Role of Strategic Direction on Service Delivery at Public Health Facilities in Nyeri County

Delivering quality healthcare services at public health facilities is fundamental to achieving universal health coverage. Strategic direction plays a crucial role in guiding healthcare institutions toward effective service delivery by aligning leadership practices with organizational goals. This study examined the influence of strategic direction on service delivery at public health facilities in Nyeri County. The research was guided by the Upper Echelon Theory, Dynamic Capability Theory, and the SERVQUAL model, each providing a framework for understanding how leadership, adaptability, and service quality impact healthcare outcomes. A descriptive research design was adopted, targeting 107 public health facilities through a census approach. Data was collected using structured questionnaires, and regression analysis was conducted to determine the relationship between strategic direction and service delivery. Diagnostic tests confirmed model assumptions, with a Variance Inflation Factor (VIF) of 1.135, indicating no multicollinearity, and Pearson’s correlation coefficient of r = 0.344 (p = 0.001), showing a positive and statistically significant relationship between strategic direction and service delivery. Regression analysis revealed that strategic direction explains 11.8% of the variance in service delivery outcomes (R² = 0.118, F = 10.876, p = 0.001), with a standardized beta coefficient of β = 0.344. These results underscore the importance of clearly articulated visions, consistent communication, and alignment of long-term strategic goals with operational objectives. Despite moderate perceptions of strategic clarity (mean scores ranging from 2.76 to 3.12), the findings highlight key areas for improvement in leadership commitment and strategic alignment. Based on these results, the study recommends the integration of strategic planning frameworks into healthcare policy, enhanced leadership training programs focused on strategic thinking and adaptability, and further research across other regions to test the generalizability of these findings. Key Words: Strategic Direction, Service Delivery and Public Health Facilities