Purpose: This study assessed how organizational culture influences health system responsiveness in diabetic and hypertensive clinics in tier three hospitals in Kenya, focusing on patients’ non-clinical expectations such as dignity, prompt attention, communication, and respect. Methodology: A cross-sectional survey was conducted among 308 respondents attending chronic care clinics in Kimilili, Uasin Gishu, and Gatundu tier three hospitals. Data were collected using a structured questionnaire measuring organizational culture and responsiveness domains. Responses were rated on five-point Likert scales. Responsiveness scores were summed and dichotomized using the demarcation threshold formula into favourable and unfavourable categories. Data were analyzed using SPSS version 27 at a 95% confidence level using descriptive statistics, one-way ANOVA, and Chi-square tests. Findings: Overall, 61.7% of respondents reported unfavourable responsiveness. Mean scores for organizational culture indicators ranged from 2.98 to 3.19. Organizational culture did not significantly differ across the three hospitals (p=0.590). However, overall organizational culture (p=0.001), respectful language (p=0.001), cultural sensitivity (p=0.029), adherence to processes (p=0.026), convenience of care steps (p=0.028), and respect for client opinions (p=0.004) were significantly associated with responsiveness, while pay arrangements and client interest focus were not. Unique Contribution to Theory, Practice and Policy: The study demonstrates that relational aspects of organizational culture significantly influence health system responsiveness in chronic care clinics. Strengthening respectful communication, cultural competence, participatory leadership, and structured patient feedback systems can enhance responsiveness and support patient-centered care in Kenyan tier three hospitals.
Hillary et al. (Mon,) studied this question.