|Title: IS FINANCIAL CAPABILITY AND MANAGEMENT CRITICAL TO QUALITY SERVICE DELIVERY IN HEALTHCARE? A CASE OF MISSION HOSPITALS IN MERU COUNTY.|
Stephen Laititi Mutunga, PhD
Fidelity to financial management in any institution makes the difference on success or failure of its operations, whether an enterprise for profit or a not-for-profit organization. Healthcare is a high-cost venture due to skill, facility, equipment and materials cost. Therefore, provision of healthcare is not an ordinary common day venture. In Kenya, Medicare is provided by broadly three categories of institutions – public hospitals fully funded by the Government, private hospitals for profit or mission hospitals funded by faith-based organizations. A number of variations of these may also be found. Health provision in Kenyan public sector cannot meet demand in both quality and timely delivery leaving a lacuna that is filled by both private and mission hospitals. The Kenyan Government is implementing a universal healthcare programmer that hopes to provide quality and affordable healthcare for all citizens through insurance. This is an ambitious plan which calls for massive resources especially financial and human. In the past, post-colonial Kenya, mission hospitals were fully supported by foreign donors especially from Europe but the support has continuously declined over the years. The hospitals have resulted to cost sharing with clients (patients) for services to remain afloat. This has led to the mission hospitals designing various strategies for survival to remain competitive and offer quality services. However, the quality of the service depends on how well the particular hospital or chain of them manages their finances. Meru County of Kenya has eight mission hospitals. To establish the role played by prudent financial management on the quality-of-service delivery in these hospitals, a survey of all the eight mission hospitals in the county was carried out in mid- 2021. A descriptive research design was used. The theories that underpinned this study were resource-based view of the firm and contingency theory. Primary data was collected from the respondents within the hospitals and their neighborhoods while secondary data was derived from repositories. Structured questionnaires targeting key relevant respondents were used. The target population comprised stakeholders from both within and outside the hospitals. Those from within included the Chief Executive Officers (CEOs), finance, customer care, quality assurance managers and from outside they were suppliers, patients and neighbors. A pilot study was conducted at Wamba hospital in Isiolo County to establish the validity and reliability of the research instruments. Drop and pick method was used to deliver questionnaires to one person in each category of respondents among hospital staff. Data was analyzed using SPSS version 23 and interpreted using descriptive statistics. The study concluded that financial capability of a hospital significantly affected quality service delivery (R= 0.537, F=10.72, P=0.00). The study concluded that prudent financial management was not only critical for success in delivery of quality service in hospitals but a necessary requirement if the hospitals were to sustain and grow their portfolios. It was recommended that such study be conducted on public and private hospitals and the actual level of critical finances be established.
|Keywords: Financial management, Financial Capability, Quality service delivery, healthcare.|