LMICs. It also recommends a differentiated approach to policies, practices, and theories of adoption of innovations using the PC-FC models.
Highlights
The use of digital health innovations such as mobile health (m-health) have disrupted and transformed the health care industry (Becker et al (2014) and Chib (2013))
This study shows that the moderating effect of Transformational Leadership Style (TLS) of Hospital Management Boards (HMBs) is different for adoption of PC and Facility Centered (FC) m-health applications by hospitals in Kenya
The difference in the effect could be attributed to two facts: 1) The nature and focus of the technology: It could be argued that FC m-health applications are by nature operational, more complex and more internally focus than PC m-health applications
Summary
The use of digital health innovations such as mobile health (m-health) have disrupted and transformed the health care industry (Becker et al (2014) and Chib (2013)). A key characteristic of hospital adoption of innovations in Sub-Saharan Africa, including Kenya, is the role that the leadership of Hospital Management Boards (HMBs) have on adoption of innovations (Abor, 2015). They provide oversight to the Top Executive (TE) and the senior management team of hospitals on strategic management and adoption of innovations. There is limited evidence in the literature reviewed on quantitative analyses of the effect of the leadership style of HMB and on implications for policies and practices for scaling up innovations in the health sector
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