Journal of Women's Health Care
Open Access

Factors Affecting the Implementation of Health Projects: Evidence from South Gondar Zone Public Hospitals

Alebel Woretaw^*, Tilahun Lakew and Gessesse Astewale ^*Correspondence: Alebel Woretaw, Lecturer, Debre Tabor University, Ethiopia, Tel: 251948949401, Email:

Author info »

Introduction

Project implementation has received increased attention across the world in recent years. To this end a number of countries have enacted policies that foster Project implementation. Many people and business nowadays have a new or renewed interest in project management. In the earlier period, project management primarily focused on providing schedules and resources to top management in just a few industries, such as the military and construction industries. Today’s project management engages much more, and people in every industry and every country manage projects. New technologies have become a significant factor in many businesses, and the use of interdisciplinary and global work teams have a significant effect on project implementation.

Health care is the major service industry in the world, and it is one in which project management is playing a vital role. Healthcare projects help to get better access to healthcare, intensification human resources, and empowering vulnerable groups. Project management practices and implementation and health Projects in Public Hospitals radically changed the work environment [1]. The healthcare industry has been involved in projects for a long time, but not essentially using formal project management methods. Healthcare institutions are recognizing that to remain competitive, they must develop skills to successfully select and run the projects they undertake. They also realize that many of the concepts of project management, especially interpersonal skills, will help them as they work with people on a day-to-day basis [2].

A project can be defined as a series of synchronized activities and tasks searched out by organizations, with clearly defined objectives, start date, duration, requirements for resources and also funding limits [3]. Projects are used in all economic and non-economic fields as means of organizing the activity, aiming the achievement of desired objectives. The project life cycle involves five main stages and these are project initiation, planning, execution (implementation), monitoring and evaluation and project termination [4].

Project implementation is the activity-based phase of the project life cycle, and this involves putting the plan into action [5]. A successful project manager must at the same time manage the four basic elements of a project: resources, time, money, and most importantly, scope. All these elements are interrelated. A project is normally measured to be productively implemented if it comes on schedule (time criterion), comes in on-budget (monetary criterion), attains fundamentally all the goals formerly set for it (effectiveness criterion), and is accepted and used by the clients for whom the project was intended (client satisfaction criterion).

Health care is a service industry which is applicable throughout the world, and it is one in which project management is playing a larger part. Healthcare is highly networked and systemic industry, with a practical impact on projects, which need to be well introduced in the territory and synergic with other healthcare and infrastructural facilities. Indeed, Suhonen, & Paasivaara indicate that today's healthcare executives and leaders must have management talent sophisticated enough to match the increased complexity of the healthcare environment. Executives are expected to demonstrate measurable outcomes and effectiveness and to practice evidencebased management. Project implementation phase requires close collaboration with clients to ensure that the project is delivered on time within the defined scope and cost to meet the organization’s needs.

Project management practices are characteristics, conditions or variables that when properly sustained, maintained, or managed, can have a significant impact on the success of a firm competing in particular industry. CSFs are inputs to project management practice, which can lead directly or indirectly to project success. It encompasses many elements, which have to be coordinated to ensure the project delivery on time [6]. Amade, Benedict and Ogbonna, Achimba Chibueze and Kaduru, Casmir Chinedu, indicate that there are twelve potential critical factors categorized into economic, environmental, technical and human can affect the delivery of a project either negatively or positively [7-9]. Meredith, and Mantle, informs that the factors considered critical for the success of a project are different for different types of projects and industries.

However, project implementation may not be successful due to different reasons. According to Srivastava, project implementation can be unsuccessful for a number of reasons ranging from unrealistic expectations, poor methodology, poor requirements, and lack of resources, poor project management, untrained teams, unrealistic budgets, poor communication and more. Hospitals as an organization face a number of challenges as they are exposed to greater risk as compared to other industry, primarily because of the complexity of its operations, ensuring appropriate quality of care, humanitarian issues, and various ethical dimensions facing healthcare [10,11]. These are too major concerns from the financial perspective include the assessment of viability and sustainability of its operations and the significance of cost recovery mechanisms, and operations and financial risks. Bhat, adds that the operational and financial risks in hospital sector and various challenges faced by managers in this sector, also emanate from the growing competition in the health sector, capital cost challenge and the lack of health insurance.

Thus, this study was directed to establish the factors affecting the implementation of health projects in south Gondar zone public hospitals in Amhara Region in accordance with the guidelines and directives indicated by FMOH in the contemporary health and training policy. This study also endeavored to investigate factors that foster or hampers project management practices and health projects implementation in the target zone.

