Monitoring Practices on the Performance of Ministry of Health Projects in Kitutu Masaba Sub County in Nyamira County, Kenya

Abstract

An extensive review of “existing studies indicates that, despite the recognized benefits of implementing monitoring practices in projects, there has been limited attention on their specific impact on the performance of health projects managed by NGOs and government agencies. Presently, knowledge about how monitoring influences project outcomes remains insufficient, and evidence suggests that county-level projects are underperforming compared to previous periods. This study aimed to investigate the effect of monitoring practices on the performance of Ministry of Health (MoH) infrastructure projects in Kitutu Masaba Sub County. The study specifically examined the influence of financial monitoring, human resource monitoring, process monitoring, and participatory monitoring on project performance. Theoretical grounding for the study was provided by Project Learning Theory and the Program Theory of Monitoring. The target population consisted of 327 individuals, including ward representatives, fund managers, and health facility committee members, from which a sample of 180 respondents was drawn. Data were collected using structured questionnaires with closed-ended questions, ensuring that respondents had sufficient information to provide accurate responses. Content validity was confirmed through expert review by supervisors and professionals with expertise in monitoring and evaluation, while reliability of the instruments was verified using Cronbach’s alpha, with a threshold of 0.7 indicating acceptable reliability. A pilot test was conducted with 18 questionnaires, representing 10% of the sample, in Kisii County. Data analysis involved both descriptive and inferential statistics. The individual effects of the four monitoring variables on project performance were assessed using simple linear regression models, while multiple regression analysis evaluated their combined effect. The strength of relationships among the variables was determined using Pearson’s Product Moment Correlation Coefficient. Data were organized in spreadsheets, coded, and analyzed using SPSS Version 23.0. Tables, charts, and figures were employed to present the findings. The results revealed that all four monitoring practices—financial monitoring, human resource monitoring, process monitoring, and participatory monitoring—had a positive and significant effect on the performance of MoH projects in Kitutu Masaba Sub County, Nyamira County. Pearson correlation analysis indicated a strong positive relationship between monitoring practices and project performance (r = 0.708, p < 0.001), demonstrating that effective monitoring significantly enhances project efficiency, accountability, and sustainability. The study concludes that financial monitoring, human resource monitoring, process monitoring, and participatory monitoring all positively contribute to MoH project performance. It is recommended that monitoring frameworks be strengthened through policy support, capacity building, and increased community involvement to further enhance the effectiveness” of MoH projects.