CHALLENGES FACING THE IMPLEMENTATION OF CITIZEN’S … · Senior Lecturer - Jomo Kenyatta University of Agriculture and Technology P.O. Box 52255 – 00100, Nairobi, Kenya, Abstract

ijcrb.webs.com

INTERDISCIPLINARY JOURNAL OF CONTEMPORARY RESEARCH IN BUSINESS

COPY RIGHT © 2013 Institute of Interdisciplinary Business Research

242

APRIL 2013

VOL 4, NO 12

CHALLENGES FACING THE IMPLEMENTATION OF CITIZEN’S CHARTER

A CASE STUDY OF KISII LEVEL 5 HOSPITAL - KENYA

Josiah Obegi Mang’era

(MBA – Strategic Management, Bachelor of Education Arts, Diploma in Computer

Application)

Senior Teacher , St. Joseph Lietego Secondary, P.O. Box 52255 – 00100,

Nairobi, Kenya,

Dr. Walter Okibo Bichanga (Ph.D., MBA, Bcom., Dip. Computer Science, Dip. Personnel Management) Senior Lecturer - Jomo Kenyatta University of Agriculture and Technology

P.O. Box 52255 – 00100, Nairobi, Kenya,

Abstract

Citizen‟s charters are intended to empower citizens by mentioning their rights, privileges

and duties; to make the administrative less bureaucratic-dominated and more citizen-led.

One of the highlights of the sweeping global reforms in public service delivery is the

concept of the citizen‟s charter adopted by many countries around the globe as an

initiative. While several governments have employed similar efforts, it is only in 2003

that Kenya rolled-out the citizen‟s charter as a nation-wide program both to enhance the

delivery of government services and to tap its potential as a tool for good governance.

Despite the fact that Citizen‟s Charters are of such great importance, in the recent years

there has been doubts among professionals on whether employees are achieving the

desired service delivery standards contained in them. This study examined the challenges

of implementing Citizen‟s Charter initiative in the health sector on service delivery. The

study specifically focused on disposition of the implementers, competence of the hospital

staff and the management structure of the hospital. This study was carried out at the

Level 5 Hospital in Kisii county and the target population was two administrators, twelve

Doctors, twenty seven Clinical Officers and two hundred and thirty eight Nurses all of

whom are permanently employed by public service in the hospital (KL5H staff register).

Stratification and simple random sampling were used to attain the required sample size of

84 respondents. Questionnaire and observation were used as tools for data collection.

Quantitative and qualitative analyses were followed. Findings showed that although

many players in the implementation team were aware of the existence and importance of

ijcrb.webs.com



243

APRIL 2013

VOL 4, NO 12

the Citizen‟s charter, still the charter program suffered greatly. Standards and time frames

set in the Citizen‟s charter were considered not to be realistic.

Keywords: Citizen’s Charter, Implementation, Kisii Level 5, Government services and

Challenges

List of Acronyms: CC – Citizen‟s Charter, CO – Clinical Officer, KL5H – Kisii Level 5

Hospital, MOPHS – Ministry of Public Health and Sanitation, NPM – New Public

Management, PSRP – Public Service Reform Programme, SS – Support Staff, TQM –

Total Quality Management, UNDP – United Nations Development Programme, SPSS -

Statistical Package for Social Sciences

1. Background of the Study

Prof Savitch, H.V (1998) in his presentation on institutional capacity, compares public

service delivery with policy implementation which he regards as the accomplishment of

policy objectives through the planning and programming of operations and projects so

that agreed upon outcomes and desired impacts are achieved. Public service for many

years has been blamed for poor service delivery which some scholars like Obsorne and

Plastnik; (1997) refer to ineffective, insensitive and inefficient and often hostile to the

very people they are supposed to serve. Many countries world over have tried to come up

with new ways of delivering services to citizens effectively and efficiently by shifting the

focus from the service providers to service receivers. One of the tools which has yielded

positive results in this shift is the citizen charter. A citizen charter can be defined as a

written statement prepared by a public institution which outlines the nature, quality and

quantity of service that citizens should expect from the institution. It should outline; what

the institution does, the standards of the services to be provided, what service users can

expect, the responsibilities of the service users and how users may seek redress if they are

dissatisfied with the services or in the event the institution does not live up to the

commitments in the charter (Ministry of Health-Kenya 2010).