General Objective

The general objective of this study was to identify factors affecting implementation of health projects in public hospital.

Specific Objectives

The specific objective of this study was defined as follow

1. To identify how planning affects implementation of health projects in South Gondar Zone public hospitals.

2. To find out how project funding affects implementation of health projects in South Gondar Zone public hospitals.

3. To establish how human resource management practice affects implementation of health projects in South Gondar Zone public hospitals.

4. To determine how a government policy affects implementation of health projects in South Gondar Zone public hospitals.

Research Hypotheses

The Research Hypotheses of this study was:

H11. There is significant effect of planning in implementation of health projects in South Gondar zone.

H12: There is significant effect of project funding in implementation of health Project in South Gondar zone.

H13: There is significant effect of human resources management practice in implementation of health projects in south Gondar zone

H14: There is significant effect of government policy in implementation of health projects in south Gondar zone.

Research Methodology

Study Area

South Gondar zone is the zone with the area of 142987 km2 in the north central Ethiopia that located in the Amhara region and constitute 13 wordas (districts) and 5 urban administrations: Lay Gaynt, Tach Gayint, Estie, Andabiet, Simada, Muja, Guna Begemdir, Farta, Dera, Fogera, Libo Kemkem, Ebinat, Menameketawaha and Nefas Mewucha urban administration, Meka Iyesus urban administration, Addis Zemen urban administration, Warta urban administration, and Debre Tabor urban administration. According to Statistical National agency of Ethiopia (2007) the zone has a population of 2609823 people with a population of 18 people per km². South Gondar has 1 general and 7 primary hospital, 96 health centers, and 394 health posts and 118 private clinics spread across the zone. Totally the zone has 498 public health facilities. The doctor/ population ratio is about 1:74566 and a nurse/population ratio of 1:15535 is depicting shortage of medical personnel to serve the people.

Research Design

This study was generally planned to assess the factors affecting implementation of health project in South Gondar zone public hospitals.

The study used an explanatory and descriptive research design because both explanatory and descriptive research designs are utilized to obtain information regarding the present status of the phenomena to clarify what exists with respect to variables or circumstances in a situation. Explanatory research design aimed at linking ideas in order to realize the associations of variables in terms of cause and result relationship [12,13]. The Explanatory research approach chooses to examine the causal relationship (association) between the dependent variable and independent variable. And also descriptive analysis used for the demographic factors.

Target Population

Orodho (2005) mentioned that a target population is the total elements, individuals, or groups to be studied. The target population of this study is the 97 hospital management teams, 41 project implementers and 25 consultants totaling to 163 persons who were involved in the health projects in one way or the other. These groups of people were selected because they are members of the top management level in a hospital context and therefore are resourceful persons in terms of project implementation. The study was limited to primary and secondary hospitals in south Gondar where majority of projects take place [14].

Sampling Techniques and Sample Size

In this study, Slovins formula was used to come up with representative sample. According to Burns (2010) this formula is a derivative of the sampling formula to estimate population proportion, not population mean. It assumes a P value of 0.5 and a confidence level of 95 percent.

n=N/1+ (N*e2)

Where: n=sample size, N=population and

e= margin of error Therefore, in a population of 163,

n=163/1+163(0.05)2=115.81

Stratified random sampling technique is a method in which the researcher divides the entire target population into different subgroups and then randomly selects the final subject proportionally from different subgroups [15]. The researcher chose this technique since every individual in the population has an equal chance of being selected and thus justifies generalizability of the findings. Therefore, stratified random sampling was used to recruit 116 respondents.

Sources of Data

To conduct this study, both primary and secondary data were used to attain data.

Methods of Data Collection

Data was collected use of structured questionnaires, interview and document analysis as data gathering instruments.

Methods of Data Analysis

After collecting the data the researcher organized it according to its type as use in the study. In this study the data was organized to ensure that the raw data is edited to free it from inconsistencies and incompleteness. This involves the inspection of the completed instruments in order to detect and reduce as much as possible errors, incompleteness, misclassification and gaps in the information obtained from the respondents. Descriptive methods such as frequency distribution, percentages, mean and standard deviation was used to organize quantitative data. The qualitative data was analyzed using thematic analysis and presented by narration. This is done by identifying information that is relevant to research questions and objectives, developing a coding system based on samples of collected data, classifying major issues or topics and, identifying major themes and then organizing it using descriptive methods. A Regression model was adopted to test the relationships between the study variables. Multiple regression was used to help indicate if selected variables have a significant relationship with project implementation and to indicate the relative strength of different independent variables’ effects on project implementation. The algebraic expression of the regression model which consists of the constant term coefficient and error term took the format below;

