MONITORING AND EVALUATION SYSTEMS AND PERFORMANCE OF LINDA MAMA HEALTHCARE PROGRAM IN WEST POKOT COUNTY, KENYA

Abstract

The Linda Mama Program was introduced in Kenya in 2013 as the government's initiative to promote the accessibility and affordability of maternal healthcare and transition to universal healthcare. However, despite its adoption in hospitals country-wide, the program has failed to make maternal healthcare affordable and expectant mothers from poor families continue to bear the burden of healthcare while many others die or lose children during childbirth. The general objective of the study was to understand the relationship between monitoring and evaluation systems and performance of Linda Mama Program in West Pokot County, Kenya. The specific objectives were to examine effect of monitoring and evaluation organizational structures and monitoring and evaluation budgeting on performance of Linda Mama Program in West Pokot County, Kenya.  The study was guided by the theory of change and pecking order theory. This study adopted a descriptive research design. The unit of analysis was 110 public health facilities in West Pokot County.  The unit of observation was 13 maternity nurse in-charge, 107 clinical officers, 208 attending nurses, 33 pharmacists, 41 lab technicians, 8 gynecologists, 113 medical social workers, and 56 county health M&E officers. Yamane sampling formula was used to calculate a sample of 236 respondents. Data was collected using questionnaires. The pilot was conducted with 24 respondents.  The study used content and construct validity. Reliability was tested using the Cronbach Alpha coefficient. Statistical Package for Social Sciences (SPSS) version 28 computer Packages.  The study used descriptive and inferential statistics. Descriptive statistics included frequency, percentage, and mean.  The inferential statistics included correlation and regression. The pilot study confirmed that the research instrument is valid and reliable for assessing the impact of Monitoring and Evaluation (M&E) Systems on the Performance of the Linda Mama Healthcare Program in West Pokot, Kenya. The study established that Monitoring and Evaluation (M&E) systems significantly influence the performance of the Linda Mama Program in West Pokot County, Kenya. Specifically, M&E budgeting had the strongest positive impact (β=0.479, p<0.000), followed by organizational structures (β=0.461, p<0.000). Pearson correlation analysis indicated strong positive correlations between program performance and all independent variables: budgeting (r=0.605), organizational structures (r=0.521), all significant at p<0.05. The regression model was highly significant (F=94.313, p<0.000), explaining 72.4% (R²=0.724) of the variation in the program's performance. These findings underscore the critical role of structured financial management, effective planning, well-defined organizational structures, and robust human resource capacity in enhancing maternal healthcare outcomes under the Linda Mama Program.

Key Words: Linda Mama Program, monitoring and evaluation, organizational structures, budgeting, performance