EMPLOYEE WELLNESS PROGRAMMES, CREDIBLE LEADERSHIP AND SERVICE DELIVERY IN FAITH BASED HOSPITALS IN NAIROBI METROPOLITAN, KENYA KARANJA BEATRICE WAIRIMU A THESIS SUBMITTED TO THE SCHOOL OF BUSINESS IN PARTIAL FULFILLMENT FOR THE AWARD OF THE DEGREE OF DOCTOR OF PHILOSOPHY IN HUMAN RESOURCE MANAGEMENT, KARATINA UNIVERSITY SEPTEMBER, 2024 DECLARATION I declare that this thesis is my original work and has not been presented to any other University for award of any academic paper. Signed… ………………… Date……23/09/2024 Beatrice Wairimu Karanja. B402/1830P/14 DECLARATION BY THE SUPERVISORS We confirm that this thesis was carried out by the candidate under our supervision and has been submitted with our approval as university supervisor Signed … ……………………., Date…23/09/2024 Prof. David Gichuhi. Department of Human Resource Development School of Business, KARATINA UNIVERSITY Signed ……………………… Date……………. Prof. Kellen Kiambati. Department of Human Resource Development School of Business, KARATINA UNIVERSITY ii DEDICATION This work is dedicated to my lovely daughter Leone Winnie Gathigia for always encouraging me to complete this course. iii ACKNOWLEDGEMENT I thank Almighty God for the gift of life and health throughout my studies. Much gratitude to my supervisor Prof. David Gichuhi and Prof. Kellen Kiambati for their able guidance to ensure that my thesis contributes to the body of knowledge and academics. Thank you for always motivating me not to give up and always keeping me on my toes to meet the set timelines. You have always encouraged me to complete my thesis and graduate. I also wish to thank Karatina University lecturers and staff for their willingness to assist any time I needed them. Particularly, I wish to acknowledge the efforts of Prof. Teresia Kyalo for her commitment to ensure that we complete our course on time. She consistently calls to enquire on the progress made. I wish to thank the management and staff of Faith-Based hospitals in Nairobi metropolitan. Specifically, I wish to thank human resource officers and medical staff in the faith-based hospitals who responded to the study. I am eternally grateful for your support. I am equally grateful to my family members, my lovely daughter Leone Winnie. You bore with me even when I was away from home and when I worked late in the night. Additionally, I wish to acknowledge my dear mum Lucy Gathigia, my sisters Grace Njoki, Virginia Mbanya and Ruth Karanja for always encouraging me to complete my studies. I also wish to acknowledge my class mates, Dr. Grace Mwangi, Dr. Joseph Kanyi, Mr.Martin Njunguna, Madam Marion Karuiru and Madam Ann Gituto whom we worked together as a group during our course work. We encouraged each other, held group discussions, shared study materials and revised together. iv TABLE OF CONTENTS DECLARATION................................................................................................................ ii DEDICATION.................................................................................................................. iii ACKNOWLEDGEMENT ................................................................................................ iv TABLE OF CONTENTS .................................................................................................. v LIST OF TABLES ............................................................................................................. x LIST OF FIGURES ......................................................................................................... xii ABBREVIATIONS AND ACRONYMS ...................................................................... xiii ABSTRACT ..................................................................................................................... xiv CHAPTER ONE ................................................................................................................ 1 INTRODUCTION.............................................................................................................. 1 1.0 Introduction ................................................................................................................ 1 1.1 Background of the Study ........................................................................................... 1 1.1.1 Employee Wellness Programmes ....................................................................... 5 1.1.2 Credible Leadership ............................................................................................ 9 1.1.3 Service Delivery ................................................................................................ 12 1.1.4 Faith-Based Hospitals in Nairobi Metropolitan ............................................ 13 1.2 Statement of the Problem ......................................................................................... 15 1.3 Objectives of the Study ............................................................................................ 17 1.3.1 General Objective of the Study ......................................................................... 17 1.3.2 Specific Objectives of the Study ....................................................................... 17 1.4 Research Hypotheses ............................................................................................... 17 1.5 Significance of the Study ......................................................................................... 18 1.6 Scope of the Study ................................................................................................... 19 1.7 Limitations of the Study .......................................................................................... 20 v 1.8 Operational Definition of Terms .......................................................................... 21 CHAPTER TWO ............................................................................................................. 22 LITERATURE REVIEW ............................................................................................... 22 2.1 Introduction .............................................................................................................. 22 2.2 Theoretical Literature Review ................................................................................. 22 2.2.1 Behavioural Decision-Making Theory.............................................................. 22 2.2.2 Social Exchange Theory ................................................................................... 24 2.2.3 Maslow’s Hierarchy of Needs Theory .............................................................. 25 2.3 Empirical Literature Review .................................................................................... 26 2.3.1 Emotional Wellness and Service Delivery........................................................ 