| dc.description.abstract | Healthcare in developing countries is a multi-billion-dollar investment. Health
managers tasked with leading and managing the hospitals often have little formal
preparation. Various studies have identified challenges in execution of management
functions by managers in public hospitals. The study objectives were to establish the
influence of management knowledge, organization capacity building systems, internal
work environment and hospital finance on the functionality of managers in public Sub
County hospitals in Bungoma County. The study was descriptive and purposive
sampling was adopted to identify managers in the hospitals. The population target was
170 managers from the 10 Public Sub County hospitals in Bungoma County. A closed
ended questionnaire was self-administered. Research ethics was observed with ethical
approvals from Kenya Methodist University Scientific Ethics Review Committee and
National Commission for Science, Technology, and Innovation. The data was
analyzed using SPSS version 24. Descriptive statistics, Bivariate Pearson correlation
and univariate regression model were adopted. The results indicated that management
knowledge of a manager had a positive and significant influence on manager’s
functionality to manage Sub-County Hospitals (β = 0.263; P-value <0.05). This
implies that a unit increase in manager’s management knowledge leads to a significant
improvement in management of Sub-County Hospitals by 0.263 units it’s an important
factor in management of Sub-County Hospitals, managers with higher levels of work
experience, qualifications, leadership knowledge and knowledge on overall health
systems structure managed public hospitals more effectively. It was established
organization capacity building systems had a positive and significant influence on
management of Public Hospitals (β = 0.327; P-value < 0.05). This implies that a unit
increase in development of organization’s capacity building systems i.e training,
mentorship and support supervision leads to a significant improvement in management
of Sub-County Hospitals by 0.327 units. Internal work environment had a positive and
significant influence on management of Public Hospitals (β = 0.360; P-value < 0.05).
This implies that a unit improvement in the hospital’s internal work environment leads
to a significant improvement in management of Public Hospitals by 0.360 units,
availability of adequate resources for managers such as finance, human resources and
information led to effective management of hospitals. It was established health finance
had a positive and significant influence on management of Public Hospitals (β = 0.112;
P-value < 0.05). This implies that a unit increase in allocation of hospital finance leads
to a significant increase in management of the Sub-County hospitals by 0.112 units.
The study recommends the county government of Bungoma County to set aside a
budget to recruit health workers to address human resource gaps. The county
government to enhance their financial commitment towards the running of the
hospitals in the county. Increase proportion of their exchequer to the public hospital
the current proportion is not adequate. County top leaders to revise the finance
accountability frameworks for efficient funds utilization. Furthermore, the local
political leaders should collectively rework their conflict resolution mechanisms with
the management of the hospitals and look for alternatives problem solving mechanism
to reduce interference with the normal operation of hospitals. | en_US |
