MBA-HCM Theses and Dissertations (2016)

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    Costing of dental services in individually owned dental clinics in Nairobi County
    (Strathmore University, 2016) Ochieng, Eric Odhiambo
    Back ground: There is very limited relevant literature on costing of dental services globally and hardly any in the sub-Saharan Africa. In Kenya, there is no empirical data available to inform decision on appropriate pricing of dental services. This study thus aimed at generating information on costs and pricing determinants for dental services in order to inform policy on pricing of dental services in Kenya. Methodology This was mainly a costing study. Provider perspective was preferred. Two facilities were purposively sampled based on physical size. Facility A was the larger facility, and Facility B the smaller facility. A bottom-up approach to costing was adopted and cost components categorized into recurrent and capital costs. Results and conclusion The cost estimates for the dentals services for facility A and B respectively were: KSh.3,596 and KSh.4,095 for a root canal treatment, KSh.2,070 and KSh.1,874 for a dental filling, KShs.1,922 and KSh.1,888 for scaling, and KSh.1,625 and KSh.1,536 for a tooth extraction.. Comparisons between estimated costs of specific dental services and prices charged for the respective services at the facilities mostly revealed huge mark ups. This information on cost estimates is crucial if dental services are to be priced accurately to assure that dentists practice profitably and patients are charged fairly
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    An exploration of strategies adopted by pharmaceutical companies in Kenya to achieve sustainable competitive advantage
    (Strathmore University, 2016) Munene, Winnie (Dr.)
    Competitive strategies are a broad range of strategies firms resort to in order to cope with competition, beat competition or keep ahead of competitors. In the pharmaceutical industry in Kenya, pharmaceuticals companies have developed competitive advantage that was only short lived due to quick imitation by fellow competitors especially companies manufacturing generic products. This study sought to determine strategies adopted by pharmaceutical companies in Kenya to develop sustainable competitive advantage, to describe the internal organizational capabilities contributing to pharmaceutical companies in Kenya competitive advantage, to analyze the external environmental factors influencing pharmaceutical companies in Kenya competitive advantage. The study adopted a descriptive survey design. The study population comprised of 25 Pharmaceutical companies in Kenya. Purposive Sampling was used to select two senior employees in each pharmaceutical company from the finance and operation department, thus a sample size of 50 respondents. Primary data was collected using pre-determined questionnaires. Quantitative data collected was analyzed by the use of descriptive statistics using SPSS and presented through percentages, means, standard deviations and frequencies. Multiple regression analysis was conducted. The study found that the strategies adopted by pharmaceutical companies in view of developing sustainable competitive advantage include cost leadership strategy, product differentiation strategy, market focus, as well as investment in research. Among the external organizational capabilities include strategic customer targeting, evaluating organizational strengths and exploring market niches. The internal organizational capabilities contributing sustainable competitive advantage pharmaceutical companies include, investment in staff development, resource allocative efficiency, maintenance of quality accounting standards. This study recommends that differentiation strategy should be highly adopted in order to promote organizational performance, that organizations should highly adopt cost leadership strategy and should periodically conduct SWOT analysis as this will be helpful in establishing business objectives and achieving the organization’s mission, vision and goals.
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    A survey of dentists’ satisfaction with patient dental covers, provided by insurance companies based in Kenya.
    (Strathmore University, 2016) Lodhi, Tariq Abbas
    The financing for public oral health care delivery in Kenya is very limited. The option for Kenyans is therefore either to pay ‘out of pocket’ or utilize dental insurance covers after paying a premium. The purpose of this study is to explore the satisfaction of dentists with patient dental insurance covers in Kenya, and investigate its benefits to their patients; since dentists are the actual dental services providers and not the insurance companies who sell these covers. An exploratory web based survey was sent to 840 dentists registered with the Kenya Dental Association, with 77 completing the entire survey, and 55 dentists fulfilling the selection criteria of having past insurance experience. The results showed that 72.73% dentists were not satisfied with insurance companies and 87.27% felt dental covers in Kenya did not meet the needs of their patients. A few specific issues were further probed. 92.31% of dentists were dissatisfied with the period of time taken to pay them by insurance companies for dental services rendered. This time was found to be 3 months or more. 90.39% of respondents were dissatisfied with the annual dental cover limit offered to patients. The common limits for these covers was found to be between Kshs 10-20,000/-. 86.54% of dentists were dissatisfied with the exclusions of dental procedures, not covered by insurance. 80.77% were dissatisfied with the fees for dental procedures paid to the dentist by Insurance companies. 76.93% were dissatisfied with the process of pre-authorization prior to treatment. 67.31% were dissatisfied with the time taken for approval by insurance companies to commence dental treatment. It is recommended that dental insurance providers reconsider their exclusion criteria and annual patient dental cover limits. ICT can further be adopted to improve the pre-authorization process. A different remuneration model for dentists can be adopted to promote preventive dental care.