27 2.3.2 Intellectual Wellness and Service Delivery ...................................................... 34 2.3.3 Occupational Wellness and Service Delivery ................................................... 43 2.3.4 Physical Wellness and Service Delivery ........................................................... 57 2.3.5 Employee Wellness Programmes Credibility Leadership and Service Delivery .................................................................................................................................... 73 2.4 Conceptual Framework ............................................................................................ 80 2.5 Summary of the Research Gaps ............................................................................... 81 CHAPTER THREE ......................................................................................................... 84 RESEARCH METHODOLOGY ................................................................................... 84 3.1 Introduction .............................................................................................................. 84 3.2 Research Philosophy ................................................................................................ 84 3.3 Research Design ...................................................................................................... 85 3.4 Target Population ..................................................................................................... 86 3.5 Sample Size and Sampling Procedure ..................................................................... 88 3.6 Data Collection Instruments .................................................................................... 90 vi 3.7 Data Collection Procedure ....................................................................................... 90 3.8 Pilot Testing ............................................................................................................. 91 3.8.1 Validity of the Research Instrument ................................................................. 91 3.8.2 Reliability of the Research Instrument.............................................................. 92 3.9 Operationalization of Variables ............................................................................... 94 The variables were operationalized as shown in Table 3.4. .......................................... 94 3.10 Diagnostic Tests ..................................................................................................... 95 3.10.1 Autocorrelation Test ....................................................................................... 95 3.10.2 Multicollinearity ............................................................................................. 95 3.10.3 Normality ........................................................................................................ 96 3.10.4 Linearity .......................................................................................................... 96 3.10.5 Heteroscedasticity Test ................................................................................... 96 3.11 Data Analysis and Presentation ............................................................................. 97 3.12 Empirical Models for Data Analysis ..................................................................... 98 3.12.1 Empirical Model for Direct Relationship ....................................................... 98 3.12.2 Empirical Model for Moderated Relationship ................................................ 99 3.13 Test of Hypothesis ............................................................................................... 100 3.14 Ethical Considerations ......................................................................................... 102 CHAPTER FOUR .......................................................................................................... 103 DATA ANALYSIS AND DISCUSSIONS .................................................................... 103 4.1 Introduction ............................................................................................................ 103 4.2 Bio Data analysis ................................................................................................... 103 4.2.1 Response Rate ................................................................................................. 103 4.2.2 Gender of Respondents ................................................................................... 104 4.2.3 Number of Years Worked by Respondents..................................................... 106 vii 4.2.4 Number of Years Worked by Respondents..................................................... 107 4.3 Descriptive Statistics .............................................................................................. 107 4.3.1 Emotional Wellness Programmes ................................................................... 108 4.3.2 Intellectual Wellness Programmes .................................................................. 110 4.3.3 Occupational Wellness Programmes .............................................................. 114 4.3.4 Physical Wellness Programmes ...................................................................... 117 4.3.5 Credible Leadership ........................................................................................ 120 4.3.6 Service Delivery .............................................................................................. 122 4.4 Diagnostic Tests ..................................................................................................... 124 4.4.1 Autocorrelation Test ....................................................................................... 124 4.4.2 Multicollinearity Test ...................................................................................... 125 4.4.3 Test for Normality ........................................................................................... 126 4.4.4 Linearity Test .................................................................................................. 127 4.4.5 Heteroskedasticity Test Results ...................................................................... 129 4.5 Correlation Analysis .............................................................................................. 130 4.6 Hypothesis Testing ................................................................................................ 132 4.6.1 Test of Hypothesis One ................................................................................... 133 4.6.2 Test of Hypothesis Two .................................................................................. 