Effect of Institutional Capacities of Both Public and Private Partners on the Performance of Healthcare Projects in Public Hospitals in Selected Counties in Kenya

Health projects are crucial to improving access and quality of services. They often face challenges such as delays, cost overruns and subpar standards. Public-private partnerships have emerged as a possible solution, but their impact on project performance in sub-Saharan Africa remains poorly understood. This study assessed how the institutional capacities of both public and private partners affect the performance of healthcare projects in public hospitals in selected counties in Kenya. It study used a mixed methods approach that combined descriptive and exploratory elements and was guided by a pragmatic research philosophy. Eight counties in Kenya were purposively selected, targeting a sample of 250 participants including hospital managers, procurement officers, hospital committee/board members, and county health department heads. Data from 155 participants were collected through stratified random sampling using semi-structured surveys, interviews, and focus group discussions. Data analysis included both qualitative thematic analysis and quantitative descriptive and inferential statistics. Regression analysis revealed that PPP management factors accounted for 76% of the variance in project success. The study findings indicate that the predictor, institutional capability (β = 1.344, p = 0.026), was significant. This study highlights that successful PPP implementation in healthcare requires strong institutional capacity. Additionally, a supportive regulatory environment is critical to promoting successful PPPs. These results contribute to the understanding of PPP management in the social sector and highlight the importance of these factors in improving project outcomes, particularly in resource-limited settings. Future research could employ longitudinal studies to explore the evolution of relational norms and their impact on institutional capabilities in PPP project delivery.