Citizen charters were first articulated and implemented in the United Kingdom by the

Conservative Government of John Major in 1991 as a National Programme with a simple

aim, to continuously improve the quality of public services for the people of the country

so that these services respond to the needs and wishes of the users. Several countries

ijcrb.webs.com



244

APRIL 2013

VOL 4, NO 12

around the world have implemented similar programmes such as the UK‟s while others

chart new ground by leaning on the service quality paradigm of the Total Quality

Management (TQM), examples Australia (service charter, 1997) Belgium (public service

users‟ charter 1992) Canada (service standards initiative 1995), France (service charter

1992), India (citizen‟s charter 1997) and Malaysia (client charter 1993) (Centre For Good

Governance 2008).

Public Service Reforms in Kenya started immediately after independence. The reforms

were aimed at addressing three challenges facing the government at the time namely

disease, poverty and illiteracy. The main focus was on Africanization of public service,

land reforms among others with the objective of improving service delivery and

performance. Noting that Public Service efficiency sets standards for other sectors, the

Kenyan government launched the Civil Service Reform Programme in 1993 to enhance

Public Service efficiency and productivity. The reforms were expected to facilitate

equitable wealth distribution necessary for poverty alleviation and create an enabling

environment for investment and enhanced private sector growth.

Since 2003 the government of Kenya has adopted different reform strategies to improve

service delivery, notably; Rapid Results Approach, Performance Contracting,

Transformative Leadership Values & Ethics, Institutional Capacity Building and

Citizen‟s Charter. All service-based government institutions are required to develop and

implement citizen‟s charter in Kenya. The ministry of health launched its service charter

in December 2006 for health service delivery. Despite the fact that these reforms have

taken place in the country and service provision improved greatly we still find service

provision from government sector being below their own set standards in their citizen‟s

charter. This study seeks to find out challenges of implementing citizen‟s charter in the

health sector.

2. Purpose of the Study

The purpose of this study was to find out challenges of implementing citizen‟s charter on

service delivery in Kisii Level 5 Hospital in Kisii county-Kenya.

ijcrb.webs.com



245

APRIL 2013

VOL 4, NO 12

3. Statement of the Problem

According to MOPHS (2008-2012) Service delivery in government health facilities in

Kenya still faces multiple challenges. These challenges can still be identified six years

down the line since the introduction of citizen charter. The Citizen‟s Charter initiative

introduced in the ministry of health in 2006 intended to improve the old bureaucratic

service delivery mechanism in the hospitals by enhancing transparency, accountability

and responsiveness to the citizens. Kisii Level 5 Hospital adopted the Citizen‟s Charter as

a tool for good governance and improved service delivery yet still clients complained of

the quality of services they received as not meeting the standards specified in the charter.

4. Objectives of the Study

1) This study tries to evaluate challenges facing the implementation of citizen’s charter in

the health sector.

2) To establish how the disposition of implementers of citizen’s charter influence in

implementation of citizen’s charter.

3) To find out how the competence of the hospital staff affect the implementation of the

citizen’s charter.

4) To explore how the hospital management structure influence the citizen’s charter

implementation.

5. Justification of the Study

All public institutions in Kenya are funded by the government to subsidize the running

costs so that citizens can be given better services. Citizens expect to receive effective,

efficient and prompt services whenever they visit any public health facility, given that the

facilities are subsidized by their own tax. Even after the introduction of Citizen‟s Charter

in public institutions, still clients of public hospitals raised eye brows as to whether the

hospitals are meeting the very standards set in their citizen charters. The study sought to

find out challenges facing the implementation of the citizen‟s charter as a tool of

improving the effectiveness, efficiency and promptness of service delivery in this public

institution.

ijcrb.webs.com



246

APRIL 2013

VOL 4, NO 12

6. Scope of the Study

The research was conducted in Kisii Level 5 Hospital within Kisii County between

November 2012 to January 2013. The research was a case study and a sample of eight-

four respondents were sampled randomly from a stratification of four levels of employees

( administrators, doctors, nurses and clinical officers ) drawn from the target population

of all two hundred and seventy eight employees of the hospital. Data were collected using

questionnaires and observation methods.