138 4.6.3 Test of Hypothesis Three ................................................................................ 143 4.6.4 Test of Hypothesis Four .................................................................................. 147 4.6.5 Testing for the Moderated Relationship ......................................................... 151 CHAPTER FIVE ........................................................................................................... 169 SUMMARY, CONCLUSIONS AND RECOMMENDATIONS ............................... 169 5.1 Introduction ............................................................................................................ 169 5.2 Summary of the Study ........................................................................................... 169 viii 5.3 Conclusions ............................................................................................................ 174 5.4 Recommendation for Policy and Practice .............................................................. 177 5.5 Contributions of the Study to Knowledge ............................................................. 178 5.6 Recommendations for Further Research ................................................................ 179 REFERENCES ............................................................................................................... 180 APPENDICES ................................................................................................................ 192 Appendix I: Introduction Letter ................................................................................... 192 Appendix II: Research Questionnaire .......................................................................... 193 Appendix III: List of Faith Based Hospitals in Nairobi Metropolitan Area ................ 198 Appendix IV: Research Authorisation from Karatina University ............................... 200 Appendix V: Research Permit ..................................................................................... 201 ix LIST OF TABLES Table 3.1: Faith-Based Hospitals in Nairobi Metropolitan Area ....................................... 87 Table 3.2: Target Population.............................................................................................. 88 Table 3.3: Sample Size ...................................................................................................... 89 Table 3.4: Reliability Statistics .......................................................................................... 93 Table 3.5: Operationalization of Variables ........................................................................ 94 Table 3.6: Test of Hypothesis .......................................................................................... 100 Table 4.1: Response Rate ................................................................................................. 104 Table 4.2: Demographic Analysis Results ....................................................................... 106 Table 4.3: Highest Level of Education ............................................................................ 107 Table 4.4: Descriptive Statistics on Employee’s Emotional Wellness Programmes ....... 108 Table 4.5: Descriptive Statistics on Employee’s Intellectual Wellness Programmes ..... 111 Table 4.6: Descriptive Statistics on Employee’s Occupational Wellness Programmes .. 114 Table 4.7: Descriptive Statistics on Physical Wellness Programmes .............................. 117 Table 4.8: Descriptive Statistics on Credible Leadership ................................................ 120 Table 4.9: Descriptive Statistics on Service Delivery ..................................................... 122 Table 4.10: Durbin-Watson Test Results ......................................................................... 125 Table 4.11: Multicollinearity Results .............................................................................. 126 Table 4.12: Normality Test Result ................................................................................... 127 Table 4.13: Linearity Test Results ................................................................................... 128 Table 4.14: Heteroskedasticity Test Results .................................................................... 129 Table 4.15: Correlation Analysis Results ........................................................................ 130 Table 4.16: Model Summary Results for Emotional Wellness Programmes .................. 133 Table 4.17: ANOVAa for Emotional Wellness Programmes .......................................... 134 Table 4.18: Coefficient Results for Emotional Wellness Programmes ........................... 135 x Table 4.19: Model Summary Results for Intellectual Wellness Programmes ................. 138 Table 4.20: ANOVA Results for Intellectual Wellness Programmes.............................. 139 Table 4.21: Coefficients Results for Intellectual Wellness Programmes ........................ 140 Table 4.22: Model Summary Results for Occupational Wellness Programmes .............. 143 Table 4.23: ANOVA Results for Occupational Wellness Programmes .......................... 144 Table 4.24: Coefficient Results for Occupational Wellness Programmes ....................... 144 Table 4.25: Model Summary Results for Physical Wellness Programmes ..................... 147 Table 4.26: ANOVA Results for Physical Wellness Programmes .................................. 148 Table 4.27: Coefficient Results for Physical Wellness Programmes .............................. 149 Table 4.28: Model Summary for EWP*CL, Emotional Wellness, Credible Leadership 152 Table 4. 29: ANOVAa for EWP*CL, Emotional Wellness, Credible Leadership ........... 153 Table 4.30: Coefficients for EWP*CL, Emotional Wellness, Credible Leadership ........ 154 Table 4.31: Model Summary for IWP*CL, Intellectual Wellness, Credible Leadership 156 Table 4.32: ANOVA for IWP*CL, Intellectual Wellness, Credible Leadership ............. 157 Table 4.33: Coefficients for IWP*CL, Intellectual Wellness, Credible Leadership ....... 158 Table 4.34: Model Summary for OWP*CL, Occupational Wellness, Credible Leadership .......................................................................................................................................... 160 Table 4.35: ANOVA for OWP*CL, Occupational Wellness, Credible Leadership ........ 161 Table 4.36: Coefficients for OWP*CL, Occupational Wellness, Credible Leadership ... 162 Table 4.37: Model Summary for PWP*CL, Physical Wellness, Credible Leadership .... 165 Table 4.38: ANOVA for PWP*CL, Physical Wellness, Credible Leadership ................ 165 Table 4.39: Coefficients for PWP*CL, Physical Wellness, Credible Leadership ........... 