STRATEGIC SOCIAL MARKETING, OPERATING ENVIRONMENT AND PERFORMANCE OF COMMUNITY BASED HIV AND AIDS ORGANIZATIONS IN NAIROBI COUNTY, KENYA

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1 STRATEGIC SOCIAL MARKETING, OPERATING ENVIRONMENT AND PERFORMANCE OF COMMUNITY BASED HIV AND AIDS ORGANIZATIONS IN NAIROBI COUNTY, KENYA JANE W. KINYUA-NJUGUNA A Thesis Submitted in Fulfilment of the Requirements for the Award of the Doctor of Philosophy Degree in Business Administration, School of Business, University of Nairobi 2013

2 DECLARATION This Doctoral Thesis is my original work and has not been presented to any University for any award. Signed Date. Jane W. Kinyua-Njuguna D80/80009/2008 This doctoral thesis has been submitted for examination with our approval as University Supervisors. Signed Date. Prof. Francis N. Kibera Professor of Marketing, School of Business, University of Nairobi. Signed Date. Dr. Justus M. Munyoki Senior Lecturer Department of Business administration, School of Business, University of Nairobi ii

3 DEDICATION I dedicate this work to my husband, James, whose love and support has been my pillar during this journey; to my children Wambui, Waithiegeni and Wangui whose young lives have been disrupted during this period; and to my late mother-in-law, Sophia Wambui, who never lived long enough to celebrate these achievements. iii

4 ACKNOWLEDGEMENTS I am very grateful to my two supervisors, Prof. Francis Kibera and Dr. Justus Munyoki for their guidance and support during the research period. Your invaluable advice, comments and constructive criticism is what made this work what it is. May God bless you. I wish to acknowledge my PhD course work instructors as well as the administrative staff in School of Business, Lower Kabete Campus. I sincerely appreciate the logistical support provided by the National AIDS Control Council (NACC) through the Director, Head of Communications and Constituency Aids Coordinators. I would like to also thank all my respondents, the executives in the CBOs, the secretaries, the treasurers and programme managers in Nairobi County. I acknowledge the efforts and support of the research assistants who assisted me in data collection To my colleagues, my friends and family members, your support and encouragement were invaluable. Above all, I thank Almighty God for bringing me this far and showering me with His grace throughout this period. May He be praised and glorified. iv

5 TABLE OF CONTENTS DECLARATION... ii DEDICATION... iii ACKNOWLEDGEMENTS... iv LIST OF FIGURES... x ACRONYMS AND ABBREVIATIONS... xi ABSTRACT... xiii CHAPTER ONE: INTRODUCTION Background of the Study Strategic Social Marketing Operating Environment Organizational Performance Community Based HIV and AIDS Organizations in Nairobi County, Kenya Research Problem Research Objectives Value of the Study Structure of the Thesis... 9 CHAPTER TWO:LITERATURE REVIEW Introduction Theoretical Foundation of the Study Strategic Social Marketing Operating Environment Organizational Performance Strategic Social Marketing and Organizational Performance Operating Environment and Organizational Performance Strategic Social Marketing, Operating Environment and Performance Conceptual Framework and Hypotheses Chapter Summary CHAPTER THREE: RESEARCH METHODOLOGY Introduction Research Philosophy Research Design Research Setting Population of the Study Sample and Sampling Design Data Collection Operationalization of the Research Variables Reliability and Validity of the Data Collection Instrument Reliability v

6 3.9.2 Validity Data Analysis Chapter Summary CHAPTER FOUR: DATA ANALYSIS, RESULTS AND DISCUSSION Introduction Response Rate Assessment of Normality, Linearity and Homoscedasticity Profile of Individual Respondents Profile of the Responding CBOs Description of the Study Variables Correlations among the Studied Variables Tests of Hypotheses Discussion Chapter Summary CHAPTER FIVE: SUMMARY, CONCLUSIONS AND RECOMMENDATIONS Introduction Summary Conclusions Limitations of the Study Recommendations Suggestions for Further Research References Appendices Appendix 1 Questionnaire Appendix II Interview Schedule for CEOs Appendix III A List of Active CBOs in Nairobi County Appendix IV Sample Distribution Appendix V Hypotheses for the Variables and their Constructs Appendix VI Principal Factors for Study Variables Appendix VII Item-Total Statistics Appendix VIII Inter-Item Correlation Appendix IX Test For Normality Appendix X Test for Linearity Appendix XI Test for Homogeneity of Variances Appendix XII Stepwise Regression Analyses Appendix XIII Pearson s Moment Correlations Appendix XIV Research Settings Appendix XV Cronbach s Alpha ( ) test vi