7. Significance of the Study

It is expected that the study will shade light to employees of the health sector on citizen‟s

charter. The study also intended to come up with new knowledge for the health sector

which would be used by the hospital management to deliver prompt efficient and

effective services. Besides, the findings of this study were expected to add value to the

existing literature on service delivery in Kenya and in general all other organizations

which might be serious enough to accommodate the citizen charter.

8. Limitations

Some respondents declined to answer a questionnaire due to fear of hospital secrets

leaking while some senior management officers declined to share some information,

which they considered vital to the hospital. This prompted some parts of the study to rely

on secondary data which was found in the hospital library and human resource

department.

LITERATURE REVIEW

9. Theoretical Framework

Due to rapid technological, political and social changes that have taken place in the last

few years, governments have been forced to take fundamental administrative changes to

embrace development. Traditionally governments dominated in decision making and

citizens were treated as service receivers with less regard of their interests. These,

according to Osborne and Gaebler (1992), caused irritation to citizens in dealing with the

arrogance of the government bureaucracy where he further argues that even skilled

people get lost in the bureaucratic wilderness in government operations. Since the

ijcrb.webs.com



247

APRIL 2013

VOL 4, NO 12

inception of the NPM policy different governments have shifted paradigm of

management to good governance which tends to move the conventionally provider-

dominated, especially in public service provision such as health care and education where

powerful autonomous professions defended vested interests and could not be held to

account (Pollitt, 1994), into one that is bottom-up and citizen driven. The study will focus

on the theory of good governance and policy implementation theory as reviewed by

different scholars as a basis for CC.

Theory of Good Governance

According to UNDP (2000), good governance means managing public in a manner that is

transparent, accountable, and participatory based on rule of law consensus. Citizens who

are service users have had problems while dealing with service providers; they have

encountered poor governance as opposed to good governance. United Nations

Development Program (2000) spells out eight characteristics of good governance;

Accountability, Transparency, Responsiveness, Equity and Inclusiveness, Effectiveness

and Efficiency, Rule of law, Participation, and Consensus building. The European

commission in 2001, published a white paper on governance that presented five

principles of good governance; openness, participation, accountability, effectiveness, and

coherence (European commission 2001).

Implementation Theory

Implementation is the process of turning policy into practice. However, it is common to

observe a gap between what was planned and what actually occurred as a result of a

policy. According to Buse (2005), there are three major theoretical models of policy

implementation. Top-down approach: This approach sees policy formation and policy

execution as distinct activities. Policies are set at higher levels in a political process and

are then communicated to subordinate levels that are then charged with the technical,

managerial, and administrative tasks of putting policy into practice. Bottom-up

approach: This approach recognizes that individuals at subordinate levels are likely to

play an active part in implementation and may have some discretion to reshape objectives

of the policy and change the way it is implemented. Principal-agent theory: In each

ijcrb.webs.com



248

APRIL 2013

VOL 4, NO 12

situation there will be a relationship between principals (those who define policy) and

agents (those who implement policy), which may include contracts or agreements that

enable the principal to specify what is provided and check that this has been

accomplished. According to Pressman and Wildavsky (1973), Implementation, is the

ability to forge subsequent links in the causal chain so as to obtain the desired result. Van

Meter and Van Horn (1975) describe Policy implementation as encompassing “those

actions by public or private individuals (or groups) that are directed at the achievement of

objectives set forth in prior policy decisions."