166 xi LIST OF FIGURES Figure 2. 1: Conceptual Framework .................................................................................. 81 Figure 4.2: Gender of the Respondents............................................................................ 105 xii ABBREVIATIONS AND ACRONYMS ANOVA : Analysis of Variance CHAK : Christian Health Association of Kenya FKE : Federation of Kenya Employers GHRIS : Government Human Resource Information Systems HIV/AIDs : Human Immunodeficiency Virus/Acquired Immunodeficiency Syndrome IQ : Intellectual quotient KCB : Kenya Commercial Bank KCCB : Kenya Conference of Catholic Bishops KMA : Kenya Medical Association KMPDU : Kenya Medical Practitioners, Pharmacists and Dentists' Union NACOSTI : National Commission for Science, Technology and Innovation OSHA : Occupational Safety and Health Administration PRISMA : Preferable Reporting Items Systematic Reviews and Meta-Analysis SERVQUAL : Service Quality SPSS : Statistical Package for the Social Sciences SUPKEM : Supreme Council of Kenya Muslims TSC : Teacher Service Commission UHC : Universal Health Coverage USA : United States of America VIF : Variance Inflation Factor WIBA : Work Injury Benefit Act xiii ABSTRACT Despite the essential role of faith-based hospitals in provision of quality health services, they continuously face challenges, including workforce-related issues such as poor working conditions such as working for longer hours, seeing more than 8 patients in a day, high rates of absenteeism, lack of critical services, depression and other mental illness as well as drug and substance abuse. These occurrences affect service delivery. The main objective of the study was to investigate the influence of employee wellness programmes on service delivery in faith-based hospitals in Nairobi metropolitan. Specific objectives were; to assess the influence of employees’ emotional wellness programmes, intellectual wellness programmes, occupational wellness programmes and employee physical wellness programmes on service delivery in faith-based hospitals in Nairobi metropolitan and examine the moderating role of credible leadership on the influence of employee wellness programmes on service delivery in faith-based hospitals in Nairobi metropolitan. The study adopted descriptive survey and correlational research designs. The study targeted 1154 employees in the faith-based hospitals in Nairobi metropolitan. The study used stratified random sampling to select the respondents. The study sample size was 297 respondents. The study obtained primary data using a questionnaire. The descriptive and inferential statistics was used to analyse data. Descriptive statistics included frequencies, mean, standard deviation and percentage. Correlational analysis was used to determine the relationship between the independent and dependent variables. The study also carried out a regression analysis to determine the level of association of the study variables. Results were presented in graphs and tables. The study established that there was moderate emphasis on employee’s emotional wellness programmes among the faith-based hospitals in Nairobi metropolitan area, there were employee’s intellectual wellness programmes, there was agreement among the respondents on the adoption of employee’s occupational wellness programmes and that there existed employees’ physical wellness programmes in the faith-based hospitals in Nairobi metropolitan. The study further established that hospital leadership demonstrated moderate credibility. Correlation analysis results showed that a significant weak positive correlation existed between service delivery and employee’s emotional wellness programmes (r=0.324), while a significant moderate positive correlation existed between service delivery and intellectual wellness programmes (r=0.519), occupational wellness programmes (r=0.666) and physical wellness programmes (r=0.539). The study determined that emotional wellness programmes had a significant influence on service delivery (R2= 0.101; β=0.324; P=0.000), intellectual wellness programmes had a significant influence on service delivery (R2= 0.267; β=0.519; P=0.000), occupational wellness programmes had a significant influence on service delivery (R2= 0.442; β=0.666; P=0.000), physical wellness programmes had a significant influence on service delivery (R2= 0.288; β=0.539; P=0.000). The study also established that credible leadership had a significant moderating influence on the relationship between employee wellness programmes and service delivery. The study thus concluded that employee wellness programmes had a significant influence on service delivery. The study further concluded that credible leadership had a significant moderating influence on the relationship between employee wellness programmes and service delivery. The study recommends that the management of hospitals should ensure that there are employee wellness programmes for emotional, intellectual, occupational and physical wellness. The study results would be relevant to the management of faith-based hospitals, the government of Kenya, particularly the ministry of Health, and county governments because it would enlighten them when developing policies aimed at improving the quality of health care and working environment for their healthcare workers. xiv CHAPTER ONE INTRODUCTION 1.0 Introduction This chapter outlines the background of the study, statement of the problem, objectives of the study, research hypothesis, significance of the study, scope of the study, limitations of the study and operational definition of terms. 1.1 Background of the Study In the modern competitive business environment, organizations and their management are realizing that their survival and competitiveness lie in quality of the services and by extension the service providers who are employees (Pandey, 2018). Intensified globalization, dynamism and drastic changes in the business and operational environments, needs managers that are astute and have foresight. Sutton (2020) argues that survival and success of modern-day organizations is pegged on internal aspects such as systems, processes, structures, cultures, practices and the people as opposed to external elements. For service-based industries such as hospitals, employees are at the core of performance and functioning of the organization. Jones, Molitor and Reif (2019) noted that employees can only deliver on their mandate and contribute to the overall goal of the firm, if their well-being is taken care of. Ng’eno (2020) affirms that employee wellness has become an important aspect to management and firms seeking to thrive and hence focus on wellness programmes. Increased consumerism in organizations and industries has shown that value delivered to clients is what differentiates between success and failure. Thus, service delivery is at the core of success in service-based organizations and industries. It is a measure of real outcomes, effective and efficient rendering of services and delivering it in a timely manner. 