Abstract:
The Introduction of ISO certification at KNH and in the public sector in general was
aimed at improving service delivery to the citizenry. However, anecdotal evidence
suggests that this has not been achieved. One of the reasons for this failure is the
inability of the workers to fully comply with the requirements of the ISO Quality
Management System (QMS) requirements. The study sought to examine the factors that
influence compliance behaviour towards ISO 9001:2015 Quality Management System
at Kenyatta National Hospital. Guided by the Theory of Planned Behaviour, the study
sought to assess 1) compliance behavior towards ISO 9001:2015 QMS at KNH; 2) the
effects of workers’ attitudes on compliance towards ISO 9001:2015 QMS procedures
at KNH; 3) the influence of organization norms on compliance with ISO 9001:2015
QMS procedures at KNH; and; 4) the extent workers’ behaviour control affects
compliance with ISO 9001:2015 QMS procedures at KNH. The study employed a cross
sectional survey design. Primary data was quantitative and was collected from 291 staff
of KNH selected through a multistage sampling procedure, by use of a questionnaire.
Augmentative qualitative data was collected from purposively selected key informants
and Focused Group Discussions. Statistical data was analysed and presented using
tables and figures. Tests conducted included cross tabulations, correlation analysis,
factor analysis as well as multiple regression analysis. Qualitative data was analysed
thematically and presented using narratives and direct quotes. Findings revealed strong
intentions to compliance with ISO 9001:2015 QMS procedures by workers at KNH
with a mean score of 82%. However, this fell short of the required threshold of 100%
compliance. Awareness levels were also high but also fell short of the required
threshold. Tests for the hypotheses revealed that attitudes, norms and behaviour control
are positively correlated with compliance with ISO 9001:2015 QMS procedures with
Pearson’s r values of 0.522, 0.477 and 0.305 respectively. (p=0.00). Prediction tests on
the other hand revealed that behaviour control had the least predictor value of
compliance followed by attitude while norms had the highest predictor value. However,
attitudes, norms and behaviour control only accounted for 37.8% of the effect on
compliance with ISO procedures. The study concluded that positive workers’ attitudes
have a positive effect on compliance with ISO 9001:2015 QMS at KNH; positive
organization norms have a positive influence on Compliance with ISO 9001:2015 QMS
at Kenyatta National Hospital and strong behaviour control affects compliance with
ISO 9001:2015 QMS positively. The study recommends that to enhance compliance
with reforms, there is need to improve on the attitudes and normative beliefs of staff.
This can be achieved by improvements on policy development and communication,
providing incentives linked with reforms, providing equipment and infrastructure, and
enhancing employee involvement in order to improve adoption of reforms.