10. Conceptual Framework

11. Knowledge Gap

Kenya‟s PSRP was introduced in 1993 and it aimed at improving service provision under

which the CC was launched as one of the tools to enhance transparency, accountability

and responsiveness of the service providers. Though this initiative of CC has been widely

adopted by many ministries and government institutions, there are no legal and social

mechanism put in place to monitor and give information on the implementation of the

CC. This study sought to find out the challenges of implementing the CC in KL5H and

come up with information that leads to enhanced and better utilization of this vital tool of

good governance.

ijcrb.webs.com



249

APRIL 2013

VOL 4, NO 12

RESEARCH METHODOLOGY

12. Research Design

The study adopted a descriptive study design. This study design would help capture the

cognition, direction of response, the intensity of response, training of staff, response to

citizen and the management structure.

13. Target Population

This study was conducted in Kisii Level 5 Hospital. The target population were all the

two (2) administrators, twelve (12) doctors, all the twenty seven (27) clinical officers and

all the two hundred and thirty eight (238) nurses who were, employed permanent as

contained in the staff register. This population was chosen because they were the most,

immediate implementers of the Citizen‟s Charter. Also, the hospital is the largest health

provider in the region and was the only Level 5 hospital within Kisii, Nyamira, Migori

and Narok counties.

14. Sampling Procedure

Employees were stratified into four levels- Administrators, Doctors, clinical officers and

nurses. One administrator, representing 50%, and an equal percentage of 30% from the

number of doctors, clinical officers and nurses were calculated as tabulated bellow;

Table 1 Sampling Procedure

15. Data Processing and Analyis

The data collected were both quantitative and qualitative nature. Qualitative and

quantitative analysis were followed to analyse the data. Quantitative data collected was

coded, organized and analyzed according to research objectives using descriptive

Level Number Percentage % Total

Administrators 2 50 1

Doctors 12 30 4

C.O 27 30 4

Nurses 238 30 71

279 84

ijcrb.webs.com



250

APRIL 2013

VOL 4, NO 12

statistics. The mean was used to determine the levels of agreement within variables.

SPSS computer package was used to present the analyzed data into tables. Qualitative

data was analyzed in narration form through coding and organizing it into themes and

concepts.

RESEARCH FINDINGS AND DISCUSSION

The main objective of this section was to use qualitative data in a process of inductive

reasoning within the context of hospital setting in order to generate ideas, as opposed to

hypothesis testing. Much of the qualitative analysis was focused on the strategies

hospitals are using to implement the charter so that they would realize the full value of

the charter.

16. Composition of Respondents

The data obtained came from four categories of respondents. The constitution of

respondents were tabulated as depicted in table 2 below.

Table 2 Categories of Respondents

Category No of Respondents % rate

Nurses 71 84

Administrator 1 1

Doctors 4 5

Clinical Officers 8 10

84 100

It was evident that out of eight-four respondents, seventy-one were nurses who

represented 84% of the total sample whereas the number of administrators who

responded to the questionnaire was one which represented 1%. Doctors, who responded

to the interviewing questionnaires, were four who represented 5% of the respondents and

clinical officers constituted 10%.

ijcrb.webs.com



251

APRIL 2013

VOL 4, NO 12

17. Years of Work Experience

It is worthwhile to take into consideration the years of experience that the respondents

have. This will somehow reflect knowledge and implementation of the CC among the

respondents.

Table 3 Years of Work Experience

Years Practiced No of Respondents % Rate

Less than 5 years 40 48

5 ≥ years ≤ 15 8 9

Over 15 years 36 43

84 100

Most of the respondents have a work experience for less than 5 years. This is represented

by 48%, followed by those with over 15 years experience represented by 43 % and lastly

those with work experience between 5 years and 15 years. It is therefore presumably safe

to say that implementation of CC has been greatly affected due to lack of many years of

work experience.

18. Findings on Implementer’s disposition

The citizens‟ charter being a new policy in the medical field in Kenya drew various

reactions on how the public responded to its implementation. The reactions were based

on the employees‟ awareness, its usefulness, whether it has made the services in public

hospitals improve, its facilitating nature of dealing with citizens and whether it could

transform a dream into reality.