1 It is also about the extent of excellence and professionalism (Attridge, 2019). Since, service delivery is based on the employee, then their well-being must be considered through provision of wellness programmes. Sickly, fatigued, unmotivated and unrecognized employees cannot deliver on their mandate. Kitali (2021) contends that in recognition of the value of employees’ health, wellbeing and economic benefits, many employees are increasingly providing wellness programmes. Increased chronic health conditions, toxicity at workplaces, depression, aging workforce and lack of work-life balances, has seen employee productivity decline. In worse cases, the turnover rates are too high when employees cannot cope with the work demands and schedules. These employee wellness programmes focus on holistic wellbeing of employees over and above absence of diseases and ailments. The programmes work to improve quality of life at the workplace through social aspects, physical, intellectual, psychological, spiritual and occupational wellbeing (Amponsah-Tawiah, Tagoe, Tamakloe & Mensah, 2020). The wellness programmes also significantly influence the productivity by promoting healthy living, disease prevention practices and a culture of health. The programmes help in creating a favourable working condition for the emotional, psychological and physical wellness of employees and indirectly it works to reduce healthcare costs and expenditures. Foster (2021) revealed the presence of poor attitude and perceptions on wellness programmes, as more employees were interested in incentives as opposed to improving their health and wellness. Training and educating employees can improve perception on workplace offered health and wellness programmes. In the global perspective on service delivery based on employee wellness programmes, researchers such as Isehunwa, Carlton, Wang, Jiang, Kedia, Chang and Bhuyan (2017) in the USA noted that working adults who had access to employee wellness programmes used 2 prevented care services to improve quality of life. Some of the preventive care services included flu vaccination, blood pressure and diabetes checks, counselling and mental health care. In the United States of America, the Occupational Safety and Health Administration (OSHA) advocates for a safe and healthful working condition free from unlawful retaliation. This is achieved by setting and enforcing standards, enforcing anti-retaliation provisions of occupational safety and health, protection of whistle blowers and ensuring that specific state occupational safety and health programs are as effective as federal occupational safety and health programs. In Canada, Attridge (2019) shared that the government and workplace health promotion practitioners advocated for support of employee assistance programmes focussed on mental health disorders. The attitude adopted was assisting workers with mental health disorders is part of the civic duties of the employer and other employees. On the regional scene, du Plessis (2019) alludes that occupational stress was witnessed in academicians in South Africa as they have increased work demands. They are forced to work long hours that creates risks of physical, physiological, psychological and behavioural disorders. As such, the researcher noted the need for social support, cognitive coping mechanism and increased vacation time. Furthermore, employee assistance programmes and health and wellness programmes can help in create work-life balance, improve health and well-being of the academics and improve work output. In Ghana, Ackabah (2018) noted the psychological wellbeing of banking staff was based on job satisfaction, the organizational climate, working condition, job security and tenure. Ajala and Osunrinde (2016) noted that employees feel their employers and managers are disinterested in their personal issues, difficulties and problems. That feeling is detrimental to work output due to lack of belongingness. To reverse these feelings and effects, the researchers push for employee assistance programmes to be initiated by organizations as a means of providing 3 counselling, stress management, supervisory handling and conflict management programmes. In the Kenyan perspective the Work Injury Benefits Act (WIBA) of 2007 provides for compensation to employees for work related injuries and diseases contracted in the course of their employment and for connected purposes (Waisiko, 2024). The act provides assurance to employees that should they sustain injuries in the course of their work, they would be compensated. This is an attempt by the government to ensure that the welfare of employees is well entrenched in the law. This is because it gives indemnity to insured for injury, disease or death of an employee arising out of and in course of employment by the insured in the business insured. Kitali (2021) opined that employees are fundamental to attainment of company’s goals. Hence need to manage their wellbeing through existence of healthy balance between work, life and wellbeing. The banking sector players like Kenya Commercial Bank have employed employee wellness programmes covering, employee support programmes, health and nutrition programmes, mental and physical health and working conditions. In addition, Ng’eno (2020) shared that the commercials bank found that employee performance was improved when wellness programmes were initiated. The recreational facilities, employee counselling programmes, drug and substance abuse cessation programmes, job satisfaction and employee characteristics improve outcomes. The wellness programmes created balance and enhance performance outcomes witnessed through reduced absenteeism rates, punctuality, morale and reduce anxiety and stress. These studies covered financial and banking institutions and found positive correlations, but will the same apply in healthcare facilities. 