| dc.description.abstract | Performance of public healthcare institutions in developed and developing countries has
attracted concern from both healthcare providers and users of the health facilities. Lack of
leadership has been cited as one of the key causes of poor performance in public healthcare
institutions. The purpose of this study was to examine the influence of strategic leadership
practices on organisational performance of public referral healthcare institutions in Nairobi
City County, Kenya. The study was guided by four specific objectives: to examine the
influence of strategic vision on performance of public referral healthcare institutions;
assess the influence of core value initiatives on performance of public referral healthcare
institutions; determine the influence of management innovation on performance of public
referral healthcare institutions; and establish the influence of human capital development
on performance of public referral healthcare institutions in Nairobi City County. The
research was anchored on Transformational Leadership Theory, Upper Echelons Theory
and Stewardship Theory. The study adopted a cross-sectional survey design. Primary data
was collected using structured questionnaires. The study targeted 135 senior and middle
level managers and 4 health facility in-charges of public referral hospitals in three (3) sub counties of Nairobi City County hosting Kenyatta National Hospital, Pumwani Maternity
Hospital, Mbagathi District Hospital and Mama Lucy Kibaki Hospital. All the managers
and health facility in-charges were sampled. Stratified sampling procedure was used to
divide respondents into the three sub-counties. Respondents from each stratum were
selected using purposive sampling method. Pilot study was conducted to help test validity
of the instrument and reliability (using Cronbach’s Coefficient Alpha). Descriptive
statistics were used to summarise data into meaningful form. For variable relationships,
inferential statistics were utilised. Analysed descriptive and inferential data was displayed
using graphs and tables. The study found out that strategic vision significantly influences
performance of public referral hospitals, β = .430, t = 4.975, p = .000. Further, core value
initiatives significantly influence performance of public referral hospitals, β = .769, t =
12.569, p = .000. Similarly, management innovation significantly influences performance
of public referral hospitals, β = .832, t = 15.675, p = .000. Lastly, human capital
development significantly influences performance of public referral hospitals, β = .634, t
= 8.568, p = .000. The study concluded that although strategic vision, core value initiatives,
management innovation and human capital development practices existed, some
respondents were uncertain whether the practices were yet to be implemented. The study
recommends that top management adopts strategies to gain trust from the facility users and
the general public. This can be done by fostering honesty and support initiatives, consistent
service delivery, and building accountability. In addition, introduction of new functional
structures would enhance efficiency in operations in the health facilities. The study also
recommends that employees be encouraged to advance their skills. This can be done
through virtual training and learning, mentoring and job rotation exercises. Top leadership
of the health facilities should ensure there exists equitable human resource development at
all functional levels. The study further recommends that comparative studies be conducted
on the same subject matter using views of lower cadre employees. | en_US |
