MBA-HCM Theses and Dissertations (2020)

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    Knowledge, Attitude and Practices regarding task shifting of eye care services in Kenya
    (Strathmore University, 2020-12) Ollando, Ernest Agola
    Task shifting is a practice whereby tasks are delegated, where possible, to staff with shorter trainings and fewer qualifications, often to address human resource shortages. Kenya, like many Sub Sahara African countries, has a shortage of Ophthalmologists, with only about 132 serving a population of almost 48 million. The main objective of this study was to establish the knowledge, attitude and practices of Ophthalmologists and Non-physician Cataract Surgeons (NPCS) in Kenya, regarding task shifting of eye care services. Four subsidiary objectives that guided this study were: to determine the knowledge of Ophthalmologists and NPCS in Kenya regarding task shifting of eye care services, to determine the attitude of Ophthalmologists and NPCS in Kenya regarding task shifting of eye care services, to determine the practices of Ophthalmologists and NPCS in Kenya regarding task shifting of eye care services and to determine the role of task shifting, its merits, demerits, critical success factors as well as duration over which task shifting should be utilized in Kenya. The Theoretical framework used in this study was Principal-Agent Theory. For this study a mixed-methods approach was employed, involving a survey and key informant interviews. A pre-tested, structured online questionnaire was sent to 267 prospective participants via email or whatsApp. A response rate of 60.3% was achieved, with 161 out of 267 prospective participants returning the questionnaire. A total of 32 key informant interviews were conducted via telephone with purposively selected participants from both groups. Quantitative data was analyzed using SPSS version 23 to generate proportions, frequencies, and percentages. Results were presented in form of graphs, pie-charts and tables. For the qualitative study, interview recordings were transcribed into a text program following which the qualitative data was analyzed using Nvivo version 11. The findings of the quantitative and qualitative methods were integrated during the interpretation/ discussion phase of the study, following a sequential explanatory model. Majority of the participants understood what task shifting is; deemed it as necessary and affirmed that they delegated some tasks to other cadres in the course of their day to day Ophthalmic practice. Medical task shifting was acceptable to majority of the respondents, as was surgical task shifting. There was concern about Optical task shifting owing mainly to erroneous prescription of spectacles by some NPCS. Majority of the workplaces did not have Policies and Guidelines to inform task shifting practices. Almost all the key informants agreed that task shifting had a role in Ophthalmology in Kenya. A number of benefits were cited by participants, including cost savings, improved access to care, equitable distribution of eye health workers, improved quality of care amongst others. Several challenges were also mentioned by participants, including: unregulated task shifting environment, unclear scope of practice, lack of a legal framework for task shifting amongst others. Participants in this study knew about task shifting, deemed it as necessary and thought it should be practiced for as long as there’s a shortage of Ophthalmologists in the country. Several benefits were brought forth by the participants, but there were also several significant challenges that ought to be addressed by the decision makers, going forward. Attention should be paid to training and deploying enough Ophthalmologists to cover the whole republic in the long term.
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    Health worker perceptions towards safe-care accreditation and quality of care: a case of the Ruaraka Uhai Neema Hospital, Nairobi, Kenya
    (Strathmore University, 2020-06) Kamau, Paul Ndungu
    Hospital accreditation is a process where hospitals meet the highest peer-agreed standards. Staff buy-in is a key factor for the success of the accreditation. This study aimed to explore perceptions of healthcare workers towards SafeCare accreditation and quality of care and to propose a model for effective inclusion of healthcare workers in the accreditation process.