4 Similarly, Bosire (2021) argued that the wellness programmes initiated at the Kenyatta National Hospital led to significant employee output levels. The medical employees and worker’s union activities advocate for initiation and expansion of wellness programmes as a means to improve output levels. The study was done in a government facility, would the same results be found when considering other types of health facilities such as faith-based hospitals. Waititu, Kihara and Senaji (2017) established that the five variables of employee welfare programmes with elements such as occupational health; succession plans; training and development; employee referral scheme and remuneration policies have an effect on employee performance at Kenya Railways Corporation. But there is need to consider other indicators of employee wellness programmes in other sector and types of organizations. This study considered wellness programmes and its influence on service delivery in faith- based hospitals in Nairobi metropolitan area. 1.1.1 Employee Wellness Programmes The wellness of employees is a deliberate effort to staying healthy in such a manner as to be able the highest potential in total wellbeing. When the employees are in optimal physical and psychological health, they can attend the workplace every day thus minimizing absenteeism, effectively handle their assignments and deliver quality products and services (Torres & Zhang, 2021). The employee wellness is linked to support of the top management, attitudes and perspectives of the employees, availability of finances, programmes, resources and legal factors. The employee wellness programmes are organized and systematic activities and interventions that work to provide health education, identify and manage health risks and purposively work to influence changes in health behaviours (McCleary, Goetzel, Roemer, Berko, Kent & De La Torre, 2017). 5 The wellness programmes include physical fitness, management of stress, nutritional matters, spirituality, safety, sexuality, health education, control and management of substance abuse and smoking and work-life programmes such as flexible working hours. These programmes aim at improving quality of the life for the employees which in turn affects productivity levels. Otenyo and Smith (2017) noted that the employee wellness programmes are beneficial to both the employer and employee. To the employer the programmes reduce costs of healthcare, disability and compensation, absenteeism rate, safety at the workplace, retention of employees, productivity, while the employees learn to lead healthy lifestyle, and maintaining balanced life. The success of the wellness programmes is based on efforts of both the employer and employee. This study operationalized employee wellness programmes based on four aspects, namely emotional intellectual, occupational and physical wellness. These aspects were deemed most appropriate applicable on the health sector. Intellectual wellness was selected because there is need to enable employees increase their knowledge and skills to improve service delivery (Otenyo & Smith, 2017). Occupational wellness was selected due to the need for employees to identify career path and opportunities for their prosperity. On the other hand, physical wellness was selected because hospital staff need to be physically fit for them to discharge their duties effectively (Torres & Zhang, 2021). Emotional wellness was used in this study because hospital employees suffer emotional turmoil due to work related stress and poor working conditions. Emotional wellness of employees is the ability to manage stress, be adaptable and resilient and generate emotions that can lead to good feeling. This can be achieved by having coaching and counselling sessions for mental health, support services, motivation and inspiration sessions and programmes to manage stress that stem from the workplace and home situation (Salami, 6 Salma & Hegadoren, 2019). Social interaction, workload, family and health matters and stability affect the emotional wellbeing of employees. In this study, it was measured by the stress management programmes, mental health programmes, support services, mindfulness trainings and regular inspiration and motivational programmes. Intellectual wellness is about recognition of creative abilities of an individual and encouraging them to expand their skills and knowledge base. Ackabah (2018) suggested that development of intellectual wellness is associated with personal and professional development, involvement in community and cultural practices and space to do hobbies and interests. The work activities should be stimulating to the mind and keep the interest of the employee. The organization can improve intellectual wellness through availing resources to expand knowledge and skills of employees. Furthermore, the supervisors should allocate tasks based on interests and IQ of the staff for full engagement of their minds (Bosire, 2021). In this study, intellectual wellness is a measure of professional development classes, on-the-job trainings, brainstorming sessions, chances for collaboration and creative and innovative thinking for full engagement of employees. Occupational wellness allows an employee to explore career options that enhance their satisfaction, enrichment and meaning of work based on the tasks and assignments they handle (Reitz & Scaffa, 2020). It also involves doing work tasks that are interesting, add value and motivating. It is also about feeling challenges and inspired by what one is doing and handling work that aligns to personal values and styles and where there is balance between work and leisure. The work can be done individually or with collaboration with others and benefits go beyond the individual, the organization and make an impact to the society and communities. Amponsah-Tawiah, et al. (2020) shared that the balance between work and personal life helps personal and professional growth and gaining of rewards. 7 Occupational wellness covered aspects of rewarding for health behaviour, regular assessments of health risks, getting family-friendly policies, regular breaks from work and growth by involvement in leadership decision making. Occupational wellness improved work output and result in higher productivity. Physical wellness covers energy levels at the work and it is caused by healthy behaviours exercised by the employees and encouraged or supported by the management. Some of the healthy behaviours include regular exercising, sleeping well, eating health foods and reduction in consumption of alcohol and smoking (Reif et al., 2020). Physical wellbeing is a section that accounts for total and whole health of a person. The initiatives can be at the instigation of the employee or the organization, involving sessions for physical fitness, drinking more water, encouraging walking and scheduling for gym and sporting activities (Otenyo & Smith, 2017). Physical health improves concentration span, mental stamina, reduces stress and improves focusing, creativity, innovation and memory; which positively impact on outcomes. The study used these indicators for measuring physical wellness; encouraging physical exercising, working health clubs, push staff to walk instead of using stairs, organizational of fitness challenges and sporting activities. When employees are healthy, happy, motivated and satisfied, they have a positive impact on organizational output since they work harder. In seeking to improve service delivery and quality products, the management need to focus on wholesome and overall wellbeing of the employees (Davis, 2021). This study considered emotional intellectual, occupational and physical wellness as instruments to deliver quality services. However, for effective design and implementation of wellness programmes there is need to have the right leadership in the organization. A leadership that is conscious and concerned about the 8 welfare of employees. Kenge and Anyieni (2021) contends that organizational leadership is directly related to the quality of services delivery. 