Abstract:
Kenya endeavors to be a regional center of excellence in healthcare, and to achieve this, various strategies have been crafted and goals put in place. Kenya has globally committed to the sustainable development goals, regionally, the African Union Agenda 2063 and the Ouagadougou convention and locally the vision 2030 and Big 4 agenda. All these initiatives have universal healthcare goals and targets. Kenya lags in the achievement of these goals and targets and envisions collaborations in healthcare as being critical to the attainment of the universal health goals. The general objective was therefore to examine the antecedents of strategic collaboration and competitive advantage among universities and teaching hospitals in Kenya. The specific objectives of the study entailed; To determine the influence of strategic leadership on strategic collaboration competitive advantage among universities and teaching hospitals in Kenya; To establish the influence of the alliance structural design on strategic collaboration competitive advantage among universities and teaching hospitals in Kenya; To determine the influence of alliance management capability on strategic collaboration competitive advantage among universities and teaching hospitals in Kenya. Others were to establish the influence of a triple helix relationship on strategic collaboration competitive advantage among universities and teaching hospitals in Kenya; To establish the joint influence of the antecedents on strategic collaboration competitive advantage among universities and teaching hospitals in Kenya, and To investigate the moderating influence of entrepreneurial orientation on strategic collaboration antecedents and competitive advantage among universities and teaching hospitals in Kenya.
This study adopted a positivist philosophy and a descriptive cross sectional research design. The study population comprised of 10 universities and 10 teaching hospitals as approved by the Kenya Medical Practitioners and Dentists Council, respectively. The unit of analysis was at the institutional level. The census technique was deployed to make use of all the elements in the population with primary data by use of a structured questionnaire, while secondary data was collected using a document review guide. The researcher sought permission from USIU-A, NACOSTI and the ethical review committees of all universities and teaching hospitals in Kenya and a pilot study conducted to test the reliability and suitability of the data collection instruments. Reliability was tested using Cronbach alpha and all the antecedents returned a result above 0.7 which was the threshold of acceptance. Average Variance Extracted (AVE) was used to assess construct validity and all the variables returned an AVE of above 0.5 hence an indication that the threshold for construct validity was satisfied. Frequencies, measures of central tendency and dispersal were used in descriptive statistical analysis while correlations, cross tabulations and ordinal logistic regression were used for inferential statistical analysis. Ordinal logistic regression helped determine the significance of relationships between the predictor and outcome variables. Statistical analysis was carried out through the statistical program for social scientists.
The study established that strategic leadership was a significant predictor of financial outcomes in universities (β = 1.524, p < 0.05), teaching hospitals (β = 1.7, p < 0.05) and combined (β = 1.556, p < 0.05). Strategic leadership was also a significant predictor of learning and growth in universities (β = 0.981, p < 0.05), teaching hospitals (β = 1.186, p < 0.05) and combined (β = 1.037, p < 0.05) therefore rejecting the first null hypothesis of the study. Alliance structural design was a significant predictor of the financial outcome of universities (β = 1.513, p < 0.05), teaching hospitals (β = 1.518, p < 0.05) and in combination (β = 1.520, p < 0.05). Alliance structural design was also a significant predictor of learning and growth in universities (β = 1.594, p < 0.05), teaching hospitals (β = 1.231, p < 0.05) and combined (β = 1.371, p < 0.05) therefore also rejecting the second null hypothesis of the study. Alliance management capability was also a significant predictor of the financial outcome of universities (β = 1.619, p < 0.05), teaching hospitals (β = 1.663, p < 0.05) and combined (β = 1.654, p < 0.05). Alliance management capability was also a significant predictor of learning and growth in universities (β = 1.577, p < 0.05), teaching hospitals (β = 2.631, p < 0.05) and combined (β = 2.049, p < 0.05) necessitating the rejection of the third null hypothesis.
Triple helix relationship was a significant predictor of the financial outcome of universities (β = 0.921, p < 0.05), teaching hospitals (β = 1.626, p < 0.05) and combined (β = 1.244, p < 0.05). triple helix relationship was also a significant predictor of learning and growth in universities (β = 0.781, p < 0.05), teaching hospitals (β = 1.062, p < 0.05) and combined (β = 0.941, p < 0.05) therefore also necessitating the rejection of the fourth null hypothesis. The fifth objective of the study tested on the overall, the antecedents of collaborative competitive advantage. The study established that the antecedents in combination, were significant for competitive advantage except for the influence of strategic leadership, the influence of the triple helix on learning and growth.
On the moderation relationships for financial outcomes, strategic leadership (β = 0.283, p = 0.238), alliance structural design (β = -0.125, p = 0.633), alliance management capability (β = - 0.196, p = 0.462) and triple helix (β = -0.48, p = 0.823), indicated that entrepreneurial orientation did not have a significant moderating effect on the relationship between strategic collaboration antecedents and financial outcome. For learning and growth, strategic leadership (β = -0.124, p = 0.607), alliance structural design (β = -0.061, p = 0.816), alliance management capability (β = - 0.408, p = 0.146) and triple helix (β = -0.187, p = 0.383), indicating that entrepreneurial orientation did not have a significant moderating effect on the relationship between strategic collaboration antecedents and learning and growth. This study contributed to the body of knowledge by investigating the antecedents of strategic collaboration and their significance on competitive advantage.
The study concluded that strategic leadership explained 42.2% of the financial outcomes and 41.92% of the learning and growth that the universities derived from strategic collaborations. Strategic leadership explained 42.1% of the financial outcome and 36.5% of learning and growth that teaching hospitals derived from strategic collaborations. Alliance structural design explained 41.1% of the financial outcome and 43.1% of the learning and growth that universities derived from strategic collaborations. Alliance structural design explained 44.8% of the financial outcome and 36.9% of the learning and growth that teaching hospitals derived from strategic collaborations. Alliance management capability explained 42.9% of the financial outcome and 59.1% of the learning and growth that universities derived from strategic collaborations. Alliance management capability explained 77.8% of the financial outcome and 69.3% of the learning and growth that teaching hospitals derived from strategic collaborations. Triple helix relationship explained 22.4% of the financial outcome and 36.2% of the learning and growth that universities derived from strategic collaborations. Triple helix relationship explained 47.5% of the financial outcome and 28.7 of the learning and growth derived from strategic collaborations. Strategic collaboration antecedents in collaboration explained 62.2% of the financial outcome and 63.1% of learning and growth that the universities and teaching hospitals derived from strategic collaborations. Entrepreneurial orientation did not have a significant moderating effect on the relationship between strategic collaboration antecedents and both financial outcome and learning and growth, hence by extension, competitive advantage.
The study recommends that boundary conditions need to be established on the nexus between strategic leadership and alliance management capability and resultant overlaps if any. On the structural design, transmission mechanisms in the identification and the resolution of the collaboration bottlenecks, needs to be probed further. The effectiveness of alliance management capability needs to be tested in the absence of strategic leadership or in the presence of another leadership style to properly explicate the nexus between strategic leadership and alliance management capability. The shortcomings of triple helix relationship influence on learning and growth need to be probed further through collaboration studies in other contexts. The level of entrepreneurial orientation may have been insignificant reflecting the need to exercise more autonomy through research, more proactiveness and more competitive aggression within the limited bounds of the study. These aspects need further examination to establish the necessary and sufficient conditions for entrepreneurial orientation.