Monitoring and evaluation, Behavioral determinants and performance of maternal Healthprogrammesin Kenyan County Governments

Abstract

Inefficiency in1 monitoring and evaluation1 which is1 one1 of the1 key stages1 in1 management1 has1 contributed significantly to operations1 failure1 in1 government1 institutions1 and programmes. Despite1 the1 Kenya government’s1 effort1 to promote1 county maternal1 health programmes1 through legal1 frameworks1 such as1 the1 county integrated monitoring and evaluation1 practices1 tool,and while1 there1 is1 empirical1 evidence1 that1 monitoring and evaluation1 practices1 contributes1 to enhanced performance, actual1 performance1 of county health sector across1 Kenya remains1 poor. The1 purpose1 of the1 study was1 to establish the1 influence1 of behavioral1 determinants1 on1 the1 relationship between1 monitoring and evaluation1 practices1 and performance1 of maternal1 health programmes1 in1 Kenyan1 County Governments. The1 study used the1 pragmatism paradigm. The1 study adopted a mixed research design. The1 study targeted 388 hospitals1 from nine1 counties. The1 unit1 of analysis1 was1 1165 respondents, including employees1 from level1 4 and 5 hospitals1 (Nurses, Clinical1 officers, Medical1 officers, Nutritionists, Pharmacists, Health Records, Laboratory technologists, Counsellors, Medical1 superintendents, Hospital1 administrators, Nursing services1 managers1 and maternal1 child health (MCH) in1 charge), County Health Management1 Team members, County governors/deputy governor, County Executive1 Members1 for Health, Health County Chief Officers, County delivery unit1 members. The1 research instruments1 that1 were1 used for data collection1 are: a self-administered structured questionnaire1 andinterview guides. Descriptive1 and inferential1 data analysis1 techniques1 were1 used in1 this1 study. The1 study found that1 there1 was1 a strong correlation1 between1 the1 performance1 of county maternal1 health programmes1 and behavioral1 determinants1 (r=0.821, p=0.001<0.05). The1 research found that1 after introduction1 of behavioural1 determinants1 in1 model1 3, there1 was1 a rise1 in1 the1 R square1 by 0.066. This1 showed that1 there1 is1 a significant1 influence1 of behavioural1 determinants1 on1 the1 relationship between1 monitoring and evaluation1 practices1 and performance1 of maternal1 health programmes1 in1 Kenyan1 county governments1 as1 isdescribed by the1 6.6% variation. The1 study therefore1 concluded that1 there1 was1 a significant1 influence1 of behavioural1 determinants1 on1 the1 relationship between1 1PhD Project Planning and Management, University of Nairobi, Email Address -gatimuj@gmail.com2University of Nairobi3University of NairobiDBA Africa Management Review http://uonjournals.uonbi.ac.ke/ojs/index.php/DBAAMRISSN -2224-2023May 2022 Vol 12 No 2 Pgs 116-141117| All rights reservedDepartment of Business AdministrationFaculty of Business and Management Sciences University of Nairobi DBA Africa Management Reviewmonitoring and evaluation1 practices1 and performance1 of maternal1 health programmes1 in1 Kenyan1 county governments. The1 research concluded thatmonitoringand evaluation1 system is1 not1 a political1 strategy to audit1 employee1 performance. Further, the1 study concluded that1 excessively high workloads1 cause1 mental1 and physical1 stress, resulting to poor performance1 and reduced productivity among staff. The1 research recommended that1 the1 Ministry of Health should review staffing needs1 in1 County Maternal1 Health Programmes1 to help them cope1 with the1 increasing numbers1 of people1 seeking skilled delivery services. The1 study also recommends1 that1 more1formal1 and refresher trainings1 should be1 included in1 the1 programs1 to help professionals1 develop their skills.