ABSTRACT
Kenya’s health sector is faced by inefficiencies and ineffectiveness that deters the achievement of its citizens goals of universal health, faireness, cost effectiveness, acceptance and sustainable development. Kenya’s Vision 2030 outlines provision of healthcare as key to improving the quality of life for all Kenyans while public hospitals guarantee improved citizens’ wellbeing. Universal health coverage is one of the pillars in the Big Four Agenda to be achieved by the Government of Kenya by the year 2022. The Ministry of Health has underlined Information Technology Integration as one of its reform strategies to ensure public health institutions perform better. Despite the increasing demand and need for healthcare, performance of public hospitals has been crippling. Therefore, this study investigated the effect of information technology integration on performance of selected public hospitals in Kenya. The specific objectives were to: establish the effect of human- information technology integration on performance of selected public hospitals; determine the effect of organizational information technology integration on performance of selected public hospitals; analyze the effect of information technology infrastructure integration on performance of public hospitals; analyze the moderating effect of organizational characteristics on the relationship between information technological integration and performance of selected public hospitals; analyze the mediating effect of user perception on the relationship between information technological integration and performance of selected public hospitals in Kenya. This study was anchored on Technology-Organization- Environment Model, Technology Acceptance Model, Diffusion of Innovations Theory as well as Dynamic Capabilities Theory. The study was guided by positivism research. An explanatory and cross-sectional survey research design were utilized. The target population of the study included ninety-eight, public hospitals in Kenya which have integrated managed equipment services, comprising ninety-four from the forty-seven counties and four national referral hospitals. A sample size of 294 respondents was drawn using proportionate stratified random sampling. The study used primary data collected using self-administered structured questionnaire. To analyze the features of the surveyed public hospitals and the respondents, descriptive statistics were used. Multiple regression analysis was carried out to determine the effect of information technology integration, organizational characteristics and user perception on performance. Results from the study showed that integration of human-information technology, organizational information technology integration and infrastructure flexibility had a significant positive impact on the performance of public hospitals in Kenya. The study further found that the characteristics of the organization and the perception of the users respectively moderated and mediated the relationship between the integration of information technology and the performance of public hospitals in Kenya. The study concluded that the integration of information technology in public hospitals plays an important role in increasing hospital efficiency, relevance, effectiveness and financial viability. The study recommends enhanced use of integrated information technology by public hospitals in Kenya for improved performance hence better service delivery.
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CHAPTER ONE INTRODUCTION
                       Background of the Study
Public institutions in developing nations are characterized by poor performance, among other organizational challenges (Munduga, 2014). A focus on performance issues in public organizations remains a topic of current policy and reforms in most governments around the world. In particular, government reforms seek to improve organizational performance in both developed and developing countries (De Waal & Tan Akaraborworn, 2013). To resolve this, governments have increased investments in Information Technology (IT).
Hospitals play a significant role in a country’s social and economic vibrancy across various regions. Healthcare is a crucial part of the growth and management of any economy. Improved health results in improved productivity, increased educational performance, improved quality of life, continued investment and savings, lower healthcare costs and debt expenditure (Kaseje, 2006). Public sector organizations’ performance has been and remains under intense and close public scrutiny (Aluvanze, Hudson & Senaji, Thomas, 2017). Likewise, citizens are increasingly demanding public institutions that are more efficient and performance – oriented.
With the continuing digital revolution ushered by the Internet, institutions are moving towards IT Integration (ITI) in order to reduce their operating costs, increase productivity and performance, and respond quickly to the needs of their customers and other partner organizations (Jardim-Goncalves, Popplewell & Grilo, 2012; Soto-Acosta, Popa & Palacios-Marqués, 2016).
