A balanced scorecard analysis of financing practices and business sustainability in private hospitals in Nairobi, Kenya

Abstract

Health is one of socio-economic components of delivering the vision’s 2030 Social pillar. However, it remains a global challenge and an impediment to the human capital growth and development. The sector is credited with the robust role it plays in ensuring healthy and skilled workforce capable of driving the economy and meeting global commitments for health such as the Abuja and Maputo Declarations. To this end, the sector contributes an average of 6% to the GDP. Therefore, the realization of fundamental rights to health and the contribution to economic development as enshrined in the vision 2030 is anchored on the development and sustainability of comprehensive investment in health systems. In Kenya, private hospitals provide over 47% of the healthcare services to the general population of over 53.8 million people in Kenya. This is an indicator of a strong yardstick in which the economic growth and prowess of a nation can be assessed. Despite the importance of hospitals in provision of health, their sustainability has been at risk. This has a major ramification on the smooth provision of health services to Kenyans, and the implementation of the Kenya Health Policy 2014-2030. Effective financing practices play a great role in safeguarding sustainability of private hospitals thus ensuring business continuity. Through a balanced scorecard analysis, this study evaluated how business sustainability was influenced by the financing practices of private hospitals in Nairobi County, Kenya. This study adopted positivism research philosophy and a descriptive research design. The study involved 68 private hospitals located in Nairobi, as advised by the 2019 Kenya Medical Practitioners and Dentist Board retention register. A closed ended questionnaire was employed in collecting primary data. A bivariate linear regression was used for inferential analysis after testing the data for normality, independence. The study established a strong, positive, and statistically significant relationship between financing practices and the sustainability of private hospitals in Nairobi. The study recommended that private hospitals should continuously build the capacity of the financing function by pooling of resources to increase efficiency in utilization of health resources as it has a significant relationship with sustainability of hospitals. In addition, they should consider borrowing assets in cases of financial crisis as a sustainability safeguard. Such practices will not only aid in developing and strengthening healthcare financing but also in reviewing of the criteria for resource allocation and utilization. Hospitals should also continuously establish good working relationships with their suppliers and service providers to enable them access necessities on credit in case of financial crisis. This will not only ensure success of the private hospitals but also in the reinforcement of the sustainability potential. In addition, hospitals should consider lease of assets to boost the financing of the hospital operations as a way of improving on the cash inflows.