NJOKI KIBE2026-03-312026-03-312025-09https://repository.cuea.edu/handle/123456789/629DissertationPublic hospitals in Nairobi County ought to operate under robust strategic change management practices. Strategic management practices should the enhanced performance variations in public hospitals. However, the current state of public hospitals in Nairobi County reveals significant operational and structural challenges that negatively affects performance. Finding out how strategic change management approaches affect the efficiency and effectiveness of public hospitals in Nairobi County, Kenya, was the overarching goal of the research. The research was framed around five distinct goals. These aimed to analyze the relationship between strategic change management and performance in the public hospitals of Nairobi County, Kenya, taking into consideration the moderating effect of organizational culture as well as the effects of strategic leadership, stakeholder engagement, organizational restructuring, and resource mobilization. Personnel from a few chosen public hospitals in Nairobi City County served as the study's unit of observation. The years 2019–2023, inclusive, were the subject of this research. This period corresponds with when the COVID-19 pandemic began, at which time several public hospitals in Nairobi County saw major operational adjustments. Complexity theory, the McKinsey 7-S Framework, Kurt Lewin's model, and Kotter's eight-step model served as the theoretical compass for the research. Pragmatism, which served as the overarching philosophical framework for the research, was the bedrock of the study. Public hospitals in Nairobi County were the settings for this study, which used a pragmatist mindset and a parallel convergent research method. The 7,197 staff members that made up the target population were selected from the following hospitals: Mathari National & Teaching Hospitals, Mama Lucy Kibaki Hospital, Pumwani Maternity Hospital, Mbagathi Hospital, and Kenyatta National Hospital. Using Yamane's method and the stratified random sampling approach, we were able to calculate a sample size of 379 staff members. A total of 384 respondents were included in the survey, with the directors being specifically chosen for the purpose of the research. For reliability, Cronbach's alpha was used, and for validity, content and face validity were used. Questionnaires and interview guides were used to gather primary data. In order to show quantitative descriptive data, figures and tables were created using SPSS version 29, which summarized the data into frequencies, percentages, means, and standard deviation. The association between variables was determined using inferential statistics, which include correlation and multiple linear regressions. A narrative format was used to convey the results of the content analysis on qualitative data. The results showed that the public hospitals in Nairobi County, Kenya, were significantly and positively impacted by strategic leadership. In Nairobi County, Kenya, public hospitals' performance was significantly correlated with stakeholder participation. The most strongly correlated factor with the efficiency of Nairobi County's public hospitals was organizational reform. In Nairobi County, Kenya, public hospitals' performance was significantly correlated with their ability to mobilize resources. When looking at the health sector in Nairobi County, Kenya, organizational culture acts as a moderator in the link between resource mobilization, stakeholder engagement, organizational restructuring, strategic leadership, and performance. The study recommended that public hospitals in Nairobi County should adopt restructuring initiatives focused on process efficiency, technological integration, and streamlined management structures to enhance healthcare service delivery and operational performance.en-USStrategic change managementorganizational cultureorganizational performancepublic hospitalshealthcare managementchange implementationNairobi CountyKenyaThesis