The „likert‟ scale guided the respondents in giving their opinion about the perception on

the implementation of the charter and was recorded according to the level of agreement.

An open question seeking a general opinion of respondents about what they feel should

be done to improve on implementation of CC was of great benefit to this variable.

According to Saunders (2007), the „likert‟ scale is the level of agreement (strongly agree,

agree undecided, disagree and strongly disagree). From these likert scale, the respondents

have a preference. The fact is that the „likert‟ scale has the advantages, as it presents a

load of data for conducting the research in a limited time and is able to analyze very

simply and effectively. The respondents gave information in order to ascertain their

ijcrb.webs.com



252

APRIL 2013

VOL 4, NO 12

views on challenges faced by hospitals in implementing citizens‟ charter, as well as to

gain an approximate picture of how their characteristics and views were similar or

different, on dimensions of relevance to the study.

Table 4 Implementer‟s disposition about the citizens‟ charter

Level of Agreement

Aspects about Citizen’s Charter 5 4 3 2 1

Awareness of employees on existence of

CC

52 24 4 4 0

Usefulness of CC in provision of service 40 28 4 12 0

Improved service 28 36 12 8 0

Improved inquiry by clients 24 44 8 8 0

Positive feedback from citizens 16 40 16 8 4

Level of realities in the CC 12 32 20 12 8

Analysis of Implementer’s disposition

Mean value of general perception of the citizens‟ charter is given by;

Mean (µ) = Where Fi is the number of respondents in each slot. Wi is the weight

that represents the level of agreement.

Table 5 Calculation of Mean

Level of Agreement


Weighted

Mean

Awareness of employees on existence of

CC

52 24 4 4 0 84 376 4.48

Usefulness of CC in provision of service 40 28 4 12 0 84 348 4.14

Improved service 28 36 12 8 0 84 336 4.00

Improved inquiry by clients 24 44 8 8 0 84 336 4.00

Positive feedback from citizens 16 40 16 8 4 84 308 3.67

Level of realities in the CC 12 32 20 12 8 84 280 3.33

Mean 4.01

ijcrb.webs.com



253

APRIL 2013

VOL 4, NO 12

The mean value level of agreement in favour of the implementer‟s disposition about the

citizens‟ charter is 4.01. The study obtained the mean through engagement of weights on

the level of agreement that was 1 – 5. The table shows that the weighted mean on

employee awareness of the CC is high. Employees also agreed that service provisions

have since improved and that CC is useful on the daily provision of service. Majority of

the respondents agreed that the CC helped to facilitate in dealing with citizens and that

citizens make more inquiries since the introduction of CC. However many of the

respondents were undecided whether the standards and time frames in the CC were

realistic, also a good number of respondents were undecided whether CCs have helped

improve on feedback from Citizens.

19. Staff Competence

Korossy (1997), defines competence as skills or abilities that enable persons to solve a

problem, and cannot be observed directly. Of course, competence, demands and

performance are related. However, competences are properties of persons, while demands

are properties of problems. While a demand requires a competence to fulfil it, the

relationship is not a one to one relation. It is worthwhile to note that when a performance

of a person is observed, it is not obvious what underlying competences have contributed

to the solution.

Table 6 Level of Staff Competence

Level of Agreement

Competence Aspects 5 4 3 2 1

Conversant with the citizens' charter 12 4 8 36 24

Inadequacy of training on new technology 8 8 16 36 16

Citizen‟s awareness of the existence of CC 28 24 8 16 8

Level of publicity 24 32 12 8 8

High level of communication about service

charter among staff

8 24 8 32 12

Awareness of local language 8 44 0 20 12

ijcrb.webs.com



254

APRIL 2013

VOL 4, NO 12

Analysis of Staff Competence

The mean was reached through the weights assigned to the level of agreement of the

competence aspect in the likert scale.

