LEADERSHIP AND GOVERNANCE IN HEALTH SYSTEMS: DIAGNOSIS AND

PRESCRIPTION FOR KIAMBU COUNTY GOVERNMENT

A PhD proposal presented to

By
Mambo Susan Njoki; Tel +254 353 748

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RECOMMENDED FORMART BY DAAD (Academic Research proposal)

15 pages times roman 1.5 spacing

1. Title

2. Introduction

3. Problem statement (Research Gap must out clearly)

4. Research questions

5. Research goals (In-line with the questions)

6. Justification

7. Scope

8. Definition of terms (Avoid dictionary definitions)

9. Hypothesis

10. Literature Review ( must capture: current trends with citations (must use a software that

inserts the citations automatically); indicate relevance of your studies quoted; must relate

to theories done in this area; no plagiarism!)

11. Theoretical framework : this is a must and should mention why a particular theory is

relevant to the study)

12. Methodology: must be explicit: study area; study design; data collection, analysis and

presentation; study population and sample size (approximately 400 respondents) etc

Methodology must proof that it will work for your achievements of the objectives/goals

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 13. Bibliography (Automatically inserted) – try Zotero software its free

14. Workplan of 3years and a budget of 2m

Abstract

Background
Leadership and Governance is a multidimensional concept, and there are normative,

instrumental, and pragmatic models of stewardship. Governance failures, in health systems

include the lack of a long-term vision and planning for essential interventions, the absence of a

functional regulatory framework, failure to address corruption, and limited efforts to assess

performance. However, existing governance frameworks have not always been explicit about the

significant role often played by private sector actors. This paper proposes a logical framework

for conceptualizing the governance/stewardship function within health systems and the role of

government in the context of an expanded role for private service provision and financing.

Keywords

Governance; Partnership; Stewardship; Leadership

Problem Statement

WHO has defined six key activities for health system stewardship. Despite the strides that have

already been made in the Kenya Health Sector Strategic plan 2008-2012, the engagement of the

private sector in the sector coordination process is still weak. Inter Agency Coordinating

Committees are too many, and not aligned to the sector policy / strategic direction. Their inter-

linkages, and linkages are weak and not adhered to; many key stakeholders are still outside of the

Code of Conduct, by design or default. Some key funders see no need / have no capacity to
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engage at this depth with other health actors, and prefer to play a peripheral role (KHSSP 2013-

2017).

The current organizational structure of county has the County Secretary of Health an appointee

of the County Executive Council. The Chief executive of the County Health System is the

County Director of health. (KHSSP 2013-2017). This structure does not recommend a model of

Governance that would enhance management of County health services with involvement of

non-government actors. There is therefore a missing link at the strategic level to address the

composition of the Board and at the tactical levels for the involvement of non-state actors at the

county.

Broad objective

To promote effective leadership in health systems for Kiambu County government

Specific objectives

1. To assess health stewardship by Kiambu County health System.

2. To evaluate health partnership arrangements for Kiambu County government health

system.

3. To assess health governance arrangements for Kiambu County government health

systems

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METHODOLOGY

This will be a cross sectional exploratory study design which will employ both quantitative and

qualitative data collection methods. This study will be conducted in Kiambu County. Kiambu

County is divided into 7 divisions namely Kiambaa, Limuru, Ndeiya, Githunguri, Kikuyu, Lari

and Kiambu Municipality. The County has thirty-seven locations and one hundred and twelve

sub-locations. Kiambu County has a total population of approximately 1,782,083 persons (Male

49 %, Female - 51 %).

REFERENCES

Barlow, J. G., Roehrich, J. K., & Wright, S. (2010). De facto privatisation or a renewed role
forthe EU?

Brady, T., Davies, A., & Gann, D. (2005). Creating value by delivering integrated solutions.
Brinkerhoff, D. W., & Brinkerhoff, J. M. (2011). Public-private partnerships: Perspectives
on purposes, publicness, and good governance. Public Administration and Development,31,
pp.2 – 14.

Grimsey, D. & Lewis, M. K. (2005). Are public private partnerships value for

money?:Evaluating alternative approaches and comparing academic and practitioner
views.   Accounting Forum, 29(4), pp. 345-378;  Health Affairs32 (1), pp. 146-154
  International Journal of Project Management,23, pp. 360-365.

Journal of the RoyalSociety of Medicine, Paying for Europe’s healthcare infrastructure in a

recession.  103, pp. 51-55.

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At which German university do you want to do your PhD (and why), OR contact of
a potential supervisor in Germany/ Graduate school

I am interested in pursuing my PhD in Ludwig Maximilian University of Munich. This is

because its one of the best old universities that offers the best PhD by research which is
my interest

Your expectations of the workshop (max. 5 sentences)

I expect to get mentored to be able to write a winning proposal, get empowered by the
DAAD scholars alumni to be able to stand a chance in the DAAD scholarships.I also
expect to meet, share and learn from my fellow mentees in the workshop. I am also
interested in understanding what is expected of me as an applicant to stand a chance. I
look forward to learning from other proposals on the trending issues in health.