STRATEGIC LEADERSHIP PRACTICES AND SUSTAINABLE HEALTH SYSTEMS
A CASE OF MOI COUNTY REFERRAL HOSPITAL TAITA TAVETA COUNTY, KENYA
Abstract
This study investigated the effect of strategic leadership on sustainable health systems in Taita Taveta County. The study was guided by the following objectives: to determine the influence of shareholder involvement on sustainable health systems, to establish the influence of financial allocations on sustainable health systems, to determine the influence of laws governing processes on sustainable health systems, and to investigate the influence of policy formulation on sustainable health systems in Taita Taveta County. The Institutional Theory and the Human Resource Theory formed the basis of theoretical framework for the study. The study employed descriptive research design. The study targeted a population of 662 people. Purposive and simple random sampling were used to sample 199 participants, which was 30% of the target population. Subject experts ascertained the content validity of the research instruments, whereas reliability of the questionnaire was ascertained through half-split method, a Cronbach alpha coefficient of 0.84 was obtained and this confirmed that the questionnaire was reliable. Qualitative data was analyzed thematically, while descriptive statistics such as frequencies, percentages and means were used to analyze the quantitative data. Further, the Pearson Product Moment of Correlation and regression analysis were used to test the hypotheses. The study established that shareholder involvement had a significant influence (p=0.001<0.05) on sustainable health systems, financial allocations had a significant influence (p=0.002<0.05) on sustainable health system, laws governing procedures had a significant influence (p=0.001<0.05) on sustainable health systems and policy formulation had a significant influence (p=0.002<0.05) on sustainable health systems. The study concluded that shareholder involvement, financial allocations, laws governing procedures and policy formulation had a significant effect on sustainable health systems in Moi County Referral Hospital in Taita Taveta County. It recommended that the Ministry of Health should devise an intensive in-service training of hospital managers on strategic leadership to empower the leaders with skills and knowledge on shareholder involvement, management of funds, formulation and implementation of policies. The County government of Taita Taveta should increase the amount of funds allocated to the hospital to enhance quality of care. The hospital leadership should also ensure proper management practices and effective supervisory functions in the hospital by ensuring that all laws governing the procedures in the hospitals are observed by all employees. The hospital leadership should revise policies and SOPs to be up to date with the current operations in the hospital.
References
Agyepong, I. A., Lehmann, U., Rutembemberwa, E., Babich, S. M., Frimpong, E., Kwamie, A., & Gilson, L. (2018). Strategic leadership capacity building for Sub-Saharan African health systems and public health governance: a multi-country assessment of essential competencies and optimal design for a Pan African DrPH. Health policy and Planning. 33(2).
Albritton, E., Edmunds, M., Thomas, V., Petersen, D., Ferry, G., Brach, C., & Bergofsky, L. (2014). Engaging stakeholders to improve the quality of children’s health care. Agency for Healthcare Research and Quality.
Arsalidou, D. (2015). Rethinking corporate governance in financial institutions. Routledge.
Auvinen, A. M. (2017). Understanding the stakeholders as a success factor for effective occupational health care. Occupational Health Journal. 25-43.
Azevedo, M. J. (2017). The state of health system (s) in Africa: challenges and opportunities. Historical Perspectives on the State of Health and Health Systems in Africa, Volume II, 1-73.
Barasa, E., Musiega, A., Hanson, K., Nyawira, L., Mulwa, A., Molyneux, S., ... & Jemutai, J. (2021). Level and determinants of county health system technical efficiency in Kenya: two stage data envelopment analysis.
Burnett, S., Mendel, P., Nunes, F., Wiig, S., van den Bovenkamp, H., Karltun, A. & Fulop, N. (2016). Using institutional theory to analyse hospital responses to external demands for finance and quality in five European countries. Journal of Health Services Research & Policy, 21(2), 109-117.
Chang, C. S., Yu, S. W., & Hung, C. H. (2015). Firm risk and performance: the role of corporate governance. Review of Managerial Science. 9(1), 141-173.
Chelagat, T., Rice, J., Onyango, J., & Kokwaro, G. (2021). An assessment of impact of leadership training on health system performance in selected counties in Kenya. Frontiers in Public Health, 8, 550796.
Cooley, S. (2016). Human relations theory of organizations. Global encyclopedia of public administration, public policy, and governance. Springer. https://doi. org/10.1007/978-3-319-31816-5_2998-1.
David, R. J., Tolbert, P. S., & Boghossian, J. (2019). Institutional theory in organization studies. In Oxford Research Encyclopedia of Business and Management.
Garcia-Basteiro, A. L., & Abimbola, S. (2021). The challenges of defining global health research. BMJ Global Health. Volume 6(12).
