BUDGET IMPLEMENTATION AND FINANCIAL SUSTAINABILITY OF CATHOLIC CHURCH-OWNED HOSPITALS IN THE NAIROBI ARCHDIOCESE, KENYA

Financial sustainability is a persistent challenge for faith-based health institutions because they must maintain financial viability while fulfilling a social and mission-oriented healthcare mandate. This study examined the relationship between budget implementation and financial sustainability among Catholic Church-owned hospitals in the Nairobi Archdiocese, Kenya. A quantitative correlational design was used, targeting 19 Catholic Church-owned Level 4 and Level 5 hospitals in Nairobi and Kiambu counties. Data were collected from heads of finance or equivalent officers through a structured questionnaire, yielding 18 usable responses and a 94.7% response rate. Budget implementation was assessed through expenditure adherence, implementation monitoring, enforcement of expenditure limits, management of deviations, resource allocation, timeliness of implementation and disbursements, adherence to implementation schedules, and the effects of funding delays. Financial sustainability was assessed through operational self-sufficiency, cash flow, financial reserves, revenue diversification, and perceived improvement in financial position. Budget implementation recorded a moderate overall mean of 3.13 (SD = 0.391) and acceptable internal consistency (α = .747). Timely allocation of resources according to the approved financial plan was the strongest implementation indicator (M = 4.06), whereas protection of service delivery from funding delays was the weakest (M = 1.67). Regression analysis showed that budget implementation had a positive and statistically significant effect on financial sustainability (B = .9634, SE = .319, t = 3.024, p = .010). The findings indicate that financial sustainability depends on translating approved budgets into timely, disciplined, and responsive financial action. Catholic hospitals should therefore strengthen cash-flow forecasting, timely disbursement, expenditure alignment, response to variances, and accountability for budget execution.