Download The Influence of Privatization on Service Delivery

The Influence of Privatization on Service Delivery in the Public Health Sector in Kenya: A
Study of Kenyatta National Hospital
Over the past years, governments have gradually turned to "privatization" or commercialization
of health care to boost equality and improve service delivery. KNH, originally a native civil
hospital, was built in 1901 with a capacity of bed capacity of 45 and later renamed the King
George VI Hospital in 1951. The hospital provided medical care to white settlers in the colonial
Kenya but after independence in 1963 it was renamed Kenyatta National Hospital becoming a
national referral and teaching hospital. In the 80s, it was turned into a semi-autonomous
institution as the government sought to improve efficiency in the referral hospital. Since then, its
bed capacity has increased over the years to currently stand at 1,800. Before commercialization,
challenges that affected quality health care at KNH were overcrowding, insufficient supply of
affordable, quality health care, shortage of equipment, drugs and lack of committed well trained
staff These were attributed to funding constraints, management weaknesses and the absence of
good controls and systems. The main objectives for the study were to evaluate the influence of
the commercialization on the public health care service delivery at KNH. The research design
used was a case study. The method was found suitable because it gives an in-depth account of
how the commercialization process has changed operations at KNH. Primary data was collected
through interviews with patients, employees of the hospital, stakeholders in the public health
sector such as the MOH and NHIF. Secondary data was also used to show if services have
improved in the hospital. The research found that after "privatization", the hospital has made
strides in improving service delivery. Infrastructure has improved following the increased
funding allocation and sourcing of funds from donors. However, the biggest referral hospital in
the country is still grappling with limited funds as the steady increase in patients seeking
treatment has not matched with the growth of physical facilities like wards. Although granted
autonomy, KNH relies heavily on the government for funds and there is a lot of political
interference since the executive and political functions are not separated.