Y=β0+β1 X1+β2 X2 +β3 X3+β4 X4+e

Where:

Y=Project implementation, β0=Constant

β1, β2, β3, β4=Co-efficient

X1=Project Planning

X2=Project Funding

X3=Human resource management

X4=Government policies

e = residual error

All analysis was conducted with the help of SPSS version 20 for windows. Regression analysis was conducted at 95% confidence level. Findings were presented using tables and figures.

Data Analysis and Presentation

From the findings, majority of the respondents 35 (31.8%) indicated that their age ranged between 26-30 years, followed by 23 (20.9%) who indicated that their age range was between 31-35 years. The findings also revealed that 18 (16.4%) of the respondents were aged between 36-40 years; 16(14.5%) respondents were between20- 25 years of age and14 (12.7%) of respondents were aged between41-45 years and 4(3.6%) of respondents were 46 and above years of age. From the findings, it can be inferred that the respondents were mature enough to provide reliable and sufficient information in relation to factors affecting health project implementation in south Gondar zone public hospitals (Table 1).

Table 1: Sampling frame to estimate population proportion.

Gender of Respondents

The study revealed that majority of respondents was males as shown by 80.9% response rate compared to 19.1% of their females corresponding person. This shows that females were inadequately represented in the study and in project implementation at South Gondar zone public hospitals. This revealed that the participation of females in the study was low (Figure 1).

Figure 1. Conceptual framework.

Marital status of Respondents

The study revealed that majority of respondents were married as shown by 73 (66.4%) and 36 (32.7%) of respondents were not married and 1 (9%) respondent was others. This shows that majority of respondents those involved in this study were married.

Educational Status of Respondents

From the study findings majority of the respondents 79 (71.8%) indicated that they had university first degree (undergraduates) as their level of education, followed by 21 (19.1%) of the respondents who had had diploma and 10 (9.1%) who had post graduate qualification as their highest level of education. The findings therefore indicate that the respondents are well educated and thus have the knowledge and skills necessary for factors affecting health project implementation in these hospitals.

Working Experience of Respondents

Majority of the respondents 49 (44.5 %) had a working experience of between 11 and 20 years. The findings therefore show that majority of the respondents had acquired adequate working experience to enable them give resourceful information on implementation of health projects in public hospitals in South Gondar Zone.

Correlation Analysis

Pearson correlation was used in the study to inspect the factors determining effective project implementation.

As indicated in Table 2 above, a strong positive correlation was found between Project implementation and project planning as indicated by a correlation of 0.433. This implies that proper of planning process significantly results to better and effective project implementation.

Table 2: Demographic characteristics of age respondents.

The findings show a strong positive significant correlation between human resources management practice and project planning with a correlation of 0.431. This infers that appropriate planning by taking into attention planning aspects such as stakeholder engagement, and risk assessment can result to effective project implementation. The findings also show strong positive correlation between health project implementation and Projects funding at 0.397.

This implies that the more effective Project funding is the better the chances of implementing an effective project. The findings also show strong positive correlation between Projects funding and project planning at 0.354. This indicated that the more effective project funding and planning are the better the chance of project implementation. The findings therefore show that funding and planning were an important consideration in project implementation. This is in agreement with findings of Kipngok et al. That finances are key factors to implementation of geothermal projects. The finding is also in agreement with findings of Price Water House Coopers indicated that funds in many government projects in Africa is limited and is a challenging factor.

Furthermore, the findings reveal a strong positive correlation between Government policy and project planning with a correlation of 0.202. This indicates that comprehensive and relevant Government policies and project planning can significantly influence the effectiveness of project implementation

The findings show a strong positive significant correlation between Government policy and Human resources with a correlation of 0.274. This suggests that comprehensive and relevant Government policy and Human resources in accordance with the goal and objectives of the organization results to effective implementation of projects.

Regression Analysis

In this study, multiple regressions were carried out. The rationale of the regression analysis was to find out the statistical significance of the attempted prediction and establish the strength of association between project implementation and the multiple independent variables. The findings from regression analysis also helped envisage the values of project implementation from the values of the multiple independent variables. Regression analysis was carried out using SPSS at 95% confidence level.

