Relationship between Strategic Planning Practices and the Performance of Devolved Healthcare among Selected Public Hospitals in Meru County

Abstract

The study investigated the relationship between strategic planning and performance of devolved healthcare, through a survey of public hospitals in Meru County.Strategic planning refers to the process of envisioning the future of the organization and breaking it down into executable strategies, goals, tactics and timelines. Organizational performance on the other hand refers to the outputs/results realized by an organization in line with their goals and objectives. The specific objectives of the study were to establish the relationship between the individual components of strategic planning (mission and vision statements, business environmental analysis, strategic formulation, strategic implementation and strategic monitoring and evaluation) with the performance of public hospitals in Meru County. Despite the evident challenges in devolved healthcare in form of frequent industrial strikes, lack of medical equipment and essential institutional structures among others, no studies had investigated these problems from a strategic planning standpoint, justifying the study. Performance of devolved healthcare was considered in light of the WHO framework for measuring the performance of health systems, which focuses on health improvement, health responsiveness and financial fairness. The study covered six Level 4 hospitals in Meru County (Nyambene, Kanyakine, Muthara, Timau, Mikinduri, Miathene) and one level 5 facility (Meru Teaching and Referral Hospital). It took the design of a descriptive survey with a semi-structured questionnaire used in data collection. Analysis of collected data was done using SPSS version.21 with descriptive statistics such as means and percentages generated. Elsewhere, linear regression model was used in inferential analysis that establishes the relationship between the dependent and independent variables. The results were consequently presented using charts and tables. It was established that four out of the five strategic planning components included in the study were significantly associated with performance of Meru County public hospitals. Specifically, the study determined that mission and vision statement, business environmental analysis methods, strategy implementation process, and strategic evaluation and monitoring practices were significantly associated with performance of Meru County public hospitals. The study concluded that effective communication of mission and vision statement would inspire the employees and all the hospital stakeholders towards achieving a common goal, an effective environmental analysis would give a healthcare institution an edge in the industry, a strategic plan however well drafted, if not implemented, would be a waste of a hospital's resources and that the continuous comparison between the actual performance versus the set targets and addressing the variances therein would positively impact the hospital's performance. The study recommended that: i) deliberate steps should be taken by the hospital management boards in communicating the mission and vision statement in an effective way to inspire the stakeholders towards the desired envisioned future, ii) the hospital management board should perform effective business environmental analysis aimed at formulating strategies that would give the hospital a competitive edge in selected areas of operation, iii) the hospital management board should avail adequate resources and motivate the employees to pursue strategic objectives and effectively implement the strategy formulated, and iv) the County government and the hospital management board should design clearly spelt out targets against which performance can be compared and corrective measures taken to address the variances. Since the study focused on public hospitals in Meru County, it is suggested that the study be extended to other Counties to assess whether different findings may be reached regarding the relationship between strategic planning elements. and performance of hospitals.