Abstract

Devolution was meant to improve efficiency in service delivery in the public healthcare facilities by improving financial allocation, human resource capacity and increasing medical supplies, equipment and health facilities. A glimpse of hope was noted with devolution especially in the ASALs with Mandera undertaking its first caesarean operation since independence and Wajir tripling its maternity facilities within three years. However, 5 years after devolution the neonatal mortality and maternal mortality still remain high. The purpose of this study was to investigate the moderating effect of democratic leadership style on the relationship between management of devolved health services and health-care service delivery in Arid and Semi-Arid Lands in Kenya. This study was guided by fiscal decentralization theory, participation theory and theory of performance improvement, as well as sequential theory of decentralization. This study used a triangulation of both positivism and phenomenology. The population under this study constitute the Sub-Counties in ASAL in Kenya with a sample size of 89 Sub-Counties being sampled and 3 patients from each of the 89 sampled sub counties. Given the findings, did not accept the null hypothesis (H0) and therefore concludes that democratic leadership style has a significant moderating effect on the relationship between management of devolved health services and health-care service delivery in Arid and Semi-Arid Lands in Kenya. Therefore, hospitals management should come up with strategies that can help improve financial resources to fund facilities improvement and purchase of equipment and supplies. These strategies can include seeking for donor funding among others.

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