The results in Table 3 above indicate that there was a positive correlation (r=0.582) between project planning, funding, human resources and government policy and health projects implementation in South Gondar public hospitals. The coefficient of determination R square is 0.338 which mean that 33.8% of variation in implementation of health projects in south Gondar zone public hospitals is explained by project planning, project funding, human resources and government policy. The findings therefore show that project planning, funding, human resources and government policy contribute positively to implementation of health projects in public hospitals.

Table 3: It represents the marital status of Respondents.

ANOVA Output

The ANOVA results for regression coefficients on Table 4 above showed that the significance of the P value is 0.000 which is less than 0.05. This implied that there was a significant relationship between project planning, project funding, human resources, government policies and project implementation of health projects in south Gondar zone public hospitals. The overall regression model is significant indicating that project planning, project funding, human resources and government policy significantly predict project implementation. Maintained, or managed, can have a significant impact on the success of a project.

Table 4: The findings therefore indicate that the respondents are well educated.

Coefficients Table

The unstandardized coefficients in Table 5 can be substituted into the study model to enable prediction of the value of project implementation from the values of the multiple independent variables.

Table 5: Working Experience of Respondents.

Y=0. 33+0.35X1+0.38X2+0. 17X3+0. -.202 X4

Where: Y=Project implementation, X1= Project Planning, X2=Project Funding, X3=Human resource management practice and X4=Government policy

From the above regression equation, it was revealed that holding project planning; project funding, human resources and government policy to a constant zero, implementation of health projects in south Gondar zone public hospital would be at 0.33. The beta values show the relative change in project implementation with a unit change in the respective variable.

Project planning has a positive and significant effect on health project implementation at the level of 0. 05 (β =0.35, t=3.103, p=0.002). This shows that a unit project planning increases the health project implementation by 0.35. Thus, the hypothesis that project planning has a positive and significant effect on the project implementation. This finding is also in agreement with Baldwin and Bordoli who stated that regardless of the definition chosen for project planning, it has the objective of achieving a number of common factors including the production of realistic schedules and costs, the completion of a project to defined standards of quality, design criteria, project resources, health and safety, and meeting projects stakeholders’ expectations.

Project funding has a positive and significant effect on health project implementation at the level of 0. 05 (β=0.38, t=3.967, p=0.000). This shows that a unit project funding increases the health project implementation by 0.38. Thus, the hypothesis that project funding has a significant effect on the project implementation. Looking at the beta values in Table project funding is the most influencing as it has the biggest beta value of the four. Especially project funding is in agreement with findings of Kipngok et al. that finances are key to implementation of geothermal projects. The finding is also in agreement with findings of Price Water House Coopers indicated that funds in many government projects in Africa is limited and is a challenging factor. The findings are inconsistent with finding of Kiarie and Wanyoike that projects require financing to take off but government projects are still influenced by other factors including political interference and this reduces the influence of funding (Table 6).

Table 6: The findings show a strong positive significant correlation between human resources management practice and project planning.

Human resource has a positive and significant effect on health project implementation at the level of 0. 05 (β=0.173, t=2.044, p=0.044). This shows that a unit human resource management practice increases the health project implementation by 0.173. Thus, the hypothesis that human resource has a positive and significant effect on the health project implementation. The findings are in agreement with findings of Chuma and Okungu that the health sector is largely underfunded and health care contributions are regressive Human resources management practice were not significant. This may be attributed to the fact that all health projects in public hospitals use the same employees as no new employees are brought in new projects. This is in agreement with findings of Wambua who established that staff welfare issues, technical expertise; planning and management have anecdotal effects on organization performance to the extent of implementation of the practice [16,17].

Government policies have a negative and insignificant effect on the health project implementation at the level of 0. 05 (β=-0.202, t=-2.265, p=0.026). This shows that a unit government policy decreases the health project implementation by 0.202. Thus, the hypothesis shows that government policies have insignificant effect on the health project implementation. This signifies that too much regulation in way of government policies negatively affects project implementation. This is consistent with Thomas and Martin who found that public service is overwhelmed by an unusually high level of bureaucracy which makes the implementation of projects to be very challenging. This finding is also in bike with findings of Akannia, Oke and Akpomiemie who established that the unnecessary delays usually experienced during development approval processes, continuity in financing of projects whenever there is a change of government are responsible for poor implementation of public projects.