Mean (µ) =

Where Fi is the number of respondents in each slot

Wi is the weight that represents the level of agreement

Table 7 Calculation of Mean

Level of Agreement


Weighted

Mean

Conversant with the citizens' charter 12 4 8 36 24 84 196 2.33

Inadequacy of training on new

technology

8 8 16 36 16 84 208 2.48

Citizen‟s awareness of the existence of

CC

28 24 8 16 8 84 300 3.57

Level of publicity 24 32 12 8 8 84 308 3.67

High level of communication about

service charter among staff

8 24 8 32 12 84 236 2.81

Awareness of local language 8 44 0 20 12 84 268 3.19

Mean

3.01

The mean value was 3.01. It exceeded the figure three (3) which represented the

undecided level in the „likert‟ scale. It was worthwhile to conclude that the respondents

had confidence in the competence of staff to embrace the spirit of citizens‟ charter.

However, data from the table above indicate that employees were not given enough

training on CC and that the training on the new technology recently introduced in the

hospital was inadequate. Also, the data show that communication amongst staff about the

CC was not adequate.

ijcrb.webs.com



255

APRIL 2013

VOL 4, NO 12

20. Management Structure

Choosing the correct management structure ensures an organization‟s continued growth,

content, employees and profitable returns for the shareholders. Choosing the wrong

structure creates tension between employees and managers, allows inefficient work

practices to flourish and reduces company profitability. In the worst case, an incorrect

management structure can lead to company closure. A number of key components that

underpin a management structure in the organization and should be considered when

implementing a new structure. They include; task definition, communication style,

formalization, type of influence, centralization, complexity and coordination.

Table 8 Management Structure and Responses

Management View on Citizens' charter

Level of Agreement

5 4 3 2 1

Adequacy of information to citizens 8 36 4 28 8

Constant supervision by the seniors 20 36 4 20 4

Adequacy of staff to implement charter 0 16 4 36 28

Teamwork is embraced 20 40 4 12 8

Decision remains the management's role 20 28 0 28 8

Barriers by rules and regulations 4 32 12 28 8

Priorities are adhered to 20 36 12 8 8

Sensible and knowledgeable seniors 8 40 12 12 12

There exists free downward communication 12 40 8 12 12

ijcrb.webs.com



256

APRIL 2013

VOL 4, NO 12

Analysis of Management Structure

Table 9 Views about Management

Management View on Citizens'

charter

Level of Agreement

Weighted

Mean 5 4 3 2 1

Adequacy of information to citizens 8 36 4 28 8 84 260

3.10

Constant supervision by the seniors 20 36 4 20 4 84 300

3.57

Adequacy of staff to implement charter 0 16 4 36 28 84 176

2.10

Teamwork is embraced 20 40 4 12 8 84 304

3.62

Decision remains the management's

role 20 28 0 28 8 84 276

3.29

Barriers by rules and regulations 4 32 12 28 8 84 248 2.95

priorities are adhered to 20 36 12 8 8 84 304

3.62

Sensible and knowledgeable seniors 8 40 12 12 12 84 272

3.24

there exists free downward

communication 12 40 8 12 12 84 280

3.33

Mean

3.20

The mean value was 3.2. It exceeded the figure three (3) which represented the undecided

level in the „likert‟ scale. It was worthwhile to conclude that the respondents had

confidence in the management structure to embrace the spirit of citizens‟ charter. The

data showed there was inadequate staff in the hospital which has resulted to low

implementation of CC, and that some rules and regulations in the hospital hinder the

smooth implementation of CC.

ijcrb.webs.com



257

APRIL 2013

VOL 4, NO 12

SUMMARY, CONCLUSSIONS AND RECOMMENDATIONS

21. Summary of the Findings

It was evident from the findings that the mean exceeded three (3) mark. This meant that

the majority of the respondents agreed, that the charter implementation benefitted from

both the implementers‟ disposition, competence of the staff and the management

structure was conducive. However, some were of the opinion that little input was in place

to make the charter popular among the beneficiaries. Owing to the numerous challenges

that hinder the implementation of the citizen‟s charter, the study established that a lot was

required. The implementers needed a thorough training on the strategies to implement the

charter. Many players were conversant with the existence and importance of the charter.

