County Health Leadership and Readiness for Noncommunicable Disease Services

County Health Leadership and Readiness for Noncommunicable Disease Services by Paul Wekesa Agunga MBA, Kenya Methodist University, 2008 MBchB, University of Nairobi, 2003 Dissertation Submitted in Partial Fulfillment of the Requirements for the Degree of Doctor of Philosophy Health Services Walden University June 2018 Abstract Premature mortality resulting from the growing global burden of noncommunicable diseases (NCDs) is a contemporary development challenge. Low-income and lowermiddle-income countries are disproportionately affected, with the poorest in society considered the most vulnerable. A paucity of literature exists on how leadership practices at the implementation level relate to ensuring readiness for NCD services. The purpose of this study was to investigate whether any relationship exists between leadership practices at the county level and readiness for NCD services in Kenya. Path-goal and adaptive leadership theories were used to guide this quantitative correlational study, using secondary data from a 2013 Service Availability and Readiness Assessment survey. Correlation and multiple linear regression tests were used to determine the strength and direction of any relationship between the independent variable of leadership practices (annual work planning, therapeutic committees, and supportive supervision), and the dependent variable of NCD readiness (county readiness score). The results indicated a statistically significant relationship between therapeutic committee (p = .002) and supportive supervision practices (p = .023) and NCD readiness. Leadership practices also had a statistically significant predictive relationship with NCD readiness (p = .009). This study may be significant to county health leaders in relation to their efforts to ensurePremature mortality resulting from the growing global burden of noncommunicable diseases (NCDs) is a contemporary development challenge. Low-income and lowermiddle-income countries are disproportionately affected, with the poorest in society considered the most vulnerable. A paucity of literature exists on how leadership practices at the implementation level relate to ensuring readiness for NCD services. The purpose of this study was to investigate whether any relationship exists between leadership practices at the county level and readiness for NCD services in Kenya. Path-goal and adaptive leadership theories were used to guide this quantitative correlational study, using secondary data from a 2013 Service Availability and Readiness Assessment survey. Correlation and multiple linear regression tests were used to determine the strength and direction of any relationship between the independent variable of leadership practices (annual work planning, therapeutic committees, and supportive supervision), and the dependent variable of NCD readiness (county readiness score). The results indicated a statistically significant relationship between therapeutic committee (p = .002) and supportive supervision practices (p = .023) and NCD readiness. Leadership practices also had a statistically significant predictive relationship with NCD readiness (p = .009). This study may be significant to county health leaders in relation to their efforts to ensure proximal access to quality NCD services in Kenya. The results of this study may help to promote the development of capacity-building programs targeting health leadership and prioritization of actions to ensure access to NCD prevention and treatment services at the county level in Kenya. County Health Leadership and Readiness for Noncommunicable Disease Services by Paul Wekesa Agunga MBA, Kenya Methodist University, 2008 MBchB, University of Nairobi, 2003 Dissertation Submitted in Partial Fulfillment of the Requirements for the Degree of Doctor of Philosophy Health Services