Analysis of Interviews

The researcher conducted oral interviews with higher authority’s government officials of south Gondar zone, and from the interview held with south Gondar zone administration, building and construction and health offices higher authorities. The researcher interviewed the areas that your organizations participate in health project Implementation in your Hospitals. The findings showed that participation of their organizations was in planning and controlling and consulting in the implementation of health the projects. The interviewees were interviewed the extent organizations contribute for reducing factors influencing health project implementation. The findings indicated that the organizations have high contribution to reduce factors influencing health project implementation. For instance they support the organization ideally through discussion with the hospital management team and finance to alleviate the dalliance of health project implementation. The interviewees were interviewed the extent do hospital managers support HMT and PI members to discharge their responsibilities. The findings revealed that the hospitals managers do in large extent to support HMT and PI members to discharge their responsibilities. The interviewees were interviewed the major problems encountered by HMT and PI members to carry out their responsibilities (Table 7,8).

Table 7: Mode Summary the Combined Effect.

Table 8: The ANOVA results for regression coefficients

Table 9: The  unstandardized  coefficients  can  be  substituted  into  the   study   model   to enable prediction of the value of project implementation  from  the  values  of  the  multiple  independent variables.

The finding revealed that hospital management team (HMT) and project implementers (PI) found financial problems for effective implementation of their projects. The researcher interviewed the interviewees about HMT and PI cooperation has an effect on health project implementation within your hospital. The finding revealed that there were less cooperation between HMT and PI. The researcher suggested that HMT and PI should co-operate each other.

Conclusion

Regarding with project planning was highly practical in projects in public hospitals. Vast majority the respondents in the study indicated that planning influenced project implementation to large extent. This implies that planning play an important role for better project implementation.

Regarding with almost all respondents in the study indicated that funding affects project implementation to a large extent indicating that the influence was to large extent. The respondents revealed that funding was the single major hindrance to successful project implementation and completion. The project management teams had good human resource management practices as they observed proper recruitment, training and remuneration measures. However, the finding suggests that motivation of project staff was not provided adequately. The finding related to government policies showed that a high agreement among respondents on the items tested. The findings therefore show that the government and government policy were an important factors controlling project implementation in public hospitals. Government policy has a positive and significant effect on health project implementation to a large extent. The average mean government policy shows that project implementation in public hospitals in south Gondar was poor.

The findings of this study revealed that there is a significant positive relationship between factors that influence implementation of health projects in South Gondar zone public hospitals. When combined with Pearson Correlation Coefficient the study found that implementation of health projects in South Gondar zone public hospitals is positively correlated to project planning, project funding and human resource. The regression model obtained R2 of 0.338. This implies that 33.8% of the variations in implementation of health projects can be explained by variations in the discussed factors (project planning, project funding, human resources and government policies) whereas 66.2% of the variations in implementation of health projects can be explained by other factors outside of the multiple regression models developed.

Following the findings, the study concluded that project planning is significantly related to implementation of health projects. This is evidenced by the correlation analysis that generated R value of with P value (0.002) less than 0.01. Hospitals with experienced project planning would therefore find implementation of health projects more achievable compared with hospitals with poor project planning. Regardless of the definition chosen for project planning, it has the objective of achieving a number of common factors including the production of realistic schedules and costs, the completion of a project to defined standards of quality, design criteria, project resources, health and safety, and meeting projects stakeholders’ expectations.

Regarding with the effect of project funding on implementation of health projects, the study concluded that project funding is the most significant variable that is positively affected implementation of health projects. Since project funding has the highest β coefficient (0.38) value with compared the β coefficient of other predictors. This was confirmed through the significant correlation between project funding and implementation of health projects realized through correlation analysis. There is strong correlation between project funding and project planning that enhance health project implementation. They are correlated by 0. 354.

For any success in health project implementation, effective human resource management which includes; recruitment, selection, training and evaluation are critical and helps in achieving project goals, thus the need for project managers to remain aware and anticipate change as re-planning is necessary throughout the project. Planning is necessary to develop reasonable project estimates, enhance the management of customer and stakeholder expectations, mitigate project risks, establish and standardize a scope management process to develop concise project scope statements and handle issues consistently. Human resource management practice and project planning were correlated strongly by 0.431 that enhance health project implementation. Project planning and health project implementation were strongly correlated by 0.433.

Recommendations

The Researcher recommends that the South Gondar zone should pay more attention to the factors influencing the implementation of Health projects particularly the health Case as it directly relates the justification and the potential significant health benefits and values to all communities. Finally, from the conclusions arrived at, the following three recommendations were made.

