EFFECT OF CORPORATE GOVERNANCE ON HEALTH SERVICE DELIVERY IN KENYA
Abstract
Corporate governance is of paramount importance to the improvement of health service delivery. When executed effectively, it can prevent corporate scandals, fraud and the civil and criminal liability. It also enhances an institution’s image in the public eye as a self-policing institution that is responsible. Indeed, weak accountability on revenue streams can affect the continuity of public service delivery and cause other long run inefficiencies. Accordingly, stable revenues make it easier for governments to maintain a stable level of public services. Access to quality healthcare has been a long term policy issue in Kenya, as well as in many countries globally; both developed and developing ones alike. Kenya has undergone significant changes from 2010 in a bid to improve its public service delivery with the latest being devolved governments that envisage bringing services closer to the people. This study aims at analyzing the effect of corporate governance on service delivery in six counties namely, Nyeri, Taita Taveta, Muranga, Embu, Bomet and Kericho. The study seeks to examine the role County Health Management Team plays in the provision of 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 service delivery. The target population was 347 comprising of senior county administrators, clinical officers, nurses and doctors, at Level 5 hospitals. The questionnaire was piloted in Nairobi County. The study adopted a descriptive research design. The study collected quantitative data using questionnaires and qualitative data using interview guide. The quantitative data was analyzed using descriptive statistics generated from Statistical Software for Social Sciences (SPSS) and the qualitative data was analyzed using content analysis. Descriptive research design was used in a combination of qualitative and quantitative models, techniques and measures.The independent variable comprise of board size, CEO duality, accountability structures and allocation of resources. The moderating variable was policy framework and comprised international conventions, intergovernmental mechanism and political insurgence. Dependent variable comprised accessibility and efficiency of health services and citizen participation. Further, the study employed multiple regression models for analysis quantitative data collected through use of questionnaire. The paper proposes recommendation on how to implement efficient service delivery in line with the uniqueness of the County Health Management Teams. The findings is useful to academicians, county governments, policy makers and donors.
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