Green Practices and supply chain performance in government hospitals in Nairobi, Kenya


Project Report, 2017
60 Pages, Grade: A

Excerpt

iii
DEDICATION
I dedicate this research project to my loving daughter Abigail Mwendwa Kiruya , my
parents; Mr. Stanley Mbaabu and Mrs. Jerusha Mbaabu ,my sister, Dr. Karen Mwaura
her husband Mwaura and my brother Evans Munya for the tireless support they have
offered me.

iv
ACKNOWLEDGEMENT
I thank the Almighty God for enabling me do and complete the research.
I thank my Loving daughter Abigail Mwendwa Kiruya, for her patience and
understanding, together with my parents and siblings for their enduring support
throughout the program.
I also thank my supervisor, Mr. Michael Chirchir for his continued guidance and
support while doing the research.
I finally thank all respondents that took their time to enable me in data collection.

v
TABLE OF CONTENTS
DEDICATION... iii
ACKNOWLEDGEMENT ... iv
LIST OF FIGURES ... viii
LIST OF TABLES ... ix
ABBREVIATIONS AND ACRONYMS ... x
ABSTRACT ... xi
CHAPTER ONE:INTRODUCTION ... 1
1.1 Background of the Study ... 1
1.1.1 Green Supply Chain Management Practices ... 2
1.1.2 Supply Chain Performance... 3
1.1.3 Government Hospitals in Kenya ... 3
1.2 Research Problem ... 4
1.3 Research Objectives ... 7
1.4 Value of the Study ... 8
CHAPTER TWO:
LITERATURE REVIEW ... 10
2.1 Introduction ... 10
2.2 Theoretical Foundation ... 10
2.2.1 Resource Based View ... 10
2.2.2 Resource Dependence Theory ... 11
2.2.3 Institutional Theory ... 12
2.3 Green Supply Chain Management Practices... 13
2.3.1 Green Procurement ... 13
2.3.2 Eco Design ... 15

vi
2.3.3 Reverse Logistics ... 15
2.3.4 Waste Management ... 16
2.4 Supply Chain Performance ... 17
2.5 Green Supply Chain Management and Supply Chain Performance ... 17
2.6 Summary of Literature Review and Knowledge Gaps ... 18
2.7 Challenges of Implementing Green Supply Chain Management Practices ... 18
2.8 Conceptual Framework ... 19
CHAPTER THREE:
RESEARCH METHODOLOGY ... 21
3.1 Introduction ... 21
3.2 Research Design... 21
3.3 Population ... 21
3.4 Data Collection ... 21
3.5 Data Analysis ... 22
CHAPTER FOUR: DATA ANALYSIS PRESENTATION AND DISCUSSION
... 24
4.1 Introduction ... 24
4.2 Response rate ... 24
4.3 General information ... 24
4.4 Current Job Designation ... 25
4.5 Green Supply Chain Management Practices... 26
4.6 Supply Chain Performance ... 29
4.7 Relationship between Green supply chain management practices and supply chain
performance ... 31

vii
CHAPTER FIVE:SUMMARY, CONCLUSION AND RECOMMENDATIONS
... 37
5.1 Introduction ... 37
5.2 Summary of Findings ... 37
5.3 Conclusion ... 38
5.4 Recommendation ... 38
5.5 Limitations and areas of further research ... 39
REFERENCES ... 40
APPENDICES ... 43
Appendix II Questionnaire ... 44
Appendix III: List of govenrnment hospitals in Nairobi County ... 48