The South Gondar Zone Hospitals’ management teams should ensure none interference of politician. Since the study found that projects were affected by interference from politicians and political stability affects project implementation and hospital management teams should be given more freedom to plan and implement their projects free of control from the government and politicians. The study found that there was great bureaucracy in the implementation of health projects in the side of government. The study therefore suggests that demonstrative processes in the government should be reviewed to reduce bureaucracy to timely establishment and thus implementation of projects will be successful.

The researcher found that incentives were not given for highly performing staff. The study therefore suggests that project staff should be motivated by incentives such as bonuses on their salaries too.

As it was founded by the study the views of all project stakeholders were rarely taken into account in every step of project planning. Therefore, the study suggests that project management teams should enhance stakeholder participation to ensure customer satisfaction and ownership of the projects.

Project implementers should cooperate and collaborate with hospital management team to implement health projects effectively Consultants should attend the planning and designing activities of hospital management team and consult them in every aspects of the performance.

Ethical Approval and Consent to Participate

The Ethical clearance letter was obtained from Debre Tabor University Ethical Review Committee. Then, a written official letter was obtained from sampled South Gondar Zone Hospitals. The objective of the study was explained to each study participant during the data collection period. We followed standard operating procedures (SOP) during data collection and tried to adhere to the declaration of Helsinki. Here, informed and written consent was obtained from each participant before the data collection. Participation in the study was entirely voluntary. For all participants, we assured that refusal was possible during any stage of the interview. The confidentiality was guaranteed by removing personal identifiers through using codes. After analyzing the data, we assured that the result of the study will be published in an international scientific journal.

Acknowledgment

The authors would like to express our sincere gratitude to those study participants for their willingness to participate in this study. The authors also thank the Debre Tabor University for support through this study.

Author Contributions

All authors made a significant contribution to the work reported, through the conception, study design, execution, acquisition of data, analysis and interpretation; took part in drafting, revising or critically reviewing the article; gave final approval of the version to be published; have agreed on the journal to which the article has been submitted; and agree to be accountable for all aspects of the work.

References

1. Akanni PO, Oke AE, Akpomiemie OA. Impact of environmental factors on building project performance in Delta State, Nigeria. HBRC J. 2015;11(1):91-97.
2. Alias Z, Zawawi EM, Yusof K, Aris NM. Determining critical success factors of project management practice: A conceptual framework. Procedia-Social and Behavioral Sci. 2014;153:61-69.
3. Amade B, Ogbonna A, Kaduru C. Determinants of successful project implementation in Nigeria. Int J Management Sci and Business Res. 2012;1(6).
4. Bailey, K. D. (2011). Methods of Research. 2nd Edition. London: Macmillan Publishers.
5. Bhat G, Hope OK, Kang T. Does corporate governance transparency affect the accuracy of analyst forecasts?. Accounting & Finance. 2006;46(5):715-732.
6. Chuma J, Okungu V. Viewing the Kenyan health system through an equity lens: implications for universal coverage. Int J for Equity in Health. 2011;10(1):1-4.
7. Khang DB, Moe TL. Success criteria and factors for international development projects: A life-cycle-based framework. Project Management J. 2008;39(1):72-84.
8. Kathy Schwalbe. (2013). An Introduction to Healthcare Project Management, Fourth Edition.
9. Kiarie AW, Wanyoike D. Determinants of successful implementation of Government funded projects in Kenya: A Case study of integrated financial management information system. Int J Innovative Res and Develop. 2016;5(10):169-75.
10. Kipngok J, Wanyoike D, Kemboi H. Determinants of Successful Implementation of Geothermal Projects in Kenya: A Survey of Menengai and Olkaria. Int J Sci and Res (IJSR) Impact Factor (2014). 2014;5.
11. Meredith JR, Shafer SM, Mantel Jr SJ. Project management: a strategic managerial approach. John Wiley & Sons; 2017.
12. Mondal SS, Chowdhury A. Key Determinants For Successful Project Implementation In Theindustrial Area Of West Bengal. Int J Technic Res and Applications 2(3); 2320. 2014;8163.
13. Nwachukwu CC, Emoh FI. Building construction project management success as a critical issue in real estate development and investment. Am J social and Management Sci. 2011;2(1):56-75.
14. Orodho, J. (2005). Education and social sciences research methods. Nairobi: Harlifax printers.
15. Thomas, E.U. Martin, L. (2014). Essentials of construction project management (first ed.) Australia: University of New South Wales Press Ltd.
16. Wambua MM. Effects of human resource factors on project performance in Nairobi County in Kenya: A case of selected organizations in Westlands. The University of Nairobi. 2013.