Technological, Human-capacity, Organizational and Policy Factors on Automation of Monitoring and Evaluation Systems in Health Projects: A Case Study Nakuru County, Kenya

This study aims to evaluate how technological infrastructure, human capacity, organisational factors and policy-regulatory frameworks influence the level of automation of monitoring and evaluation (M&E) systems in health projects in Nakuru County. It examines factors such as technological infrastructure, workforce skills, organisational readiness, data quality issues, and policy frameworks that influence the deployment and performance of automated systems. The study adopts a descriptive research design, with data collected using structured questionnaires and key informant interviews. Both quantitative and qualitative data were collected. The study is guided by the Technology Acceptance Model (TAM) and Diffusion of Innovations Theory (DIT), which provide a basis for understanding the perception, adoption and scaling of technological innovations. The findings indicate opportunities to improve data reliability and timeliness, alongside persistent challenges associated with inadequate ICT infrastructure, limited technical skills and resistance to change. The study highlights the importance of aligning automation initiatives with existing institutional frameworks, improving staff skills through training and supporting appropriate policy frameworks. It offers practical recommendations for stakeholders implementing digital M&E systems in health projects, particularly in devolved government settings such as Nakuru County. Technological infrastructure showed a positive, statistically significant association with the extent of M&E system automation (B = 0.479; p = 0.000). Human capacity had a positive but statistically insignificant association with M&E system automation (B = 0.055; p = 0.378). Organisational factors were also positively associated with the level of automation (B = 0.383; p = 0.000); this association was statistically significant. The policy-regulatory environment had a positive but statistically insignificant association with M&E system automation (B = 0.125; p = 0.165) in health projects in Nakuru County, Kenya. The study recommends that the County Government of Nakuru and development partners invest in reliable hardware and software, high-speed internet connectivity (particularly in rural and peri-urban facilities) and interoperability with DHIS2. Proposed measures include allocating additional funds to purchase and maintain devices, using solar power to address unreliable electricity supplies and establishing a county-level technical support centre. These investments may improve automation, data accuracy and reporting timeliness.