viii
LIST OF FIGURES
Figure 2.1 Conceptual Model ... 20

ix
LIST OF TABLES
Table 3.1: Summary of Data Analysis methods ... 23
Table 4.3.1 Working duration at the facility ... 24
Table 4.3.2: Current Job Designation ... 25
Table 4.5.1 Extent to which the facilities practiced green procurement ... 26
Table 4.5.2 Extent to which the facility practiced eco design ... 26
Table 4.5.3 Extent to which the facility practiced reverse logistics ... 27
Table 4.5.4 To what extent did the facility practice waste management ... 28
TAble 4.6: GSCM and Their Average Response Rate ... 28
Table 4.6.1 Performance of supply chain in regard to costs ... 29
Table 4.6.2 Performance of supply chain in regard to flexibility ... 30
Table 4.6.3 Performance of supply chain in relation to innovation ... 31
Table 4.7 : Model Summary ... 33
Table 4.7.1: ANOVA ... 32
Table 4.8 Challenges faced in implementing Green supply chain practices ... 35

x
ABBREVIATIONS AND ACRONYMS
BSC Balanced Score card
EIA Environmental Impact Assessment
EMAS Eco- Management and Audit Scheme
EMS Environmental Management Systems
EPP Environmental Preferred Purchasing
GDP Gross Domestic Product
GSCM Green Supply Chain Management
GSCP Green Supply Chain Practices
ISO International Organization for Standardization
3Rs
Reduce Reuse Recycle
KEMSA Kenya Medical Supplies Agency
KPI Key Performance Indicators
RBV Resource Based View
MOH Medical Officer in-charge of Health
NEMA National Environmental Management Authority
NHIF National Hospital Insurance Fund
PPOA Public Procurement Oversight Authority
SCM Supply Chain Management
SCOR Supply Chain Operations Reference
WHO World Health Organization

xi
ABSTRACT
A research was done to establish Green practices and performance of government
hospitals in Nairobi County. The study had three research objectives namely; To what
extent is Green supply chain management is practiced in Government Hospitals in
Nairobi County, To determine the practices in Healthcare supply chain management
that enhances performance in Nairobi County, To establish the challenges faced in
the implementing Green supply chain management practices in Government Hospitals
in Nairobi County. The research design used was a census survey, frequencies and
percentages were used to analyse and represent objective one regression analysis was
used to analyse the relationship between Green supply chain management practice and
performance of Government Hospitals .the finding were represented in tables. It
emerged that there is a significant relationship between green supply chain practice and
performance. Data was collected using a questionnaire, that was administered through
drop and pick later method. Percentages and frequencies were used to analyse the first
objective, while objective two and three correlation and regression methods were
utilized. Findings from analysis of objective one indicated that most of the government
hospitals in Nairobi had implemented a number of green supply chain management
practices. The study focussed on Government Hospitals in Nairobi County, as given in
the ministry of health website. The study confirmed that Green supply chain practices
are relevant in the performance of supply chains. The study recommends that hospitals
should empower and educate their employees on the importance of efficient waste
management and reverse logistics approaches to enhance green supply chain. A major
limitation of the study was that, it only studied Government health facilities within
Nairobi County. Another limitation of the study was that, it did not highlight the
suppliers' willingness to participate in aspects of green supply chain management.
Suggestions for further research would be to establish the impact of reverse logistics
on efficient product consumption along the supply chain. Another area of future
research will be to evaluate suppliers' willingness to conform to consumers' eco design,
and its impact on performance.

1
CHAPTER ONE
INTRODUCTION
1.1 Background of the Study
The term green is currently used to represent a holistic view of environmental, social
and economic impact on a firm's activities (Rahimifard and Clegg 2010). Green supply
chain management (GSCM) is an emerging field propelled by the need to be
environmentally conscious (Srivastava 2011). Scholars and practitioners have recently
developed interest in the science behind GSCM. Various practitioners are using Green
supply chain management knowledge to reduce waste and preserve the quality of
product life and the natural resources around the firm's premises (Guise and Srivastava
2011).
Karliener and Gautier (2009) observe that globally, public health related risks together
with ecological challenges have emerged and become destructive than individual
aspects. Ecological factors for example, climate change, unsustainable resource use,
have fuelled ill heath in the globally. They continue to observe that; hospitals consume
a lot of energy in a quest to serve a sick population. There are many elements that pose
danger unknowingly to the populace. For example, intensive use of x-ray machines may
produce emissions, improper disposal of lab waste, air pollution during incineration,
heat emissions from computer use and other diagnostic tools.
Globally, countries like the USA have adopted a scheme, Environmentally Preferred
Purchasing (EPP) that ensures the whole supply chain is green (Emmett and Sudd
2010). In the African context, sustainable development is crippled by factors like
Poverty, Poor Governance, Corruption, and lack of appropriate frameworks (Economic
Commission for Africa 2010).

