Strategic Management and Organizational Performance: Findings from Health Institutions in Nairobi County

Abstract

The purpose of this study was to determine the effects of strategic management on organizational performance in health institutions in Nairobi County. The study had three research questions on what was the effect of strategic thinking, planning and strategy implementation on organizational performance of health institutions in Nairobi County. This study was descriptive and the study design was cross – sectional. The study was designed to capture utilization of strategic management in health institutions in Nairobi, representing a snapshot of one point in time. The study described and explained phenomena that observations reflected measure social reality or describe what was in use in health institutions in Nairobi. The independent variables were strategic thinking, strategic planning and strategy implementation, while the dependent variable was organizational performance. The study population was the management at health institutions that are Kenya Essential Package for Health (KEPH) level four, five and six, and are in Nairobi County. For this study, the sampling frame was the list of all health institutions that were KEPH level four or five or six, and in Nairobi County based on the Kenya Master Health Facility List (Ministry of Health, 2017). The health institution was the sampling unit. Census was used to enroll every health institution into this study since they are few, and the unit of analysis was the health institution. Primary data for this study was collected using a structured self-administered questionnaire, that captured both qualitative and quantitative data, administered to the study prospective participants after they had been recruited and enrolled. Stata 12 ® was the statistical software used to analyze the data from the study. Data was presented in charts and graphs. Of the health institutions surveyed, 23 (96%) carried out strategic thinking while 7 (29%) agreed that strategic thinking improves organizational performance. From the study, organizational performance was positively correlated to strategic thinking, but the strength of the relationship was weak since the value of the correlation coefficient was 0.0801. With regard to strategic planning, 15 (63%) of the health institutions surveyed carried out strategic planning, while only 6 (25%) agreed that it improved organizational performance. On the other hand, organizational performance was negatively correlated to strategic planning with the value of the correlation coefficient being – 0.4175. Of the health institutions surveyed, 10 (42%) carried out strategy implementation, while only 3 (12%) agreed that it improved organizational performance. Strategy implementation had a negative correlation with organizational performance among health institutions in Nairobi County with the value of the correlation coefficient being – 0.3164. The study concludes that strategic thinking has a weak positive relationship on organizational performance, while strategic planning and strategy implementation have a negative relationship on organizational performance among health institutions in Nairobi County. This study has raised the specter of there being other underlying factors that have a bearing on organizational performance among health institutions in Nairobi County. This study has provided evidence of the relationship between strategic management and organizational performance in health institutions. Going forward, much as the study found that the relationship between strategic thinking and organizational performance was positive, this will be best measured through a key informant interview that is open since a lot of details on strategic thinking are lost through closed ended questions in a questionnaire. In addition, much as the correlation between strategic planning and organizational performance was negative in this study, there is need to draw a distinction between public and private health facilities since the drive between the two sets are different. Finally, it is important to design a study that will make management of health institutions less sensitive about the information they offer. This is so since many, especially the privately-owned health institutions guarded the information they could share because it was competitive in nature.