Abstract:
The constitution of Kenya (2010) introduced a devolved system of governance which
entrenches health as a right for every citizen, to the highest attainable standard. Further, it
also designates the health services functions of the national government and County
Government and principles under which such services should be provided. Following the
first general elections under the constitution of Kenya (2010) and creation of County
Governments, the need to address the administration, planning and management of health
services in response to the changes became necessary. Notably, several Counties have been
bedevilled with monumental challenges ranging from strikes, corruption and delayed
salaries resulting to poor service delivery among others. The research general objective was
to assess the influence of devolution on healthcare quality service provision in Busia
County. The specific objectives were: to assess the influence of resource allocation, health
leadership, organizational structure and health workforce competence on healthcare quality
service delivery in Busia County. The study employed descriptive research design targeting
healthcare workers and other County Government officials. Questionnaires and interview
schedules were used in collecting Primary data from target population; Doctors, Nurses,
Clinical officers, Pharmacists, Laboratory technicians, Hospital administrators, Medical
superintendents and County health officials; County assembly health committee, health
Director, Chief Officer for health and the County Executive Committee member for health.
The sample size comprised of 200 individuals from the target population arrived at by
consulting Yamane Taro formula. Descriptive and inferential statistics was utilized in data
analysis and study findings were presented in form of frequency tables. The summary of
the findings show‘s that resource allocation had to a great extent helped in the healthcare
quality service delivery in Busia County. Similarly, health leadership, workforce
competence and organizational structure were significantly effective in influencing
healthcare quality service delivery in Busia County. The study concludes that the
availability of resources have had a significant provision of quality health services in Busia
County. The study thus recommends that: The county government management should
ensure that they engage in proactive and effective resource allocation mechanisms like
financing, technology and human resource to improve provision of quality healthcare
services. The allocations should be deliberate with significant resources given to critical
service delivery areas. The County Government management should use transformational
leadership in their health leadership style. The County Government management should
integrate a decentralized structure. The study has found that strongly decentralized
structures perform well in several contexts, notably in service delivery and implementation
of strategy. The management should also ensure that the workers are results oriented in a
bid to improve the Healthcare workforce competence, and consequently improve the
provision of quality healthcare services. Finally, the government through the Ministry of
Devolution and Planning should improve on its devolution policy to further fortify health
provision in the counties.