Evaluation of determinants of strategy implementation in government hospitals in Nairobi County

Abstract

This study sought to establish the determinants influencing strategy implementation in Government hospitals in Nairobi County. The study sought to examine whether organization structures, culture, leadership, resources and communication influences strategy implementation in government hospitals. A descriptive survey was adopted. The target population was the CEO and Head of department employees from the 18 government hospitals in Nairobi County and given the size of the population, a sample size of 108 employees was selected through stratified random sampling method. The employees were stratified into two strata which was CEO employee and Head of departments employees. Within each stratum, simple random sampling was used to identify individual employee respondents. Data was collected by use of questionnaires. The questionnaire consisted of structured open and closed ended statements. The study adopted a descriptive case study research design. Data was analyzed by the use of descriptive statistics and inferential analysis. Specifically, means, frequencies and percentages were used. Factor Analysis and Correlation analysis was used to extract the relevant factors and their relationship with strategy implementation. The findings were presented in tables, figures and graphs. It can be concluded that there was effective strategy implementation at the government hospitals. It is possible to conclude that organization structures in place in government hospitals in Nairobi distort and dilute the intended strategy. Organization structure at government hospitals was inconsistent with strategy implementation and this may have led to poor strategy implementation. It can be concluded that the implementation of a strategy in Kenyan hospitals often encounters rough going because of deep rooted cultural biases in the organization .Therefore it was possible to conclude that culture at government hospitals was not conducive for strategy implementation and this may have led to poor strategy implementation. It was concluded that leadership at government hospitals was not effective and this may have led to poor strategy implementation. The study concluded that organization resources are key determinants of strategy implementation. The management of organization resources at government hospital is not effective and this had led to poor strategy implementation the study concluded that communication channels for strategy implementation at government hospitals are not conducive and this may have contributed to the poor implementation of strategy. The study recommends for strategy implementation to be successful, government hospitals and other health centre institutions needs effective leadership and to align its culture to strategy. Specifically, hospitals need to address the resistance of employees by improving on communication and training.