Effect of Total Quality Management Practices on Service Delivery in Health Sector in Nairobi County, Kenya


  • Omore Judith Achieng KCA University
  • Dr. Nyaribo Misuko KCA University




This study sought to examine the influence of Total Quality Management (TQM) practices on quality services in healthcare sector in Nairobi County, Kenya. Specifically, this study examined the influence of customer focus, quality improvement, employee involvement and management support on quality services in healthcare sector in Nairobi County. The study adopted cross-sectional descriptive design and targeted healthcare providers in five hospitals (three public and two private) in Nairobi County including; Mbagathi hospital, Mama Lucy hospital, Pumwani hospital, Coptic hospital and Aga Khan Hospital. Yamane formula was used calculate the sample size of 115 respondents from healthcare workforce population of 1,652.  Data was collected using questionnaires and analyzed through descriptive and inferential statistics. The study found that customer focus promoted effective assessments and follow-ups on patients and helped to build strong relationships between healthcare providers and patients through effective communication and continuous quality improvement through Continuous Quality Improvement (CQI) teams and routine Multidisciplinary teams (MDT) promoted service quality while employee involvement enhanced motivation and productivity of staff. Management support was essential in setting and ensuring implementation of goals and vision of healthcare facilities, motivation of staff and resource mobilization to implement core services in healthcare facilities. The study concluded that there is a significant relationship between TQM practices and quality services in healthcare sector in Nairobi County, Kenya and recommended that healthcare facilities (public & private) should bolster implementation of TQM interventions since they promote quality of services.

Keywords: Customer Focus, Quality Improvement, Employee Involvement, Management Support & Service Delivery

Author Biographies

Omore Judith Achieng, KCA University

Postgraduate student, KCA University

Dr. Nyaribo Misuko, KCA University

Lecturer, KCA University


Ahmad, Z., Ahmad, Areiqat, A., & Tailakh, W., (2012). The Impact of Health Service Quality on Patients’ Satisfaction over Private and Public Hospitals in Jordan” A Comparative Study". International Journal of Marketing Studies. 4. 123-137. 10.5539/ijms.v4n1p123.

Al Manhawy, A. (2013). TQM Critical Success Factors in Hospitality Industry and their Impact on Customer Loyalty: A Theoretical Model. International Journal of Scientific & Engineering Research. 4(1), 25-37.

Amporfu, E., & Nonvignon, J., & Ampadu, S., (2013). Effect of Institutional Factors on the Quality of Care in the Ghanaian Health Sector. Journal of African Development. 15. 99-123. https://doi.org/10.5325/jafrideve.15.1.0099

Attakora-Amaniampong, E., Salakpi, A., & Bonye, F., (2014). Total Quality Management and its impact on the level of Customer Focus within Construction Project Management in Ghana. International Journal of Business and Management Invention 3. 2319-802836.

Balasubramanian (2016). Total Quality Management in the Healthcare Industry - Challenges, Barriers and Implementation. Science Journal of Public Health, Vol 4 No 4, 271 -278. https://doi.org/10.11648/j.sjph.20160404.11

Bruno, A., Dell'Aversana, G., & Zunino, A., (2017). Customer Orientation and Leadership in the Health Service Sector: The Role of Workplace Social Support. Frontiers in Psychology. 8. 1920. 10.3389/fpsyg.2017.01920.

Dangmei, J., & Singh, A.,(2018). Effect of Employee Engagement on Quality of Care: Emotional Labor as a Mediator. Asia Pacific Journal of Research Vol: I. p. 185

Darma, J., Susanto, A., Mulyani, S. & Suprijadi, J.. (2018). The Role Of Top Management Support in the Quality of Financial Accounting Information Systems. Journal of Applied Economic Sciences. 13. 1009-1020.

ElZeneny, S. R.; Seada, A. M., & AleamEtewy, E. E. (2017). Effect of Clinical Supervision Training Program for Nurse Managers on Quality of Nursing Care in Intensive Care Units. ijnd, 7, 08-17.

