Procurement Practices on Service Delivery in Level 5 County Referral Hospitals in Kenya: The Moderating Role of Leadership Styles

Authors

  • Mbuba Susan Kambura Kenya Methodist University
  • Peter Kihara Kenya Methodist University
  • Kenneth Mugambi Kenya Methodist University

DOI:

https://doi.org/10.70619/vol6iss4pp1-16-795

Keywords:

Financial management, Procurement practices, service delivery, Leadership style, level 5 County Referral Hospitals

Abstract

Service delivery in Kenya’s county referral hospitals remains inconsistent despite ongoing reforms aimed at strengthening fiscal accountability and budgetary discipline. Procurement practices have increasingly emerged as a key determinant of service delivery, influencing the availability of medical supplies, efficiency of resource utilization, and responsiveness to patient needs. This study examined the effect of procurement practices on service delivery in Level 5 county referral hospitals in Kenya, while assessing the moderating role of leadership styles. The study was anchored on the Resource-Based View and Transformational Leadership theories and adopted a descriptive quantitative research design. The target population comprised all 47 county referral hospitals, stratified across Kenya’s eight administrative regions. A sample of 148 respondents drawn from hospital management teams was selected using stratified random sampling. Data were collected through structured questionnaires, which were subjected to pilot testing to ensure validity and reliability. Data analysis was conducted using descriptive statistics, Pearson correlation, and multiple regression, alongside moderation analysis. The findings indicate that procurement practices exert a strong, statistically significant influence on service delivery. However, leadership styles did not demonstrate a significant moderating influence on this relationship. The study concluded that strengthening procurement practices is critical in enhancing service delivery in county referral hospitals.

Author Biography

Mbuba Susan Kambura, Kenya Methodist University

Business School

References

Alharahsheh, H. H., & Pius, A. (2020). A review of key paradigms: Positivism vs interpretivism. Global Academic Journal of Humanities and Social Sciences, 2(3), 39–43.

Ali, M. (2024). Research philosophy and quantitative methods in social sciences. Journal of Research Methodology, 12(1), 15–28.

Amemba, C. S., & Nyambega, E. (2022). Procurement planning and service delivery in public healthcare institutions in Kenya. International Journal of Supply Chain Management, 11(2), 98–110.

Barasa, E., Kazungu, J., Orangi, S., & Kabia, E. (2021). Examining health system responsiveness in Kenya. International Journal for Equity in Health, 20(1), 1–14.

Bass, B. M., & Avolio, B. J. (2020). Multifactor Leadership Questionnaire Manual. Mind Garden.

Bass, B. M., & Riggio, R. E. (2021). Transformational leadership (3rd ed.). Routledge.

Brown, M. E., & Trevino, L. K. (2022). Ethical leadership: A review and future directions. The Leadership Quarterly, 33(1), 101–115.

Cooper, D. R., & Schindler, P. S. (2014). Business research methods (12th ed.). McGraw-Hill.

Creswell, J. W., & Creswell, J. D. (2018). Research design: Qualitative, quantitative, and mixed methods approaches (5th ed.). Sage Publications.

Field, A. (2020). Discovering statistics using IBM SPSS Statistics (5th ed.). Sage Publications.

Hair, J. F., Black, W. C., Babin, B. J., & Anderson, R. E. (2022). Multivariate data analysis (8th ed.). Cengage Learning.

Hayes, A. F. (2022). Introduction to mediation, moderation, and conditional process analysis (3rd ed.). Guilford Press.

Kamau, E. M., & Muli, D. M. (2023). Procurement compliance and healthcare service delivery in county referral hospitals in Kenya. Journal of Public Procurement and Health Systems Management, 7(1), 21–35.

Kariuki, M., & Gitonga, L. (2022). Leadership styles and workforce performance in public health institutions in Kenya. African Journal of Health Systems, 10(1), 55–70.

Kim, S., & Lee, H. (2022). Participatory leadership and organizational performance. Public Management Review, 24(3), 345–360.