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    Influence of organizational climate on employee performance at public hospitals in Makueni County, Kenya
    (Strathmore University, 2020) Khalid, Shyreen
    Human resource for health is considered essential to the production, delivery and provision of quality health care services. However, Kenya, like other countries in Africa, faces a challenge with its healthcare human resource as most of its trained employees are moving to developed countries. The general objective of this study was to establish the influence of organizational climate on employee performance at public hospitals in Makueni County, Kenya. Specifically, the study sought to assess effects of working conditions, interpersonal relationships and incentives on performance of employees. Accordingly, a descriptive survey research design was adopted. The target population was the 837 employees at public hospitals in Makueni County. The study selected a sample of 270 respondents using stratified random sampling method. Data collection was via a semi-structured questionnaire. Descriptive statistics were used to analyze quantitative data and the findings presented in tables and figures. Qualitative data analsysis was by use of content analysis. The study also determined the direction and strength of the relationship between independent and dependent variables through correlation and regression analysis. The study found that working conditions, interpersonal relationships, and incentives had a positive and statistically critical impact on employee performance. The study also found that changes in working conditions, interpersonal relations and incentives affects middle level management more, followed by members of staff and lastly top-level management. Additionally, hierarchical level was established to have a positive moderating influence on the relationship between organizational climate and employee performance at public hospitals. Based on the above findings, our recommendations are that the administration of public hospitals should ensure that they provide employees with conducive working environment. This includes ensuring that they have enough working space and amenities. Hospitals may also consider regularizing activities that can help improve interpersonal relations such as team building. This study had several limitations: the study focused on a single county; the study focused on only three aspects of organizational climate; not all factors affecting performance were explored. Further studies that address these limitations are therefore recommended.
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    A framework for robotic process automation (RPA) for the first-line resolution of customer queries: a case study of Safaricom
    (Strathmore University, 2020) Muriithi, Kelvin Wachira
    Customer support is important for every institution, be it profit-making or non-profit making. Better services save money, complains and time. Big companies with millions of customers, strives to provide better customer care support due to the high number of customers. They have always found themselves not achieving the kind of support that their customers want. The biggest challenge that such companies with large customer base face in their customer care department, is having enough workforce to respond to customer queries. Keeping on employing new staff does not solve the problem fully as there is a limit to how many employees the company can be able to sustain beyond which the company running cost will exceed the returns. Therefore, this research proposed to solve this challenge by developing a framework for Robotic Process Automation that would enable the creation of a digital workforce to augment the human workforce available for first-line customer query resolution. The main literature that was supporting this research was previous frameworks on RPA. These frameworks do not address customer query resolution, are specific to a given technology and hence not adaptable to different technology. The existing frameworks are also specific to processes and companies which makes them inapplicable to changes in process or company. This research developed a framework that guides the implementation of RPA for customer care department. The framework is not specific to any technology and hence can be used across the company. Test processes used was customer query response process in Safaricom which is a Telcom company in Kenya. The test results gotten from the test bots was 75% success rate with 100% accuracy rate on the pulled response. There are failures that happened with accounted for 9% due to third-party applications. With this framework and the resultant prototype bot, time taken to given customers their feedback in each shift was reduced from 2 hours to about three minutes. This research enabled streamlining and standardization of the customer care processes as well as automating the reporting part of the customer care process. The results indicated that the value is not only in the bot. This study gives organizations insight on how to successfully implement RPA and what factors to beware of to avoid failure.
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    Assessing employee retention strategies at AAR Healthcare Limited Kenya
    (Strathmore University, 2020) Khalibwa, Irene
    Organizations are facing the hurdles of retaining their most valued employees with the current cutting competition among companies to have team of high performing workers. Studies have shown that the healthcare industry has very high staff turn-over with doctors who are key drivers of the healthcare industry having an average of 3 years’ length of stay in one particular employer. Some health facilities such as AAR however buck this trend. AAR Healthcare is one of the Tier 1 leading private healthcare services provider in Kenya with comparably high employee retention rate. This study assesses various employee retention strategies applied by AAR Healthcare Kenya. The study specifically investigates how work environment, training and development, recognition and compensation and leadership and management of employee strategies have been applied at AAR Healthcare Kenya and their effectiveness. The research applied a quantitative cross-sectional design approach. A multi-stage convenient sampling technique was adopted to select research respondents from the 21 branches and the headquarters with a total population of 343 employees. The findings of study showed that there was a relationship between employee retention and work environment safety, organization culture, leadership management style and reward recognition, all at 10% significance level. Conversely, the number of trainings did not have a statistically significant relationship with employee retention. Additionally, the study found that the employees were happy with the strategies employed to provide a good working environment and also with the organization culture. However, when it came to the reward and recognition and the leadership and management styles, there was room for improvement based on the responses. The study recommends that healthcare practitioners look into their strategies on these key areas the study focused on and especially, in reward and recognition and leadership and management style as this will further increase their chances of retaining their work force. Additionally, this study serves as a benchmark for policy makers on what can be done to help formulate strategies based on retention and offer guidance on what to do to increase employee retention for organizations .