1.1.2 Credible Leadership Leadership scholars, Kouzes and Posner (2006) in their book ‘leadership challenge’ opined that followers can only follow their leaders if they can trust them. If managers are perceived to be credible, employees are therefore more likely to associate with the company, feel attachment with the organization, cultivate team work, align own personal values with those of the organization and tell others about their company. Conversely, they feel less appreciated, less motivated, unproductive and have intentions to quit. The four most critical attributes of credible leaders that have stood the test of time include honesty, forward- looking, inspiration and competence (Kouzes & Posner, 2011). On his part, Maina (2022) suggests that credible leaders exhibit attributes of honesty, trustworthiness, inspiration, accountability, and skill. Besides credible leaders demonstrate values, experiences, act as role models, mentor their juniors, possess charismatic attributes and easily attract followers. In an attempt to improve leadership credibility, Riggio (2021) stated that leaders should cultivate honesty, respect, competence and accountability. In this study credible leadership was assessed through honesty, inspiration, accountability, forward-looking and competence as adopted by Kouzes and Posner (2011), Riggio (2021), Kenge and Anyieni (2021) and Maina (2022). A critical element in credible leadership according to Kouzes and Posner (2011) is honesty. Honesty is crucial for effective leadership because it builds trust, encourages feedback, and fosters accountability. Further, it is suggested by Brosy (2021) that honest and transparent leaders are more likely to inspire their juniors and help them to achieve organization's goals. Besides for leaders to create effective relationships with stakeholders within in the firm, it 9 is indispensable that leaders must be transparent and truthful in their exchanges with their followers and other stakeholders in the organization (Fisher & Hopp, 2020). Moreover, honest leaders create a positive work environment in which team members feel comfortable sharing their thoughts and concerns thereby fostering open communication and better performance (Brosy, 2021). Inspiration on the other hand refers to the ability of the leader to positively influence their followers and motivate them toward success (Reza, 2019). Inspirational leader inspires their team members and enable them to get the best of themselves which enables the organization to overcome to obstacles. Rogan and Nace (2022) suggested that inspirational leaders they are humane, good listeners, resilient, have integrity and nature talent. On her part, Kurter (2022) concluded that inspirational leaders are value-driven, understand the importance of investing in their personal development, they radiate authenticity, they are skilful communicators, encourage unity, approachable and inclusive and embrace vulnerability and risk. Inspirational leadership influences organizational performance. Ali (2022) reported that a direct relationship exists between inspirational leadership and organizational performance. Thus, there is need for organizations to obtain inspirational leaders for superior results. Accountability is an attribute where leaders take responsibility for their actions and decisions they make. It also implies that when they make mistakes, they admit it and work rectify (Angana, 2021). According to Pont (2020) leadership accountability is demonstrated when leaders reliably deliver on their commitments and show their team members that they can be trusted to do what they say they will do. At the same time leaders show accountability by leading by example. Besides leaders can be pacesetters and demonstrating accountability by being candid about the likelihood of delivering on 10 commitments, and apologizing when things turn unexpectedly, communicate and share information as well as demanding accountability from team members (Paller, 2019). Forward-looking leadership refers to the ability of leaders to make decisions today with a focus on the future (Roberts, 2021). As a result, forward looking leaders make decisions on present-day business activities strategically while fixated on future success of the business. To do this, leaders must be in touch with emerging trends in the rapidly changing modern business landscape and keep in touch with their team members (Kurter, 2022). Moreover, according to Fisher and Hopp (2020), for leaders to be successful they must be open to new ideas, new technologies, and new trends while protecting the values of the company. Forward-looking leadership is also characterised by skilful planning and think ahead about future strategies and being inquisitive to discover new insights and perspectives (Roberts, 2021). As such forward looking leaders tap into insights and opportunities from outside firms such as industry insights, informal interactions and published articles. The ability of a leader to carry out a task successfully or efficiently is critical to every organization. Thus, leadership competence can significantly contribute to better performance of the business (Wisittigars & Siengthai, (2019). According to Khoso and Alwi (2022), leadership competence represents a set of knowledge, skills, and abilities that define an effective leader in an organization. Classical leadership competency models such as Boyatzis (1982) model, viewed leadership competence as ability of management to be goal oriented, demonstrate leadership, human resource management, focus on others, and directing subordinates. However, contemporary leadership scholars opine that competent leaders should demonstrate cognitive skills which relate to the ability of the leader to effectively communicate and the ability to learn and adapt, interpersonal skills which 11 involve effective social interactions and the ability to influence others and business skills which enable them to manage operations as well as resources of the business (Simha, 2022). 