Qualitative data on: Sustainability drivers and inhibitors for the health system performance improvement projects in selected health facilities in Kenya

Objectives to investigate the health managers perceived sustainability
status of the health facilities institutional improvement projects and
their experiences on factors that facilitated or constrained their
maintenance, with intentions of informing relevant strategies or policies
in Kenya's health sector. Methods A qualitative study, nested within
a quasi-experimental study. Thirty-three project-teams of health managers
were purposively selected and interviewed based on their project
implementation success rates post-training. The managers had previously
undergone a 9-month leadership training, complimented with facility-based
team coaching around the chosen projects. The training was funded by the
USAID; however, the implementation of the projects was based on how the
participants could innovatively utilize the existing resource to create a
positive change. The projects were housed within 20 public, nine
faith-based, and four private health facilities in 19 Counties in
Kenya.  The interviews explored the manager’s experiences in
sustaining the successfully implemented projects within the (24-60 months
post-training period).  We asked Managers to describe factors
they perceived enabled or hindered the sustainability of the successfully
implemented institutional improvement project. The digitally
audio-recorded interviews were transcribed verbatim.  Data on
barriers and enablers were thematically analyzed. Results Twenty-seven out
of the 33 successfully implemented projects reported sustainability within
periods ranging from 24-60 months post-training. Seven themes related to
drivers of sustainability emerged, namely; program design,
stakeholder's buy-in, board members, communication, coaching,
presence of change champion, devolution and political good-will. Four
sustainability inhibitors identified were; human resources constraints,
policy implementation, misalignment of projects with daily operations,
devolution and political interference. Conclusions The sustainability of
institutional improvement strategies such as projects implemented
post-leadership training in public and private health facilities depends
on the quality of board members, communication management and
institutionalization of coaching culture. These findings are pertinent for
planning and implementing similar health systems strengthening
intervention in low-income countries.