t h e R O L E o y THE CONSTITUENCY DEVELOPMENT LUND ON HEALTH CARE SERVICE DELIVERY IN KENYA: A CASE QV R A N G V /L CONSTITUENCY BY ATHEROL A. BEATRICE PROJECT REPORT SUBMITTED IN PARTIAL FULFILMENT FOR Till. REQUIREMENTS OF 'HIE AWA A) OF I iiE LEG REE OF MASTER OF A UTS IN PROJECT PLANNING AND MANAGEMENT OF THE UNIVERSITY OF NAIROBI 20! 2 DECLARATION This project report is my original work and lias not been presented for a degree or any other award in any other university. L50/7233 3/2008 This Project report has been submitted with my approval as the university supervisor Prof. G.P. Pokhariyal School of Mathematics University of Nairobi ii DEDICATION This work is dedicated to my parents, my husband and my children Edger and Patience. May God bless you abundantly. m ACKNOWLEDGEMENT I wish to acknowledge the support of all people who in one way or the other made this research project successful. Firstly, 1 thank God for enabling me to come this far with this study and secondly 1 sincerely thank my Supervisor Prof. G.P. Pokhariyal whose honest criticism and guidance has enabled me to refine this document. My deep appreciation also goes to my husband Mr. Oyugi for his enduring support which has enabled me to complete this project report in good time. I am greatly indebted to my brother Erick and my dear children Edgcr and Patience whose prayers and support has immensely contributed to the completion of this research project. I recognize the effort of Dorothy Mulonzi for her continuous reading and constructive criticisms of the work. Her contributions has gone a long way in coming up with this report. 1 also recognize my peers and friends for their ideas, constructive criticism and assistance in various ways. Further gratitude goes to the respondents particularly the Constituency Development Fund beneficiaries of Rangwe Constituency and the Committee. For those who assisted in one way or another and who are numerous to be mentioned by names, May God bless you! tv TABLE OE CONTENTS Page DECLARATION....................................................................................................................................ii DEDICATION.......................................................................................................................................iii ACKNOW LEDGEMENT...................................................................................................................iv TABLE OF CONTENTS......................................................................................................................v LIST OF TA B LES............................................................................................................................. viii LIST OF FIG U R ES.............................................................................................................................. x ABBREVIATIONS AND ACRONYMS.......................................................................................... xi ABSTRACT.......................................................................................................................................... xii CHAPTER ONE: INTRODUCTION................................................................................................ I 1.1 Background of the Study................................................................................................................... 1 1.2 Statement of the Problem..................................................................................................................7 1.3 The purpose of the Study................................... A..:....................................................................... 8 1.4 Objectives of the Study.....................................................................................................................9 1.5 Research Questions.......................................................... 9 1.6 The Study Assumptions.................................................................................................................. 10 1.7 Significance of the Study................................................................................................................ 10 1.8 The Scope of the Study................................................................................................................... 11 1.9 Limitations of the Study.................................................................................................................. 12 1.10 Definition of Key Terms Used in the Study................................................................................ 12 1.11 Organization of the Study.............................................................................................................14 CHAPTER TWO: LITERATURE REV IEW ................................................................................15 2.1 Introduction.......................................................................................................................................15 2.2 Theoretical Literature.......................................................................................................................15 2.2.1 The Concept of Decentralization................................................................................................16 2.3 Empirical Literature........................................................................................................................20 2.3.1 Community Participation in Decision Making.........................................................................21 2.3.2 Communication............................................................................................................................ 24 2.3.3 Monitoring and Evaluation......................................................................................................... 27 2.4 Conceptual Framework...................................................................................................................32 v 2.5 Summary 34 CHAPTER THREE: RESEARCH METHODOLOGY............................................................. 35 3.1 Introduction......................................................................................................................................35 3.2 The Study Design............................................................................................................................ 35 3.3 Target Population............................................................................................................................ 36 3.4 Sampling size and Procedures........................................................................................................36 3.5 Data Collection Methods and Instruments....................................................................................37 3.6 Validity and Reliability...................................................................................................................37 3.7 Data Analysis and Presentation of the Findings.......................................................................... 38 3.8 Summary.......................................................................................................................................... 41 CHAPTER FOUR: DATA PRESENTATION AND INTERPRETATION...........................42 4.0 Introduction......................................................................................................................................42 4.1 The Socio-Economic Profiles of the Respondent^........................................................................42 4.2 Influence of the Annual CDF Allocation on the Health Care Service Delivery......................43 4.3 The Level of Community Participation in Decision Making for the Improvement of Health Care Service Delivery........................................................................................................................... 48 4.4 Communication channels Used to Support Health Care Services Delivery............................ 51 4.5 Monitoring and Evaluation Approaches Used by the CDFC on Health Care Service Delivery 54 4.6 Summary.......................................................................................................................................... 60 CHAPTER FIVE SUMMARY OF FINDINGS, DISCUSSIONS, CONCLUSION AND RECOMMENDATIONS....................................................................................................................61 5.1 Introduction...................................................................................................................................... 61 5.2 Summary of the Findings............................................................................................................... 61 5.2.1 Influence of the Annual CDF Allocation on the Health Care Service Delivery.....................61 5.2.2 The Level of Community Participation in Decision Making to Improve Health Care Service Delivery.................................................. *................................................................................62 5.2.3 Communication channels Used by the CDFC for the Health Care Services Delivery........ 62 5.2.4Monitoring and Evaluation approaches used by the CDF'C on Health Care Service delivery .................................................................................................................................................................62 5.3 Discussions of the Findings.........................................................................................................