Abstract: This study reports findings of an investigation into functional integration as a strategic management driver of service delivery in public national teaching and referral hospitals in Nairobi City County, Kenya. Service delivery in these hospitals has deteriorated over the past five years despite considerable policy reform and financial investment, with patient satisfaction falling from 68 percent in 2019 to 56 percent in 2024, average outpatient waiting time rising from four to six hours, and institutional maternal mortality ratios remaining at 99 to 104 per 100,000 live births against a national target of 70. Grounded in the Technology Acceptance Model and the SERVQUAL model, the study conceptualized functional integration, disaggregated into process integration, teamwork and collaboration, and service coordination, as a strategic management driver, and service delivery as the outcome it was expected to explain. The study adopted a descriptive cross-sectional research design targeting 420 staff drawn from Kenyatta National Hospital, Mathari National Teaching and Referral Hospital and the National Spinal Injury Referral Hospital. Using a proportionate stratified random sampling technique and Yamane's formula, a sample of 205 respondents was selected, and 195 usable questionnaires were returned, representing a response rate of 95.6 percent. Primary data were collected using a semi-structured questionnaire anchored on a five-point Likert scale, and reliability for both functional integration and service delivery exceeded the 0.7 threshold. Data were analyzed using descriptive statistics and linear regression. The study finds that functional integration was deployed to a high level, with process integration and service coordination rated most strongly and the regularity of multidisciplinary teamwork the weakest-performing indicator. Service delivery was rated at a more moderate level. Functional integration has a significant positive effect on service delivery (β = 0.623; p = 0.001). The study concludes that functional integration is among the most consequential strategic management drivers of service delivery in tertiary public hospitals and calls on hospital managers to institutionalize structured cross-departmental coordination as a deliberate strategic asset. Future research is invited to extend the conceptual and methodological scope of the study to enhance the generalizability of the findings.
Keywords: Strategic management drivers, functional integration, service delivery, public national teaching and referral hospitals, Nairobi City County, Kenya.
Title: Strategic Management Drivers and Service Delivery: The Role of Functional Integration in Public National Teaching and Referral Hospitals in Nairobi City County, Kenya
Author: Stanslaus Mbithi, Annstellah Gakii
International Journal of Social Science and Humanities Research
ISSN 2348-3156 (Print), ISSN 2348-3164 (online)
Vol. 14, Issue 3, July 2026 - September 2026
Page No: 217-224
Research Publish Journals
Website: www.researchpublish.com
Published Date: 21-August-2026