7 LIST OF TABLES Table 2.1: Summary of Knowledge Gaps Table 3.1: Summary of Operationalization of Study Variables Table 3.2: Research Objectives, Hypotheses, and Analytical Methods Table 4.1: Response Rate Table 4.2: Respondents gender and highest level of education Table 4.3: Respondents Length of Service across Gender Table 4.4: Sources of Funding for the CBOs Table 4.5: HIV and AIDS Interventions by CBOs Table 4.6: One sample t- test for Strategic Social Marketing, Operating Environment and performance of CBOs Table 4.7: Correlations for Strategic Social Marketing and Performance of CBOs Table 4.8: Correlations for Operating Environment and Performance of CBOs Table 4.9: Correlations for Strategic Social Marketing, Operating Environment and Performance of CBOs Table 4.10: Simple Regression: Policy, Strategy and Implementation Predicting Effectiveness Table 4.11: Simple Regression: Policy, Strategy and Implementation Predicting Efficiency Table 4.12: Simple Regression: Policy, Strategy and Implementation Predicting Relevance Table 4.13: Simple Regression: Policy, Strategy and Implementation Predicting Financial Viability Table 4.14: Simple Regression: Policy, Strategy and Implementation Predicting Performance Table 4.15(a): Goodness-of fit of the Regression of CBO s Effectiveness, Efficiency, Relevance and Financial Viability on Strategic Social Marketing Table 4.15(b): Significance of the Regression CBO s Effectiveness, Efficiency, Relevance and Financial Viability on Strategic Social Marketing Table 4.16(a): Goodness-of fit of the Regression of CBO s Performance on Strategic Social Marketing Table 4.16(b): Significance of the Regression CBO s Performance on Strategic Social Marketing vii

8 Table 4.17(a): Table 4.17(b): Table 4.18(a): Table 4.18(b): Table 4.19(a): Table 4.19(b): Table 4.20(a): Table 4.20(b): Table 4.21(a) Table 4.21(b): Table 4.22(a): Table 4.22(b): Table 4.23(a): Table 4.23(b): Table 4.23(c): Table 4.24: Goodness-of fit of the Regression of CBO s Effectiveness, Efficiency, Relevance and Financial Viability on Internal Environment Significance of the Regression CBO s Effectiveness, Efficiency, Relevance and Financial Viability on Internal Environment Goodness-of fit of the Regression of CBO s Performance on Internal Environment Significance of the Regression CBO s Performance on Internal Environment Goodness-of fit of the Regression of CBO s Effectiveness, Efficiency, Relevance and Financial Viability External Environment. 82 Significance of the Regression of CBO s Effectiveness, Efficiency, Relevance and Financial Viability on External Environment Results of goodness-of fit of the Regression of CBO s Performance on External Environment Significance of the Regression of CBO s Performance on External Environment Goodness-of fit of the Regression of CBO s Effectiveness, Efficiency, Relevance and Financial Viability on Operating Environment Significance of the Regression of CBO s Effectiveness, Efficiency, Relevance and Financial Viability on Operating Environment Goodness-of fit of the Regression of CBO s Performance on Operating Environment Significance of the Regression of CBO s Performance on Operating Environment Goodness-of fit of the regression of CBO s Performance on Strategic Social Marketing Moderated by Operating Environment ANOVA of the Regression of CBO s Performance on Strategic Social Marketing Moderated by Operating Environment Significance of the Regression of CBO s Performance on Strategic Social Marketing Moderated by Operating Environment Step Wise Regression: Strategic Social Marketing and Operating Environment Predicting Performance viii

9 Table 4.25(a): Goodness-of fit of the Regression of CBO s Performance on Strategic Social marketing and Operating Environment Table 4.25(b): Significance of the Regression of CBO s Performance on Strategic Social Marketing and Operating Environment Table 4.26 Summary of the Hypotheses and Findings ix

10 LIST OF FIGURES Figure 2.1: Conceptual Framework Figure 4.1: Age of the Responding Organizations Figure 4.2: Geographical Distribution of Responding Organizations Figure 4.3: Conceptual Framework and Summary of Hypotheses Results x

