Effects Of Devolution On Employee Performance In The Health Care Sector In Kenya: A Case Of Kakamega County

ABSTRACT

Devolution of health care, as other types of decentralization, immensely changed governance structures and relations in the healthcare system. Devolution was seen by its proponent as a way to improve services delivery and performance of the health system by transferring responsibilities and authority to locally elected governments with an aim to creating a more intense community involvement in order to adjust service to communities’ specific needs. However, there is no clear assurance of improved performance or gains brought about by this phenomenon in the health care sector as eluded by devolution literature. From other studies carried out on the devolution no researcher had carried specific study on how devolution had affected employee performance in healthcare sector in Kakamega county. The broad objective of the study was to determine the effect of devolution on employee performance in the healthcare sector in Kakamega county referral hospital in Kenya. The Study was conducted at the Kakamega county referral hospital. The target population was employees in Kakamega county referral hospital who were 400 in total as per the Ministry of healthy 2014-2015 annual report. Simple random sampling technique was used to select respondents who participated in the study. Each employee was given equal chance of inclusion and out of 400 employees the study worked with a sample size of 120 employees by use of (Yamane, 1967) formula. Questionnaires, interview and documentary study were used to collect both primary and secondary data. The pilot study was carried out in Mumias Sub County hospital whose results were not included in the final result. The data was collected and fed in statistical packages of social science (SPSS) version 20 and analyzed by use of descriptive data analysis technique, and presented in the form of frequency tables. The study found out that training practices conducted by the county government had positive impact on performance thus there was improved performance. The study would help the County Government to come up with better ways of motivating its employees in order to improve employee performance. The health sector especially in the rural county governments needs broad minds; this is as result of vast demographic and geographical distribution. Manpower in the health sector was always low with patients being on the receiving end. From that situation it required staff in the health sector to be equipped with skills, have balance and attractive terms of service and better working condition to ensure effective and efficiency operation at the county hospitals. Finally, the study serves as a data bank for researchers who wish to conduct further research on effects of devolution on employee.