The Influence of Privatization on Service Delivery in the Public Health Sector in Kenya: A Study of Kenyatta National Hospital

Abstract

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.