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      Influence of Participative Leadership Style on Public Health Service Delivery in County Governments in the Western Kenya Region

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      African Journal of Empirical Research
      AJER Publishing

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          Abstract

          Poor health service delivery has been linked to the devolution of health services, with some health workers walking off the job due to inadequate pay and unsafe working conditions. This research aimed at establishing the influence of participative leadership style on public health service delivery by county governments in the Western Kenya region. Taking a positivist approach, the study was anchored on participative leadership theory. Descriptive survey and causal-comparative research designs were adopted with a target population of 966 personnel consisting of the CECMs, Chief Officers, Directors, and County Nursing Officer for Health, Medical Superintendents, Hospital Administrator, Human Resource Officer, Head of Pharmacy, Head of Nursing, Health Records Information Officer, Head of Laboratory, Head of Clinical Services and number of patients admitted, treated and discharged drawn from all four counties of Bungoma, Busia, Kakamega, and Vihiga. Primary data was collected using both structured questionnaires and interview schedules. Qualitative data was analysed by content analysis while quantitative data was analysed using both descriptive and inferential statistics. The SPSS Software version 26 was used for statistical analysis which was both descriptive whereby frequencies, percentages, means, and standard deviation were clearly shown in the form of both tables, models and charts. The hypothesis tested for significance of the study at 5% significance level. From the results, the beta value for participative leadership from the regression model was 0.777 at p<0.05. Participative leadership explains 60.4% (R2 =0.604) of the variance in public health service delivery. Therefore, the hypothesis was rejected. The study recommends establishing transparent and straightforward policies and procedures for managing human resources, which are essential for promoting productivity, equity, and workplace peace. In order to improve service delivery, the report suggests that county governments implement methods to promote collaborative decision-making. Consultation is a necessary part of the decision making process. In this regard, as many of the perspectives of workers who are directly affected by the decision as are feasible should be considered.

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          Health Care Spending in the United States and Other High-Income Countries

          Health care spending in the United States is a major concern and is higher than in other high-income countries, but there is little evidence that efforts to reform US health care delivery have had a meaningful influence on controlling health care spending and costs.
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            From transactional to transformational leadership: Learning to share the vision

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              Ten challenges in improving quality in healthcare: lessons from the Health Foundation's programme evaluations and relevant literature

              Background Formal evaluations of programmes are an important source of learning about the challenges faced in improving quality in healthcare and how they can be addressed. The authors aimed to integrate lessons from evaluations of the Health Foundation's improvement programmes with relevant literature. Methods The authors analysed evaluation reports relating to five Health Foundation improvement programmes using a form of ‘best fit’ synthesis, where a pre-existing framework was used for initial coding and then updated in response to the emerging analysis. A rapid narrative review of relevant literature was also undertaken. Results The authors identified ten key challenges: convincing people that there is a problem that is relevant to them; convincing them that the solution chosen is the right one; getting data collection and monitoring systems right; excess ambitions and ‘projectness’; organisational cultures, capacities and contexts; tribalism and lack of staff engagement; leadership; incentivising participation and ‘hard edges’; securing sustainability; and risk of unintended consequences. The authors identified a range of tactics that may be used to respond to these challenges. Discussion Securing improvement may be hard and slow and faces many challenges. Formal evaluations assist in recognising the nature of these challenges and help in addressing them.
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                Author and article information

                Journal
                African Journal of Empirical Research
                AJERNET
                AJER Publishing
                2709-2607
                January 04 2023
                April 11 2023
                : 4
                : 1
                : 116-132
                Article
                10.51867/ajernet4.1.10
                4dbf0045-0a7d-45b5-a15e-c94ef41f635b
                © 2023

                https://creativecommons.org/licenses/by-nc/4.0

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