However, what was on the ground did not portray the same. This was evident from the

findings that established that patients could stay in ques for long hours more than

stipulated in the CC and they only complained to hospital management when there was a

problem but kept quiet when not aggrieved. It was found that some rules and regulations

in the hospital hindered CC implementation also communication among staff was

inadequate. Many employees were undecided whether standards and time frames in CC

were realistic.

22. Conclusion

Citizen‟s charter is an important strategic process that seeks to address the challenges that

affect service delivery in hospitals. It is worthwhile to note that its implementation suffers

a lot since various players have received less support, both materially and non-materially.

The research attained its basic objectives; to evaluate the challenges that face the

implementation of citizen‟s charter. A lot was required to ensure service delivery became

so efficient in hospitals across the country and even beyond. They included; training,

publicity through advertisement, recruitment of more staff and embraced modern

technology. Besides, for the service charter to realize better implementation exercise the

ministry needed to employ enough and qualified personnel to undertake the exercise of

citizen‟s charter implementation. Lack of enough and qualified staff, stagnated the

process of effectiveness in service delivery as provided in the charter. It is imperative to

note that adequate training on new technologies eased the challenge of implementation of

ijcrb.webs.com



258

APRIL 2013

VOL 4, NO 12

the charter. This would go along with staff motivation and even translation of citizen‟s

charter to local languages which the intended beneficiary would understand.

23. Recommendations

The ministry should recruit field officers ought to synthesize the citizens about the

existence of the charter that ensured efficient service delivery in hospitals. The exercise

would reduce the incidences of manipulation of the citizens by hospital staff. The staff

required intensive training about the strategies towards implementation of the charter and

consequently, on how to maximize the utilization of the existing staff. The ministry

should employ some resources to train its workers and even encourage the employees to

go and pursue courses on their own, which would be beneficial to the implementation of

the charter.

Motivated workers efficiently increased output. The ministry should motivate workers,

both psychologically and economically. It is worth to note that the ministry did very little

to make the profession in medical, administration and management fields seen lucrative.

Regular workshops and trips are necessary to psychological satisfaction whereas salary

increment is necessary to economic satisfaction.

ijcrb.webs.com



259

APRIL 2013

VOL 4, NO 12

References

Aminuzzaman, M.S.(1991). Introduction to social research. Dhaka, Bangladesh Printers.

Anwaruddin ,A.(2005). “Improving public service development through bureaucracy

reform”. A paper presented at NAPSIPAG. Available at:

http://mazawang.wordpress.com/2009/12/11/improving public-service delivery-through-

bureaucracy-reform/ (Accessed on 15, December, 2011).

Bardach, E. (1977). The implementation game: What Happens After a Bill Becomes

Law? Cambridge, MA, MIT.

Beniwal, V. S. (2005). Challenges and prospects of implementing citizen‟s charter: A

Study of Panchkula (Haryana) Municipal Council in India. M. Phil. Dissertation.

Department of Administration and Organisation Theory, University of Bergen, Norway.

Brodkin, E. (1990). “Implementation as policy politics”. In Implementation and the

Policy Process. Opening the Black Box, eds., D.J. Palumbo and D.J. Calista, Greenwood

Press.

Buse, K., Mays, N., &Walt G. (2005). Making health policy. Understanding Public

Health Series Open University Press.

Edwads (1978).The policy Predicament, making and implementing public policy, San

Francisco: W.H. Freeman and Company.

Elke Loffler (2006). Making quality sustainable. Co-Design, Co-Decide, Co-Produce,

Co-Evaluate; Conclusions of the 4Qs Quality Conference for Public Administrations in

the EU, Finnish Ministry of Finance, Helsinki.

Grindle, M.S.(1990). Policy content and context in implementation. In Grindle M.S.

(Ed.),

Politics and policy implementation in the Third World. Princetown, NJ: Princetown

University

Press.

Hill, H.C. (2003). “Understanding implementation. Street-Level Bureaucrats‟ Resources

for Reform”, Journal of Public Administration Research and Theory, 13(3), 265-282.

Hofstede Geert (2005). Cultures and Organizations.

