Assessment of Strategic Management Practices Influencing Service Delivery in Kenya’s Level Five Public Hospitals

This study assessed the influence of strategic management practices on service delivery across 16 gazetted Level Five public hospitals in Kenya. Operating within the sub-national healthcare referral system, these institutions encounter persistent service delivery challenges despite adopting strategic management frameworks. Grounded in the Resource-Based View and Strategic Control theories alongside an integrated patient-centred healthcare delivery model, the research employed a quantitative cross-sectional descriptive survey design. Data were gathered from a target population of 160 heads of departments, utilising a sample size of 114 respondents determined via Yamane's formula. Structured questionnaires with Likert-scale items were used for data collection and subsequently analysed using SPSS version 27 through descriptive statistics, Pearson correlation, and simple linear regression models. Descriptive findings showed that strategy formulation had a mean of 4.21 ( ), strategy implementation had a mean of 3.68 ( ), strategy evaluation recorded a mean of 3.75 ( ), and service delivery recorded a mean of 4.29 ( ). Pearson’s correlation analysis showed positive associations between service delivery and strategy formulation ( ), strategy implementation ( ), and strategy evaluation ( ). The regression coefficients indicated that strategy formulation, implementation, and evaluation accounted for 20.5%, 8.3%, and 3.5% of the variance in service delivery, respectively. The study contributes theoretically by advancing the application of the Resource-Based View and Strategic Control frameworks to public health administration. The study recommends that the Ministry of Health and respective County Governments institutionalise evidence-based strategy formulation frameworks, establish robust execution structures, and embed routine monitoring and evaluation practices across all Level Five public hospitals in Kenya