Supplier Contracting and Perceived Healthcare Service Delivery in Selected Referral Hospitals in Kenya

Authors

DOI:

https://doi.org/10.53819/81018102t70128

Abstract

Reliable access to pharmaceutical products is essential for continuity of clinical care, yet procurement arrangements in public hospitals are frequently challenged by delivery delays, supplier non-performance and uneven commodity availability. This article examined the association between supplier contracting and quality healthcare service delivery in selected referral hospitals in Kenya. The analysis was guided by Principal–Agent Theory and Institutional Theory. A quantitative descriptive cross-sectional survey covered personnel in five referral hospitals, with 213 valid questionnaire responses drawn from a target population of 630 through proportionate stratified sampling and a planned sample of 245. Supplier contracting was measured through perceived logistics reliability, supplier certification, enforcement of delivery timelines, and supplier financial and operational capacity; healthcare service delivery was assessed through five indicators of medicine access, supply continuity, patient satisfaction and treatment adherence. Descriptive analysis yielded an average supplier contracting item mean of 3.87 on a five-point scale. Supplier contracting was positively correlated with perceived healthcare service delivery (Spearman’s ρ = 0.40, p < .001). In a proportional-odds ordinal regression adjusting for supplier relationship management and strategic supplier evaluation, contracting remained positively associated with the ordered service delivery outcome (B = 0.230, p = .007; odds ratio = 1.259). The findings support the significance of contracting-related supplier assurance and delivery discipline, although the cross-sectional, self-reported evidence does not establish causation. Hospital procurement managers should strengthen documented supplier capacity checks, measurable delivery obligations, performance reviews and proportionate remedies while maintaining emergency responsiveness.

Keywords: supplier contracting; pharmaceutical procurement; healthcare service delivery; contract compliance; referral hospitals; Kenya

Author Biographies

  • Hellen Natilikia Nkapese, Maasai Mara University

    School of Business and Economics, Maasai Mara University, Kenya

  • Kevin Gudda, Maasai Mara University

    School of Business and Economics, Maasai Mara University, Kenya

  • Pauline Jeruto Keitany, University of Kabianga

    School of Business and Economics, University of Kabianga

References

Chikophe, R. M., Tenambergen, W. M., & Kyalo, C. K. (2024). Influence of procurement process on availability of essential drugs in public health facilities in Mombasa County, Kenya. International Journal of Health Sciences, 7 (3), 44–56.

DiMaggio, P. J., & Powell, W. W. (1983). The iron cage revisited: Institutional isomorphism and collective rationality in organizational fields. American Sociological Review, 48 (2), 147–160.

Fallahnezhad, M., Langarizadeh, M., & Vahabzadeh, A. (2024). Key performance indicators of hospital supply chain: A systematic review. BMC Health Services Research, 24, Article 1610.

Jensen, M. C., & Meckling, W. H. (1976). Theory of the firm: Managerial behavior, agency costs and ownership structure. Journal of Financial Economics, 3 (4), 305–360.

Meyer, J. W., & Rowan, B. (1977). Institutionalized organizations: Formal structure as myth and ceremony. American Journal of Sociology, 83 (2), 340–363.

Ministry of Health. (2023a). Kenya health facility census report. Government of Kenya.

Ministry of Health. (2023b). Kenya essential medicines list 2023. Government of Kenya.

Ministry of Health. (2024, March 13). Bridging the health products gaps for universal health coverage. Government of Kenya.

Mugwiria, J. M., & Osoro, A. (2024). Contract management practices and procurement performance of public health facilities in Nairobi City County, Kenya. International Journal of Social Sciences Management and Entrepreneurship, 8 (4).

Muuki, A. K., & Nderui, D. N. (2024). Supplier sourcing and performance of public Level 5 hospitals in Nairobi City County, Kenya. International Journal of Social Sciences Management and Entrepreneurship, 8 (3), 680–696.

Mwangi, S. W., Sang, P. K., & Gachengo, L. W. (2025). Effect of contract management processes within public-private

partnerships on the performance of healthcare projects in public hospitals in selected counties in Kenya. International Journal of Business Management, Entrepreneurship and Innovation, 7 (1), 103–117.

Nepomnyashchiy, L., & Yadav, P. (2022). Decentralized purchasing of essential medicines and its impact on availability, prices, and quality: A review of current evidence. Center for Global Development.

Onyango, J. O., Ogira, D., & Kokwaro, G. (2024). Availability of essential medicines during the COVID-19 pandemic: A qualitative study examining experiences and level of preparedness in Kenya. PLOS Global Public Health, 4 (7), e0002547.

Parmaksiz, K., Pisani, E., Bal, R., & Kok, M. O. (2022). A systematic review of pooled procurement of medicines and vaccines: Identifying elements of success. Globalization and Health, 18, Article 59.

World Health Organization. (2023). Access to NCD medicines: Emergent issues during the COVID-19 pandemic and key structural factors.

World Health Organization. (2024a). Access to essential medicines: Proportion of health facilities that have a core set of relevant essential medicines available and affordable on a sustainable basis.

World Health Organization. (2024b). WHO results report 2022–2023: Improved access to essential medicines, vaccines, diagnostics and devices for primary health care.

World Health Organization. (2024c). Quality assurance of pharmaceuticals: A compendium of guidelines and related materials (10th ed., Vol. 1).

World Health Organization. (2024d). World health statistics 2024: Monitoring health for the SDGs, Sustainable Development Goals.

World Health Organization. (2026). Procurement: Quality assurance.

World Health Organization Regional Office for Africa. (2024). 2024 Kenya health facility assessment: Quality of care and human resources for health report.

Downloads

Published

2026-11-03

Issue

Section

Articles

How to Cite

Supplier Contracting and Perceived Healthcare Service Delivery in Selected Referral Hospitals in Kenya. (2026). Journal of Procurement & Supply Chain, 10(1), 64-74. https://doi.org/10.53819/81018102t70128

Article metrics

Views: 14
Downloads: 5

Most read articles by the same author(s)