The Influence of Decentralized Human Resource Functions on Hospital ServiceDelivery: A Case Study of Nandi County, Kenya

Abstract

This study investigated the influence of decentralized human resource functions on hospital service delivery in Nandi County, Kenya, addressing the critical need to understand how structural shifts in healthcare administration affect service outcomes in developing countries. An ex-post facto research design was employed targeting 829 healthcare workers from five sub-county hospitals and one county referral hospital in Nandi County, along with 501 in-patients. Using Yamane's 1967 formula with stratified and simple random sampling techniques, 267 respondents were selected. Data collection utilized structured questionnaires with descriptive and inferential statistical analysis. Decentralization of human resource functions demonstrated significant positive influence on hospital service delivery (β=0.184; p<0.05). The study revealed strong agreement that decentralization improved recruitment and selection of trained staff (M=4.55, SD=0.669), effective dispute management between health workers (M=4.53, SD=0.831), and created healthy work environments (M=4.51, SD=0.662). The regression analysis showed R²=0.423, indicating that decentralized HR functions explained 42.3% of variance in hospital service delivery. The F-statistic (F=31.354; p<0.05) confirmed statistical significance of the relationship. The study concludes that decentralization of human resource functions significantly enhances hospital service delivery in Nandi County, with a grand mean of 4.028 indicating overall positive impact. For every one-unit increase in decentralization of HR functions, hospital service delivery improved by 0.184 units. The findings support the hypothesis that decentralized HR management leads to better healthcare outcomes through improved staff recruitment, dispute resolution, and working conditions, providing empirical evidence for continued healthcare decentralization policies in Kenya.