Foley E.E., (2008). Neoliberal Reform and Health Dilemmas. Medical Anthropology Quarterly.

Hill, et al., (2020). The effectiveness of continuous quality improvement for developing professional practice and improving health care outcomes: a systematic review. Implementation Sci 15, 23. https://doi.org/10.1186/s13012-020-0975-2

Javed, S., (2015). Impact of Top Management Commitment on Quality Management. International Journal of Scientific and Research Publications, Volume 5, Issue 8, ISSN 2250-3153 www.ijsrp.org

Kenya National Bureau of Statistics (KNBS, 2019). Distribution of Population by Socioeconomic Characteristics. Nairobi Kenya: KNBS

King’oo, P., (2017). Top Management Support and Quality Service Delivery in Nairobi County Government, Kenya. (Thesis). Kenyatta University, Nairobi, Kenya.

Mildred, A., (2016). Effect of Employee Involvement on Job Performance at the Kenya Medical Research Institute (Centre for Global Health Research) Kisumu. (Thesis). University of Nairobi, Kenya

Mu, Y., Bossink, B., & Vinig, T., (2018). Employee Involvement in Ideation and Healthcare Service Innovation Quality. Service Industries Journal. 38. 67-86. 10.1080/02642069.2017.1374374.

Nazar, N., Ramzani, S., Anjum, T., & Shahzad, I., (2018). Organizational Performance: The Role of TQM Practices in Banking Sector of Pakistan. European Scientific Journal. 14. 10.19044/esj.2018.v14n31p278.

Ngambi, M & Nkemkiafu, A.G (2015). The Impact of Total Quality Management on Firm’s Organizational Performance. American Journal of Management Vol. 15(4)

Otieno, A., (2016). Continuous Improvement Practices and Efficiency of Commercial Banks in Kenya. (Thesis). University Of Nairobi, Kenya.

Oyeledun, et al.,(2017). The Effect of a Continuous Quality Improvement Intervention on Retention-In-Care at 6 Months Postpartum in a PMTCT Program in Northern Nigeria: Results of a Cluster Randomized Controlled Study. JAIDS Journal of Acquired Immune Deficiency Syndromes. 75. S156-S164. 10.1097/QAI.0000000000001363.

Parasuraman, A. Zeithaml, V. A & Berry, L.L (1985). SERVQUAL .A multiple items scale for measuring consumer perceptions of service quality. Journal of Retailing 1988, 64(1) 12

Phipps, S., Prieto, L., & Ndinguri, E.N., (2013). Understanding the impact of employee involvement on organizational productivity: The moderating role of organizational commitment. Journal of Organizational Culture, Communications and Conflict. 17. 107-120.

Sendawula, K., Kimuli, S., Juma, B., & Muganga, G.,(2018). Training, employee engagement and employee performance: Evidence from Uganda’s health sector. Cogent Business & Management. 5. 10.1080/23311975.2018.1470891.

WHO (2018). Strengthening integrated, people-centered health services. Resolution WHA69.24, adopted at the World Health Assembly. Geneva: World Health Organization.

World Health Organization (2006): The world health report 2006: working together for health. Geneva, World Health Organization.

World Health Organization (WHO, 2018). Delivering quality health services: a global imperative for universal health coverage. WHO, Geneva

Yaacob, Z. (2014). The Link between Quality Management and Muslim Customer Satisfaction. International Journal of Business and Society, 15, 81.

Yapa, et al., (2020). The impact of continuous quality improvement on coverage of antenatal HIV care tests in rural South Africa: Results of a stepped-wedge cluster-randomised controlled implementation trial. PLOS Medicine 17(10): e1003150. https://doi.org/10.1371/journal.pmed.1003150




How to Cite

Omore, J. A., & Misuko, N. (2023). Effect of Total Quality Management Practices on Service Delivery in Health Sector in Nairobi County, Kenya. Journal of Strategic Management, 7(1), 74–88. https://doi.org/10.53819/81018102t2118