Hood, C. (1999). “A public administration for all seasons‟, Public Administration, 69,

pp.3-19.

Howlett, Michael & Ramesh, M. (2003), Studying public policy: Policy Cycles and

Policy Subsystems, Oxford University Press.

Ingraham, P.W. (1997). “Play it again sam; It Still Not Right: Searching for the Right

Notes in Administrative Reform”, Public Administrative Review, 54(4), 325-31.

Korossy (1997). Evaluating developmental assessment centres as interventions. New

York: Academic Press.

Kotler, P. (1988). International journal of marketing research, 54 (2).

Lane, J.E. (2005). New public management. London, Routledge.

Lipsky, M. (1980). Street level bureaucracy: Dilemmas of the Individual in Public

Services, New York, Sage Foundation.

Lin, A.C. (2000). Reform in the making; The Implementation of Social Policy in Prison,

Princeton University Press.

ijcrb.webs.com



260

APRIL 2013

VOL 4, NO 12

Matland, R.E. (1995). Synthesizing the implementation literature: The Ambiguity-

Conflict Model of Policy Implementation. Journal of Public Administration: Research

and Theory ,5(2), April.

Mazmanian, D.A. & P.A. Sabatier (1981). Implementation and public policy. New York,

University Press.

Mazmanian, D.A. & Sabatier, P.A. (1981). Effective policy implementation. Lexington,

Heath and Co.

Meter Van & Horn Van. (1975). “The policy implementation process: A Conceptual

Framework” Administration and Society. February.

Michael (1998). “Citizen‟s charter: People‟s Charter in the U.K” International Review of

Administrative Science (Vol 64).

Ministry of Health (2005). “The national health sector strategic plan (NHSSP II) (2005-

2010): Reversing the trends”. Nairobi. Government of Kenya.

Ministry Of Public Health and Sanitation(2008). “Public health and sanitation strategic

plan.2008-2012”. Nairobi.

Mugenda O.M & Mugenda G.A. (1999). Research methods; Quantitative and Qualitative

Approaches, Nairobi: ACTS Press.

OECD (2010). Ministerial symposium on the future of public service, Paris: OECD.

Osborne, David & Peter Plastrik (1997). Banishing bureaucracy: The Five Strategies for

Reinventing Government, Addison-Wesley, Massachusetts.

Osborne, D. & Gaebler, T. (1992). Reinventing government. How the entrepreneurial

spirit is transforming the public sector, New Delhi, Prentice-Hall of India.

Peters, B. Guy, (2001). The future of governance; Four Emerging Models, Lawrence,

University press of Kansas.

Pollitt C. (1994). Managerialism and the public services, The Anglo-American

Experience, Oxford, Blackwell.

Pressman, J.L. & Wildavsky, (1973). Implementation, Barkley and Los Angeles,

University of California Press.

Roscoe,J.T. (1975). Fundamental research statistics for the behavioral science (2nd

.ed),

New York: Rinehart and Winston.

Saunders, M. (2007). Research methods for business students. Harlow, Prentice Hall.

Savitch, h.v. (1998). Global challenge and institutional capacity: Or, How We Can Refit

Local

Administration for the Next Century. Administration & Society, 30(3), 248-273.

Service Charter Handbook (Oct, 2010). Ministry of medical services; Department of

Pharmacy

Sekaran, U. (2010). Research methods for business: A Skill Building Approach, U.K,

John Wiley and Sons.

United Nations Development Programme (2002). “Citizen‟s Charters. Selected

Examples”.

Warwick, D.P. (1982). Bitter pills population policies and their implementation in eight

developing countries. Cambridge, Cambridge University Press.

World Bank (1989). World bank development report. Washington DC: World Bank.

Yanow, D. (1996). How does a policy mean. Georgetown ,University Press.

Documents

CHALLENGES FACING THE IMPLEMENTATION OF CITIZEN’S … · Senior Lecturer - Jomo Kenyatta University of Agriculture and Technology P.O. Box 52255 – 00100, Nairobi, Kenya, Abstract