2
Nixon (2011) observes that in Kenya in particular, strides have been made previously
by the late Professor Wangari Maathai who championed for environmental justice and
won a Peace price for her work in creating awareness of environmental conservation
(NEMA2012). The Government of Kenya launched the Kenya Vision 2030; it
highlights the development goals to be archived by the year 2030. The vision does not
mention the use of environmental criteria to be used to observe green supply chain
practices in public healthcare. The research thesis intends to determine the practices
necessary for a green supply chain in public hospitals.
1.1.1 Green Supply Chain Management Practices
Gilbert (2009) views greening the supply chain as the process of incorporating
environmental criteria into the organizational purchasing decisions and long term
relationships with the suppliers. Environmental relationships, setting environmental
requirements, sharing information and collaboration for improving processes and
products are some of the ways a firm can implement Green Supply Chain management
practices (Theyel, 2008). In the past, innovation was predominately driven by the focus
on exceeding consumer's expectations and creating simpler processes. Recently,
several organizations are required to respond to the increased pressure from the
community environmental conscious consumers that lead the manufacturers to adopt
environmental oriented practices (Nunes, 2008).
The implementation of GSCM practices is expected to result in improved
environmental performance measured by reductions in air emissions, solid waste,
effluent waste (Zelbst, 2012). In addition, it has been observed that GSCM practices
like recycling, repacking in environmental friendly packs helps avoid environmental
degradation (Basu and Wright, 2008).

3
Green supply chain management include all the supply chain activities from green
purchasing, later on incorporating completer product life cycles from the manufacturer
to the end user and eventually closing the loop by reverse logistics Zhu (2008).
1.1.2 Supply Chain Performance
Hayfield and Nichols (2010), state that supply chain involves activities associated with
the flow and transformation of goods from the raw (extraction), through the end user as
well as the associated information flows. Supply chain performance, is the evaluation
of supply chain and include both tangible and intangible factors for example utilization
factors (Chang, 2013). Evidence indicates that firms have used green SCM practices in
an attempt to improve performance.
According to Beamon (1999) Supply chain performance can be viewed in three
categories that are: resource related, output related and flexibility related. Gunasekaran
and Patel (2004) classified performance metrics as strategic, tactical and operational.
Hofmann and Locker (2009) observed that performance measurement includes
financial and non- financial aspects. Lorentz (2012) observes that Supply chain
performance, is an intra ­ firm measurement that goes beyond a firm's financial aspects
and efficiency in customer satisfaction but rather considers conservation of the
environment in the quest for profitability.
1.1.3 Government Hospitals in Kenya
Healthcare in Kenya has been guided by Kenya's health policy has been based on the
country's landmark post-colonial nation-building and socio-economic development
blueprint, the sectional Paper No. 10 on African Socialism and its application to Kenya
of 1965, which emphasized the elimination of disease, poverty, and illiteracy (Kenya
Health Policy Framework Paper, 2010).
Excerpt out of 60 pages

Details

Title
Green Practices and supply chain performance in government hospitals in Nairobi, Kenya
College
University of Nairobi
Grade
A
Author
Year
2017
Pages
60
Catalog Number
V383679
ISBN (eBook)
9783668622562
ISBN (Book)
9783668622579
File size
1168 KB
Language
English
Tags
green, practices, nairobi, kenya
Quote paper
David Mbaabu (Author), 2017, Green Practices and supply chain performance in government hospitals in Nairobi, Kenya, Munich, GRIN Verlag, https://www.grin.com/document/383679

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