Abstract
Despite ongoing efforts to improve healthcare service delivery in Level Five hospitals in Nairobi City County, Kenya, supply chain inefficiencies, regular stock-outs, and limited resources still pose significant challenges. Strategic procurement management is now seen as a key facilitator of effective and equitable delivery of healthcare services in these hospitals. This study examined the influence of four strategic procurement management practices procurement planning, supplier relationship management (SRM), contract management, and procurement risk management on healthcare service delivery in Level Five hospitals in Nairobi City County, Kenya. The study was anchored on Agency Theory, Transaction Cost Economics, and Supplier Relationship Management Theory. A quantitative cross-sectional survey design was adopted with a target population of 234 staff members across all 18 Level Five hospitals (three public and fifteen private) in the county. A sample of 148 respondents was determined using Yamane's (1967) formula and selected through stratified random sampling. A total of 121 questionnaires were returned, a response rate of 81.8%. Data were analysed in SPSS version 29 using descriptive statistics, Pearson correlation, multiple linear regression, and the Mann–Whitney U test. Mean ratings were positive for all four practices, with contract management (M = 3.68, SD = 0.47) and healthcare service delivery (M = 4.32, SD = 0.34) rated highest overall. The overall regression model was significant and accounted for 68.7% of the variance in healthcare service delivery (R² = .687, F(4, 116) = 63.562, p < .001). All four practices were significant positive predictors: supplier relationship management (β = .593, p < .001), contract management (β = .397, p < .001), procurement planning (β = .269, p < .001), and procurement risk management (β = .253, p < .001). A Mann–Whitney U test found that private hospitals had a significant advantage over public hospitals in service delivery outcomes (U = 406.50, Z = −3.056, p = .002). The study concludes that supplier relationship management and contract management have the greatest influence on healthcare service delivery, and recommends structured supplier relationships and strong contract governance for hospital management, alongside improved procurement oversight in public hospitals for policymakers, to close the service delivery gap.
Keywords: strategic procurement management, supplier relationship management, contract management, healthcare service delivery, Level Five hospitals, Kenya