Project Management Practices and Performance of County Referral Hospitals in Kenya

Abstract

In Kenya, health sector reforms have aimed largely at addressing affordability and access to healthcare services, including the introduction of the National Health Insurance Fund, Universal Health Care, Proposed social health insurance fund, and tax exemptions and waivers. However, many health facility managers in Kenya lack the necessary project management practices, experience, and knowledge to effectively manage projects, often being health professionals rather than qualified professional managers. The study sought to establish the relationship between project management practices and performance of county referral hospitals in Kenya. Health projects play a fundamental role in the development of a nation and helps in meeting one of the society’s key needs. The general objective of the study was to establish the relationship between project management practices and performance of county referral hospitals in Kenya. The specific objectives were to; assess the relationship between project procurement management, cost management, project risk management, time management and the moderating relationship of stakeholder participation on performance of county referral hospitals in Kenya. Despite the growing demand worldwide for qualified project managers, there is a substantial number of health project managers who do not have the requisite practices, experience, knowledge nor the relevant project management practices for successful project delivery. The study was based on Agency theory, Transactional Cost Theory, Enterprise Risk Management Theory, Pickle Jar Theory and Stakeholder Theory of Project Management. The study adopted a descriptive research design. The total target population was therefore 432 respondents drawn from senior hospital superintendents and departmental managers. Therefore, the units of analysis comprised of the 48 county referral hospitals in Kenya while the unit of observation for this study comprised the hospital superintendents and departmental managers giving a total of 432 respondents. This study adopted Slovian’s formula to calculate the sample size of 207 respondents. Primary data collected using structured and semi- structured questionnaire. Pilot study was conducted on 10 % of the Sample size to test validity and reliability of the data collection instrument. The study collected both qualitative and quantitative data. The qualitative data was analyzed using descriptive statistics while quantitative data was analyzed using statistical analysis (SPSS) version 27. Tests such as multicollinearity, linearity and normality were tested. Data was presented using tables, figures and charts. The study found that procurement management practices had a significant relationship with performance of county referral hospitals, cost management practices had a significant relationship with performance of county referral hospitals, risk management practices had a significant relationship with performance of county referral hospitals, time management practices had a significant relationship with performance of county referral hospitals, and stakeholder participation moderates the relationship between project management practices and performance of county referral hospitals in Kenya. Based on the findings of the study, the study concluded that procurement functions, risk management, cost management and time management practices had a role to play on performance of county referral hospitals. The study therefore recommends that, County referral hospitals should have procurement functions established in line with PPADA (2015), The county hospitals should provide training on project management practices to all staff and management on cost control measures, they should regularly evaluate and report on performance to ensure that goals and objectives were being met on timely manner and to the desired quality outcome and the county hospital project managers should ensure that risk management practices are integrated in service delivery if performance has to improve.