Perceptions on policy, implementation, and coordination of the emergency health system suggest the administrative trilemma of disaster response in Kenya

Résumé fourni par la source

Kenya has robust policies, such as the National Disaster Management Policy (2012). However, complete implementation is constrained by administrative bureaucracies. As a result, this study assessed opinions about how public administration procedures and structures help or impede the successful execution of emergency health policies. In this study, a descriptive, cross-sectional survey was conducted with a purposively and snowball-sampled group of stakeholders via an online questionnaire. Then, data from 40 Likert-scale items were analyzed using descriptive statistics; open-ended responses underwent modified thematic analysis to identify trends. Findings revealed a systemic "policy-implementation-administration trilemma." Key figures from stakeholder perceptions (n = 121) include: 76.9% were neutral on county-national policy alignment; over 90% were neutral on metrics like response promptness and hospital preparedness. Additionally, 100% strongly agreed that unequal regional resources hinder coordination, and 84.3% were neutral or disagreed that financial resources are adequate. Furthermore, qualitative analysis identified severe resource constraints and a critical reliance on informal communication networks over formal protocols. This study's findings bridge public administration, disaster management, and health policy literature, offering a diagnostic model for decentralized systems. Additionally, the respondents perceived coordination failures as stemming from Kenya's administrative structure, not merely from a lack of policy. The integrated theoretical framework explains how administrative structures mediate policy intent and on-ground actions. We acknowledge that the use of non-probability sampling and self-reported data limits generalizability and may introduce social desirability bias. Based on these perspectives, this study suggests that fundamental changes in public administration are necessary to enhance health and emergency response.

Ce résumé expose les affirmations des auteurs. BNTIC ne l’interprète pas comme une validation indépendante des résultats.