Kotter, J. P. (2021). Leading change. Harvard Business Review Press.

Liden, R. C., Wayne, S. J., & Sparrowe, R. T. (2022). Servant leadership and team outcomes. Academy of Management Journal, 65(4), 1201–1225.

Mandala, S., Otieno, J., & Kibet, P. (2022). Factor analysis in social science research. Journal of Applied Statistics, 14(2), 78–90.

McPake, B., Hanson, K., & Mills, A. (2023). Health economics: An international perspective (4th ed.). Routledge.

Ministry of Health. (2024). Kenya health sector performance report 2023/2024. Government of Kenya.

Mugenda, O. M., & Mugenda, A. G. (2019). Research methods: Quantitative and qualitative approaches. ACTS Press.

Mutinda, L. K., & Mbatha, M. N. (2024). Enhancing procurement performance through digital systems in Kenya’s devolved health sector. African Journal of Procurement and Supply Chain Management, 9(2), 55–70.

Mwangi, T., & Gituro, W. (2023). Governance and procurement performance in public institutions. Journal of Public Administration, 11(1), 23–39.

Mwikali, S. N., & Ndiritu, M. W. (2020). Procurement challenges and service delivery in Kenya’s public health sector. International Journal of Procurement Management, 13(4), 389–405.

Ndiritu, S., Kibet, J., & Wanjiru, L. (2021). Budget transparency and service delivery in Kenya’s health sector. International Journal of Public Sector Management, 34(5), 522–538.

Obadha, M., Nyangena, E., & Wekesa, M. (2020). Procurement practices and healthcare service delivery in Kenya. International Journal of Supply Chain Management, 9(4), 155–165.

Odhiambo, R., & Onyango, D. (2024). Public procurement accountability and service delivery in devolved health systems. International Journal of Public Administration, 47(3), 210–225.

Omari, D., & Wanjala, G. (2022). Transactional leadership and organizational performance in public health institutions. Journal of Leadership and Governance, 6(2), 88–102.

Otieno, P., & Wambua, J. (2022). Procurement practices and service delivery in Kenyan public hospitals. International Journal of Supply Chain Management, 11(3), 145–160.

Ouma, S., Kimathi, L., & Wambua, J. (2023). Leadership and crisis response in Kenya’s healthcare system. BMC Health Services Research, 23(1), 1–12.

Rotich, G., & Wanyama, D. (2023). Procurement compliance and operational efficiency in county health facilities in Kenya. African Journal of Procurement and Logistics, 8(1), 45–60.

Scott, W. R. (2014). Institutions and organizations: Ideas, interests, and identities (4th ed.). Sage Publications.

Skogstad, A., Hetland, J., & Einarsen, S. (2021). The impact of laissez-faire leadership. Work & Stress, 35(2), 1–19.

Taherdoost, H. (2021). Sample size determination in research projects. International Journal of Economics and Management Systems, 6, 237–239.

Tavakol, M., & Dennick, R. (2021). Making sense of Cronbach’s alpha. International Journal of Medical Education, 2, 53–55.

Tsofa, B., Molyneux, S., Gilson, L., & Goodman, C. (2022). Decentralization and health system performance in Kenya. Health Policy and Planning, 37(3), 312–321.

Wachira, S., Njoroge, P., & Mutiso, F. (2023). Industrial actions and healthcare service disruptions in Kenya. BMC Health Services Research, 23(1), 1–12.

World Bank. (2020). Improving public procurement for better service delivery. World Bank Publications.

World Health Organization (WHO). (2019). Ethics in health research: Principles and guidelines.

Downloads

Published

2026-05-03

How to Cite

Kambura, M. S. ., Kihara, P. ., & Mugambi, K. . (2026). Procurement Practices on Service Delivery in Level 5 County Referral Hospitals in Kenya: The Moderating Role of Leadership Styles. Journal of Finance and Accounting, 6(4), 1–16. https://doi.org/10.70619/vol6iss4pp1-16-795

Issue

Section

Articles