Effect of Corporate Governance on Health Care Service Delivery in Kenya

Abstract

Corporate governance is vital to the improvement of health care service delivery in Kenya. When implemented effectively, it can avert corporate scandals, fraud, and criminal liability. It also improves an institution’s perception as a self-policing institution that is responsible. Similarly, weak accountability can negatively affect continuity of service delivery and result in other inefficiencies. Accordingly, steady revenues ensure that governments maintain efficient delivery of public services. Indeed, access to quality health care for all has been a long-term plan in developed and developing countries. Kenya has undergone significant changes from 2010 to improve its public service delivery with the latest being devolved governments that envisage bringing services closer to the people. This purpose of this study was to investigate the effect of corporate governance on health care service delivery. The study sought to examine the role County Health Management Team plays in the provision of health care service delivery. Further, the study examined the interface between board size, chief executive officer duality, accountability structures and allocation of resources – to establish their influence on health care service delivery. The study hypothesized that, board size, chief executive officer duality, accountability structures and allocation of resources affects service delivery. The target population was 347 comprising of senior county administrators, clinical officers, nurses, and doctors, at Level 5 hospitals. The study adopted a descriptive research design. The study collected quantitative data using questionnaires and qualitative data open ended section of the questionnaire. The data was analyzed using descriptive statistics generated from Statistical Software for Social Sciences (SPSS) and the qualitative data was analyzed using content analysis. The independent variable comprises of board size, CEO duality, accountability structures and allocation of resources. The moderating variable was policy framework and comprised international conventions, intergovernmental mechanism, and administrative transformation. Dependent variable comprised of accessibility and efficiency of health care services and citizen participation. Further, the study employed multiple regression models for analysis quantitative data collected through use of questionnaire. The result suggests that board size, chief executive officer duality, accountability structures and allocation of resources affects health care service delivery. Other findings from the study confirmed that; board size have a significant effect on health care service delivery. The result disputed the null hypothesis on board size and concluded that board size affects health care service delivery. Other findings indicate that that accountability structures have a significance influence on health care service delivery. Further, the study concluded that allocation of resources plays a significant role in the health care service delivery in Kenya. The study recommends that both National and County should put in place a set of deliberate and proactive processes, policies and structures that supports board size to improve health care service delivery. The study also suggests that statutory bodies should enact laws that will mandate all counties to maintain corporate governance.