Institutional factors influencing implementation of strategic plans in government hospitals in Kitui Central Sub-County, Kitui County, Kenya

Abstract

The Government of Kenya has adopted strategic planning in various institutions and Ministries to address distinct and prioritized strategic issues in order to upgrade service delivery. In the Ministry of Health, strategic planning is part of the on-going public sector reforms aimed at improving efficiency and effectiveness in the delivery of health services. Strategic planning in the Ministry of Health is aimed at achieving the international Millennium Development Goals (MDGs) as well as the targets set in the Kenya’s Economic Recovery Strategy. This is the one of the commitments of the Ministry of Health as a way of realizing the national vision of providing accessible, affordable and quality health care for all Kenyans and in particular the poor. The objective of the study was to assess whether organizational structures, human resource, adequate financial resources, monitoring and evaluation are factors affecting the implementation of strategic plans in the Ministry. The descriptive study was employed, whereby a sample size of 76 officers selected through stratified random sampling from the Ministry of Health Staff in Kitui Central Sub-County. Data was gathered through semi-structured questionnaires that were pre-tested on 10 individuals randomly selected from the study population to ensure reliability and validity of the tools. An Interview guide was also used on select individuals who were picked randomly from those that were not interviewed. The data collected in the descriptive survey was analyzed by descriptive statistics. Multiple Linear Regression analysis was conducted to determine the influence of the factors on strategic plan implementation. The study established that organizational structure of hospitals influences the implementation of strategic plan with chi-square results indicating that there is a significant association between organizational structure(χ 2 (1, 4) = 70.0, p< 0.05) and implementation of strategic plans by Government Health facilities and a strong positive correlation r, (76) = 0.851, p<0.05 between organizational structure and implementation of strategic plan. The study also established from majority of the responses that human resource influences implementation of strategic plan implementation includes and there is a significant association (χ 2 (1,4) = 36.973, p< 0.05) between human resources and implementation of strategic plan and a strong positive correlation r (76) = 0.782, p<0.05). Also resource adequacy influences strategic plan implementation. The Chi-square results indicated that there is a significant association (χ 2 (1, 4) = 57.973, p< 0.05) and strong positive correlation r (76) = 0.833, p<0.05) between resource adequacy factors implementation of strategic plan. Lastly monitoring and evaluation influences implementation of strategic plans with (χ 2 (1, 4) = 65.423, p< 0.05) and a strong positive correlation r (76) = 0.742, p<0.05, between M&E and strategic plan implementation. The study recommended that all the officers in charge of the management of Government health facilities should be trained by the government on the organizational structures, there should be staff involvement in the development of strategic plan, the Government should allocated adequate funds for strategic plan implementation in health facilities and the Ministry of health should have frequent monitoring and evaluation on the implementation of strategic plans in the government facilities with immediate feedback on the way forward.