Influence of Public-Private Partnership on Healthcare Service Delivery in Nairobi County, Kenya

Abstract

The Kenyan healthcare sector suffers from challenges in service delivery due to poorly remunerated staff, low retention rates, low motivation, shortage of medical supplies and corruption. This led to the sector to be devolved and interest in getting private and public partners to improve quality of service delivery. The study was set out to assess the influence of Public-Private Partnerships (PPP) on health care service delivery in Nairobi County, Kenya. In achieving this objective, it set out to determine the influence of PPP in financial support, and PPP managerial support on health care service delivery in three major hospitals within Nairobi County – Kenyatta National Hospital, Mbagathi District Hospital and Kibera South Health Centre. The study is informed by principal-agent theory and stakeholder’s theory. The study used descriptive research design. The study targeted healthcare providers and facility administrators in the three hospitals and the population was 1288 respondents. Stratified sampling was applied to the target population as per facility and simple random sampling was applied in getting the respondents who participated in the study. A sample of 304 respondents was reached by using the Yamane (1967) and the 7 administrators were selected to be interviewed through the application of purposive sampling. The primary data for the study was obtained using a structured questionnaire and an in-depth interview guide coupled with an observation checklist. Secondary data used to complement primary data. A pre-test was done using 15 healthcare providers and 2 administrators at the Carolina for Kibera Health Facility to test for validity and reliability of the instrument. The quantitative data was analyzed using descriptive, regression and correlation analysis and qualitative data was analyzed to fit the preset study variable theme. From the findings, public private partnership financial support (β=1.428, p<0.005), public private partnership managerial support (β=.191, p<0.005) public private partnership human resource support (β=.196, p<0.005) and public private partnership risk-sharing (β=.090, p<0.005) are all significant predictors of healthcare service delivery within Nairobi County. The study concludes that public private partnership is a critical driver of healthcare service delivery. The study recommends that finance managers of the Health care providers in Nairobi City County in Kenya should exercise prudence in spending of the money disbursed by public private partnership in executing projects that significantly contribute towards effective health care service delivery. Public private partners should provide necessary support to the leadership and the top management ream working in the health care providers in Nairobi to ensure effective health service delivery is attained. Public private partners should collaborate and work closely with the human resource managers of the health care service providers in Nairobi City County to provide state of the art training to employees so that they are up-to-date with the changing dynamics