Fridah Njiru1 and Wilson Muna, Ph.D2

1Scholar in the field of Public Policy and Administration, Kenyatta University
2 Lecturer of Public Policy, Administration, and Management, Kenyatta University

Fiscal transfers to finance health infrastructure projects in Embu County of Kenya runs into billions of shillings since health was declared a devolved function under 2010 constitution. Yet, despite such bold investments, and in a bid to reform delivery of the health care system, its infrastructure remains ineffective, inefficient and inadequate. This study sought to analyse the extent to which key factors, such as (1)health policies, (2) funds allocation, (3) human resource capacity and (4) governance structures, determines the implementation of devolved health infrastructure projects in Embu County. The study was guided by Nutt’s theory of project implementation as well as Goldratt’stheory of constraints. A total of 553 medical staff of level4 and 5 hospitals and the health administration staff were targeted, and a sample of 56 respondents were sampled. The study adopted a descriptive case study research design. A semi-structured questionnaire, with both open and closed-ended questions was used to collect both qualitative and quantitative data. Quantitative data was analyzed through descriptive statistics which include; percentages, frequencies, mean, standard deviation, and regression, while qualitative data was analyzed through thematic analysis. Authorization to conduct the field study was sought from the National Commission for Science, Technology and Innovation. Results of the study indicated that majority of the respondents were not conversant with health policies governing the development of health infrastructural projects. A disconnect was also noted between the funds allocated and the number, size, design, and quality of health projects established. Although majority of administrators in this sector were found to be adequately trained, gaps were identified in the area of training, particularly in relation to the installation, operation, and maintenance of new infrastructure and technologies. Governance structures were found to be rigid, old fashioned and lacked a clear chain of command, which constrained the performance of key decision makers.

Keywords: Health Policies, Funds Allocation, Human Resource Capacity and Governance Structures

Cite this article:
Njiru, F. & Muna, W. (2019). Analysis of the Implementation of Devolved Health Infrastructure Projects in Kenya. International Journal of Arts and Commerce, 8(9), 45-58.