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    Determining the differences between patients’ and employees’ perceptions and expectations of quality of service in outpatient departments in Kiambu County Public Hospitals
    (Strathmore University, 2016) Maina, Stephen Mwangi
    The demand for effective healthcare within the Kenyan population has continued to rise making it hard for the government to provide sufficient health care services. Despite the on-going reform effort, the majority of the people in many counties still have limited access to quality health services. Living in the world of information and technology, patients are now more aware of their needs and rights. Health is a social good and needs public participation, including proper allocation of resources responding to public needs. In order for the health sector to meet the given public needs, it needs to change in line with the changing needs of the customers, this can only be met if these needs are determined by use of the surveys which ensure that the healthy sector offer quality services. The objective of this study was to determine the differences between patients’ and employees’ perceptions and expectations of quality of customer service in an outpatient department in 3 public Kiambu County hospitals, Kenya. The study was conducted in Kiambu County. SPSS (version 20) was used to analyze the study’s data. Basic descriptive statistics was done. The data was analyzed through percentages, frequencies, mean, standard deviation and Chi-Square test and the findings were presented in tables, graphs and narratives for easy comparisons and understanding to the readers. The study revealed that there is difference in patients and employees’ perception of quality of service at the hospitals. Patients don’t expect much from the treatment facilities though hospital staff perceives these facilities to affect the quality of service offered to a great extent. Both patients and employees’ opinion on the effect of customer care related factors on service quality are moderate. Patients in public hospitals don’t expect much of customer care services from the employees hence they perceive it as affecting service quality to moderate extent. Patients view the effect of medical care related factors on service quality as moderate while employees view it as very great. Patients appreciate medical care while employees view it as not enough. The study recommends that the county government of Kiambu should strive to improve quality of patient service in all hospitals under their management. This can be enhanced through provision of physical facilities in order enhance patient satisfaction. Periodic assessments should be consistently carried out to determine the physical state of each hospital and appropriate measures taken as per the report, the county government needs also to ensure consistent supply of basic hospital amenities in order to enhance the quality of health care provision. Patients should also be sensitized on the kind of customer service to expect from public hospitals.
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    An investigation of clinical knowledge management practices at the Aga Khan University Hospital, Nairobi
    (Strathmore University, 2016) Hirani, Mumtaz Shaffique
    Globalization has had a lot of impact on the management of various organizations, and the health care sector is not exempt. In the era of knowledge economy, management of knowledge has become a significant tool for enhancing the competitiveness of firms. The Aga Khan University Hospital, Nairobi is the tertiary, teaching and referral healthcare facility in Kenya. Their approach to care is guided by their core principles of Quality, Access, Impact and Relevance. Knowledge management at The AKUH is primarily facilitated by the University hospital library and The Continuous Medical Education (CME) department. The libraries provide the university community access to comprehensive and multi-disciplinary information resources in print and digital formats. This access is provided through innovative services and state-of-the-art systems. Despite all the above there still exist an empirical gap in the knowledge management practices of the healthcare institution. This study investigated the knowledge management practices implemented in the university hospital. Simple random sampling technique was applied to select a sample size of respondents picked from the university hospital setting. The research applied both quantitative and qualitative data analysis. Out of 201 questionnaires’ distributed, 188 responded giving a response rate of 93%. 8 of the respondents were section heads and 10 were program directors, 64 were consultants, 28 were registrars, 24 were senior house officers and 54 were residents. Data was collected from the respondents using structured questionnaires. For qualitative study, semi structured interviews were conducted on 13 senior managers out of which 8 were chairs of different clinical departments,1ICT officer, 1 regional librarian and 1 head librarian, 1 dean of the medical college and 1 CME coordinator to make a total of thirteen giving a response rate of 81%. Descriptive and causal research designs were used in analysis of the data. The design was ideal in describing the characteristics of the large targeted sample used in the study. The results of the study established that the use of Electronic medical records, Continuous medical education, Communities of Practice, Knowledge cafes, and Web based system are the key knowledge management practices that are in place in the university hospital. The leadership role played by top management emerged as being a key facilitator of knowledge management practices in the healthcare facility. The results from this study will inform the hospital management on the knowledge management practices in the hospital, suggest that knowledge management practices directly influence the performance of clinical staff. Key recommendations from the study were that an alignment of knowledge management policy to the organizational strategy would act as guideline on how knowledge should be disseminated within the organization, secondly the role of leadership in managing KM activities in terms of management support is key and finally, incentive programs which reward knowledge sharing are important so as to encourage employees to actively share knowledge both in the departments and across department knowledge sharing. Further research efforts can investigate the impact of social media in the improving implementation of knowledge management within organizations or between sector partners. The study was limited to the Aga Khan University Hospital which is a private health care facility, further studies can be carried out in public health care facilities.