The Efficacy of Relationship Marketing on Service Quality Perception in Kenyan Healthcare Providers: A Systematic Empirical Literature Review

Relationship marketing (RM) enhances perceived service quality in healthcare by shifting interactions from isolated transactions to sustained, trust-based relationships through personalised communication, engagement, and feedback. In Kenya, embedding these principles into routine care faces challenges due to resource limitations and cultural diversity, which adversely affect patients’ perceptions of service quality. This systematic review synthesises evidence on the impact of RM on patient perceptions in Kenyan healthcare, emphasising personalised and culturally sensitive engagement, implementation barriers, feedback mechanisms, and cultural heterogeneity. A PRISMA-aligned search of PubMed, Scopus, Web of Science, and Google Scholar identified peer-reviewed quantitative, qualitative, and mixed-methods studies published in English between 2016 and 2025 using keywords related to RM, service quality, and patient satisfaction. Screening and data extraction were conducted independently by two reviewers, with quality assessment performed using the JBI, CASP, and integrated mixed-methods criteria. The synthesis was guided by Relationship Marketing Theory, Social Exchange Theory, and an RM-adapted SERVQUAL framework. Findings indicate that personalised communication and culturally sensitive engagement foster trust, rapport, and support, enhancing perceived service quality, particularly in empathy, assurance, and responsiveness. However, RM implementation is hindered by high patient volumes, scarce resources, limited relational training, weak feedback infrastructure, and ethnic diversity with varied health beliefs. This review integrates evidence on RM in Kenya’s resource-constrained, culturally diverse public healthcare sector, demonstrating that while RM can improve service quality perception, its success depends on overcoming systemic barriers and addressing cultural heterogeneity. To address these challenges, an adapted RM-SERVQUAL framework is proposed, extending tangibility, reliability, responsiveness, assurance, and empathy with cultural competence and resource adaptability. Low-cost, high-impact interventions are recommended, including peer-led cultural competence training modules, SMS-based patient feedback systems, and tiered communication protocols based on patient acuity and cultural complexity, to enhance the feasibility and effectiveness of RM in Kenyan healthcare settings.