NETWORKS AND THEIR ROLE IN MANAGEMENT OF HEALTHCARE SYSTEMS IN KENYA

ABSTRACT
The independent operation of health policy actors has demonstrated a slow response to health concerns. In the Kenyan healthcare system, the public sector covers about 48% of health facilities, with commercial private sector at 37%, while faith based organizations covers the rest of 15% (Kenya Healthcare Federation, 2018). Healthcare networks (where policy communities such as public and private hospitals, faith-based facilities, universities, and other interest groups) have proved to work, particularly in developed countries like Canada, something that developing countries such as Kenya can leverage. This study has explored the extent to which policy actors in Kenya are leveraging on licensing policy, sharing of relevant technology, financing of budgets, sharing of relevant knowledge and skills, as well as strategies to engage local communities. The study uses actor network theory to explore the interactions of multiple actors with different interests in the management of healthcare systems. It targeted 90 managerial staff from selected major institutions: The Nairobi Hospital – a private hospital, Kenyatta National Hospital – a public hospital, and St. Mary’s Mission Hospital based in Kenya’s Capital, Nairobi. A semi-structured questionnaire was used to collect both qualitative and quantitative data. Correlation analysis was used for quantitative data while thematic analysis was used to analyse qualitative data. The study found out that all doctors are not limited to work in one place. Specialized doctors offer services on call at either in Nairobi hospital, Kenyatta National Hospital or ST. Mary’s Mission Hospital. The study shows that Nairobi hospital has adequate specialized doctors therefore, making it easy to outsource services to the other hospitals. Kenyatta National Hospital receives60% of the ministry of health’s recurrent budget in addition to donor contribution. The St. Mary’s Mission hospital operates with a budget template from its donors whereas the Nairobi hospital amasses a lot of financial support from its financially well-off sponsors. The Nairobi Hospital has modern and adequate technological equipment, systems and technology-literate employees compared to inadequate (some) broken-down modern equipment at Kenyatta National hospital. St. Mary’s has adequate equipment for primary care. All hospitals actively participate in community development. Through donor prescriptions, the Kenyatta Hospital engages in HIV and AIDS sensitization, reproductive health and immunization whereas Nairobi hospital offer almost free services to extreme referral cases of the disadvantaged patients. St. Mary’s hospital offers relatively less costly services in addition to free quarterly screening of cancer, immunization and reproductive health.