Abstract:
This study aimed to evaluate the effectiveness of good governance practices in
government departments, specifically focusing on the transparency, accountability,
and participation in health service delivery at Kahama District Hospital. Using a
mixed-methods research approach, the study employed both qualitative and
quantitative methods to collect data from a sample of 196 respondents, selected through
simple random and purposive sampling techniques. The research philosophy was
grounded in pragmatism, which advocates for using multiple methods to gain a
comprehensive understanding of the research problem. Data were collected via
questionnaires and interviews, with quantitative data analyzed using descriptive
statistics, including mean scores, while qualitative data were analyzed through
thematic coding, identifying key themes and patterns related to governance practices
and health service delivery challenges. The findings revealed that while the hospital
had made notable progress in promoting transparency (mean score of 3.7) and
accountability (mean score of 3.5), several challenges such as inadequate facilities,
financial constraints, and limited information systems were hindering optimal service
delivery. Client satisfaction was relatively high, with 71% of respondents indicating
that their service expectations were met. The study concludes that while Kahama
District Hospital has laid a strong foundation in governance practices, there is a need
for targeted interventions such as enhanced staff training, improved decision-making
policies, increased government funding for infrastructure, and alignment of
governance structures with theoretical frameworks. These recommendations are in line
with studies by authors such as Ochieng et al. (2016), Mushi and Chacha (2018), and
Mhando (2020), who emphasize the need for continuous improvements in governance
to enhance health service delivery. The qualitative analysis provided further insights
into the key governance challenges faced by the hospital, offering a richer
understanding of how the hospital can better align its governance practices with
community expectations to achieve better health outcomes.