11 ACRONYMS AND ABBREVIATIONS ADB AIDS ANOVA ART BCC CBOs CDC CEO CHW CMV COBPAR CSOs GBV GoK HBC HBM HIV HR HTC IDRC IOA KMO KNASA KNASP NCCBO MDGs NACC NGOs OPA OVC PCA PMTCT Asian Development Bank Acquired Immuno-Deficiency Syndrome Analysis of Variance Antiretroviral Therapy/Treatment Behaviour Change Communication Community Based Organizations Centre for Disease Control Chief Executive Officer Community Health Work Common Method Variance Community Based Programme Activity Reports Civil Society Organizations Gender Based Violence Government of Kenya Home Based Care Health Belief Model Human Immuno-Deficiency Virus Human Resource HIV Testing and Counselling International Development Research Centre Institutional and Organizational Assessment Kaiser-Meer-Oklin Kenya National AIDS Spending Assessment Kenya National AIDS Strategic Plan National Council of Community Based Organizations Millennium Development Goals National AIDS Control Council Non Governmental Organizations Organizational Performance Assessment Orphans and Vulnerable Children Principal Component Analysis Prevention of Mother-to-Child Transmissions xi

12 SCT SPSS STDs SWOT TOWA UNAIDS UNDP USA USDA USDHHS VMMC WHO WIC Social Cognitive Theory Statistical Package for Social Sciences Sexually Transmitted Diseases Strength, Weakness, Opportunities and Threats Total War against AIDS Joint United Nations Programme on HIV/AIDS United Nations Development Programme United States of America United States Department of Agriculture United States Department of Health and Human Services Voluntary Medical Male Circumcision for HIV World Health Organization Women, Infants and Children xii

13 ABSTRACT The aim of this study was to evaluate the effect of strategic social marketing and operating environment on performance of community based HIV and AIDs organizations in Nairobi County in Kenya. The specific objectives were to: determine the relationship between strategic social marketing and performance of community based HIV and AIDs organizations; explore the relationship between operating environment and performance of community based HIV and AIDs organization; assess the moderating effect of operating environment on the relationship between strategic social marketing and performance of community based HIV and AIDs organizations; and evaluate the combined effect of strategic social marketing and operating environment on performance. This study was anchored on resource based theory, exchange theory, DICES model as well as social network. The study was guided by positivistic research philosophy. A descriptive cross-sectional survey research design was employed. The target population of the study was 350 CBOs located in Nairobi County. A sample of 183 CBOs was used from eight constituencies which were proportionately represented. Area and random sampling techniques were used to select sample elements. Descriptive statistics were used to profile characteristics of the surveyed organizations and the respondents. Correlation and multiple regression analyses were used to evaluate the relationships between strategic social marketing, operating environment and performance as well as to assess the effect of each on performance. Strategic social marketing and operating environment were found to correlate with performance indicators. Strategic social marketing was found to impact more on effectiveness, efficiency and relevance but had low influence on financial viability. Internal environment was found to have statistically significant linear relationship with performance indicators while external environment had more effect on relevance measures of performance. Operating environment was also found to have a significant impact on performance of community based HIV and AIDS organizations. However, the operating environment had no significant moderating effect on the relationship between strategic social marketing and performance of CBOs. The joint effect of strategic social marketing and operating environment on performance was found to be statistically significant as they both explained 68.5% variation of the dependent variable. The study concluded that for CBOs to enhance their performance they ought to scan both the internal and external environment; apply strategic social marketing approach in their activities; and create synergy by integrating strategic social marketing and operating environment. The study recommends that CBOs and other organizations involved in marketing social goods embrace this approach as their planning and implementation tool as it contributes to their performance. The study further recommends development of a social marketing policy to provide guidance on how social marketing activities should be carried out. A thorough study and understanding of the factors influencing donors choice of implementing partners is recommended. Developments of new mechanisms and strategies that can facilitate CBOs to achieve financial sustainability are also recommended. Further, the study recommends formation of a National CBO Council to provide a forum for information sharing amongst the organizations especially on successes and challenges in implementation and sources of funding. Further research is recommended to establish the effect of strategic social marketing on other civil society organizations, government agencies as well as CBOs in other sectors such as education. xiii

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