Human Resource Management Practices and Service Delivery in the Health Sector, Nyeri County, Kenya

Abstract

Health Sector Service delivery is core to the effective functioning of human resources. It impacts on the health of citizens who provide labour force in the economy in several ways. The implementation of devolution in Kenya, has had several readjustment challenges witnessed. The human resource practices adopted, among other things can influence effective delivery of service in the Health sector. This study focused on Nyeri County, it was undertaken in the context of devolved health system in Kenya. The following objectives guided this study to examine employee reward and remuneration; working conditions; resource infrastructure management; recruitment, selection and retention on health sector service delivery. This research was conducted in Nyeri County, in three sub-county hospitals and one level five referral hospital. Human Capital Theory, Herzberg two factor theory and Vroom’s Expectancy Theory, anchored the theoretical framework of this study. Pragmatic philosophy was adopted to examine the implication of human resource practices, on health sector service delivery in Nyeri County. The study used a sample size of 266 randomly selected objects of the study out of target population of 916. Interviewees were purposively selected, that included three top management staff in all hospitals. The primary data collection was carried out by use of structured questionnaires and interview schedule. Secondary data was obtained from existing published literature available, related to the study. Quantitative data analysis was achieved by use of SPSS version 21. The researcher used co-current mixed research methods. Descriptive design was used to collect both quantitative and qualitative data simultaneously. The specific analysis tests were descriptive and inferential. Regression model was applied to test hypothesis and data obtained was presented in bar charts and graphs, percentages and frequency tables. The qualitative data obtained from interviewees was analyzed thematically. Qualitative and quantitative data was integrated at results level. The findings revealed that there was a strong positive relationship with a high level of positive relationship with a significance that determined the strength and direction of the findings of the study. Employee reward and remuneration significantly positively predicted the healthcare service delivery (𝛽 =0.417+<∝ = 0.05).<α =0.05, Working conditions, significantly predicted the level of health sector service delivery (𝛽 =0.479<∝= 0.05). Physical resource infrastructure management, significantly positively predicted the level of health sector service delivery (𝛽 =0.707<∝= 0.05).; Employee recruitment, selection and retention, significantly positively predicted the level of health sector service delivery; Selection and retention significantly positively predicted the level of health sector service delivery (𝛽 =0.677<∝= 0.05) Physical resource infrastructure management is the key component in determining the level of health sector service delivery. Qualitative findings complement the quantitative results. The findings of the study concluded that the four variables influenced health sector service delivery. The study further concluded that health sector address employee reward and remuneration; working conditions, staff recruitment and selection strategies, physical resource infrastructure management and maintenance of facilities and equipment, lack of pharmaceuticals, drugs to enhance health sector service delivery. Based on the conclusion, the study recommends that health sector in Kenya should develop human resource management practices geared towards improving service delivery. The government should enforce labour laws and regulations to enhance health sector service delivery.