Ghiasipour, M., Mosadeghrad, A. M., Arab, M., & Jaafaripooyan, E. (2017). Leadership challenges in health care organizations: The case of Iranian hospitals. Medical journal of the Islamic Republic of Iran. Vol 3(1) 96.
Global Health | East Africa Regional | U.S. Agency for International Development. (20). Global Health | East Africa Regional | U.S. Agency for International Development. Retrieved November 18, 2022, from https://www.usaid.gov/east-africa-regional/global-health
Goldenberg, T., Reisner, S. L., Harper, G. W., Gamarel, K. E., & Stephenson, R. (2020). State policies and healthcare use among transgender people in the US. American Journal of Preventive Medicine.59(2), 247-259.
Hoffman, S. J., & Cole, C. B. (2018). Defining the global health system and systematically mapping its network of actors. Globalization and health, 14(1), 1-19.
Iordanoglou, D. (2018). Future Trends in Leadership Development Practices and the Crucial Leadership Skills. Journal of Leadership, Accountability & Ethics, 15(2).
Kabaniha, G. A., Ataguba, J. E. O., & Kutzin, J. (2020). Global Healthcare Financing: Economics, Methods, and Strategies for Sustainable Healthcare. Handbook of global health, 1-42.
Kieny, M. P., Bekedam, H., Dovlo, D., Fitzgerald, J., Habicht, J., Harrison, G., & Travis, P. (2017). Strengthening health systems for universal health coverage and sustainable development. Bulletin of the World Health Organization, 95(7), 537.
Kruk ME, Gage AD, Arsenault C, Jordan K, Leslie HH, Roder-DeWan S, Adeyi O,. High-quality health systems in the Sustainable Development Goals era: time for a revolution.
Lafarre, A., & Van der Elst, C. (2018). Shareholder sustainability activism in the Netherlands. European Corporate Governance Institute (ECGI)-Law Working Paper, (396).
Liaropoulos, L., & Goranitis, I. (2015). Health care financing and the sustainability of health systems. International Journal for Equity in Health, 14(1), 1-4.
Massuda, A., Hone, T., Leles, F. A. G., De Castro, M. C., & Atun, R. (2018). The Brazilian health system at crossroads: progress, crisis and resilience. BMJ global health, 3(4), e000829.
Moses, M. W., Korir, J., Zeng, W., Musiega, A., Oyasi, J., Lu, R., & Di Giorgio, L. (2021). Performance assessment of the county healthcare systems in Kenya: a mixed-methods analysis. BMJ Global Health, 6(6), e004707.
Ohio University. (2021, November 16). Health Care Legislation: Updates to Regulations and Policies. https://onlinemasters.ohio.edu/blog/health-care-legislation/
Patel, V., Saxena, S., Lund, C., Thornicroft, G., Baingana, F., Bolton, P., & UnÜtzer, J. (2018). The Lancet Commission on global mental health and sustainable development. The lancet, 392(10157), 1553-1598.
RohitKushwaha, S. (2022, May 29). Emergence of Strategic Leadership in the Healthcare sector: A Bibliometric Analysis. https://www.cibgp.com/article_18139.html
Semrau, M., Evans-Lacko, S., Alem, A., Ayuso-Mateos, J. L., Chisholm, D., Gureje, O., ... & Thornicroft, G. (2015). Strengthening mental health systems in low-and middle-income countries: the Emerald programme. BMC medicine, 13(1), 1-9.
Sherman, J. D., Thiel, C., MacNeill, A., Eckelman, M. J., Dubrow, R., Hopf, H., & Bilec, M. M. (2020). The green print: advancement of environmental sustainability in healthcare. Resources, Conservation and Recycling, 161, 104882.
Stadhouders, N., Kruse, F., Tanke, M., Koolman, X., & Jeurissen, P. (2019). Effective healthcare cost-containment policies: a systematic review. Health Policy, 123(1), 71-79.
Stenberg, K., Hanssen, O., Edejer, T. T. T., Bertram, M., Brindley, C., Meshreky, A., & Soucat, A. (2017). Financing transformative health systems towards achievement of the health Sustainable Development Goals: A model for projected resource needs in 67 low-income and middle-income countries. The Lancet Global Health, 5(9), e875-e887.
Tangcharoensathien, V., Mills, A., & Palu, T. (2015). Accelerating health equity: the key role of universal health coverage in the Sustainable Development Goals. BMC medicine, 13(1), 1-5.
World Health Organization. (2017). Environmentally sustainable health systems: a strategic document (No. WHO/EURO: 2017-2241-41996-57723). World Health Organization. Regional Office for Europe.
Zhang, F., Zhu, L., & Wei, L. (2020). Shareholder involvement and firm innovation performance: Empirical evidence from Chinese firms. Chinese Management Studies.