1.1.3 Service Delivery Service delivery is defined as effective rendering of services to the clients in a manner that meets industry standards of quality (Milliman, Gatling & Kim, 2018). It is also about timelines in delivering of the services without foregoing its quality. In the service sector, quality will determine if the customers were satisfied with the services and encourage repeat business and loyalty to the company and the brand. According to Dibua and Okoli (2018) service delivery is a measure of reliability in meeting the needs of the customers and the market when and where needed. It must also be responsive to the needs and tastes of the customers and be able to carter to the preference of the consumer. When customers get exactly what they desired, it speaks to the high standards and high ratings of the establishment and company. Meeting the needs of the market leads to customer satisfaction in the services provided and the positively leaning towards a single company or service provider. Service-based organizations can only survive in competitive sectors, knowledgeable clients and customers and many service providers, through quality service delivery. The services delivered was able to differentiate between one service provider and another based on the quality of the services, professionalism of the staff, and meeting needs, demands and preferences (Isehunwa, et al., 2017). In focusing on employee wellness programmes, the researcher seeks to understand its effects on service delivery with measurement indicators including customer satisfaction, fast turnaround time, reliability, assurance and accessibility of the services. 12 The Kenyan healthcare system is structured to cover six levels at the first level is the community, then the dispensaries, health centres, primary referral facilities, secondary referral facilities and sixth which is at the top level is the tertiary referral facilities. The healthcare facilities and services by provided by different stakeholders, majorly done by the government and more recently the county governments, private investors who set up private hospitals and healthcare centres and faith-based hospitals. The healthcare system has the mandate of eliminating communicable diseases, reverse the rising burden linked to non-communicable health conditions, reduce burden of injuries, accidents and violence, provide essential healthcare services and manage health risk factors. The duty is assigned to both private and public health sector players. 1.1.4 Faith-Based Hospitals in Nairobi Metropolitan Faith-based hospitals are religious-oriented health facilities which are often nonprofit but charge fees for self-reliance (Kenge, 2021). Faith-based hospitals are critical in provision of healthcare services especially in developing countries such as in sub-Saharan Africa where they provide approximately 40% of healthcare services (World Bank, 2022). Wandera (2016) shared that faith-based hospitals and facilities help to ease the burden caused by increased population, severity of health conditions and easing pain of citizens. These health facilities have complied with the standards, regulations and policies set by the ministry of health at the national and county level. Additionally, Kinyanjui, Gachanja and Muchai (2015) the patients receiving care on the faith-based hospitals had positive perceptions on quality-of-service delivery when compared to public hospitals, while private facilities were said to be very costly. The role played by faith-based hospitals is critical. World Bank (2022) observed that the although the contribution of faith-based health institutions to the global health care is often 13 understated, they are particularly effective in reaching the poor and service delivery. Therefore, their contribution to achieving universal health coverage cannot be overemphasised. Particularly, World Bank (2022) noted that faith-based health providers are believed to be responsible for the largest share of the health services available in Africa. In Africa, faith-based health facilities provide over a third of all the available beds capacities in most in most countries. However, these hospitals owned by faith-based organizations largely depend on donor funding and government subsidy for their operation which significantly limit their capacity to handle the demand for their services. With significant reduction in donor funding in recent years, the effectiveness of functioning and service delivery of the hospitals has been negatively impacted (Kenge, 2021). Thus, many faith-based hospitals have been struggling with constrained funds. This has led under staffing the hospitals leading to overstretching of employees where some are forced to work for longer hours and attending to more patients in a day than recommended. As a result, incidence of fatigue, burnout and depression have been reported prompting this study. The study focused on faith-based hospitals that is sponsored and managed by the religious organizations including Supreme Council of Kenya Muslims (SUPKEM) for Islamic based hospitals, The Christian Health Association of Kenya (CHAK) and Kenya Conference of Catholic Bishops (KCCB). The CHAK oversees 15 hospitals spread across the country, SUPKEM oversees 11 hospitals and KCCB oversees 49 hospitals. Therefore, this study covered 75 hospitals that are run and management by different religious organizations on how service delivery is influenced by employee wellness programmes. 14 1.2 Statement of the Problem The role of Faith-based hospitals cannot be over emphasised due to their contribution in the healthcare system of Kenya, often these hospitals complement government efforts in providing health services particularly to the vulnerable communities where the government has not reached (World Bank, 2022). However, they continuously face numerous challenges, including workforce-related issues that affect the quality-of-service delivery. KMPDU (2022) consistently, detested poor working conditions where health workers are forced to work for longer hours and see many patients in a day. Besides, World Bank (2022) reported that on average health worker in Kenya see on average 13.3 patients per day against 8 recommended by World Health Organization (WHO). There are also high rates of absenteeism making patients go without critical services. Kenya Medical Association (KMA) (2021) further revealed that owing to challenges faced some health practitioners suffer from depression and other mental illness, while others have become drug and substance addicts. Therefore, it is important for the hospitals to invest in wellness programmes for its employees. NACADA reported that prevalence of drug abuse among health care workers is dire. It was noted that alcohol was the most frequently abused drug standing at 35.8%, followed by tobacco (23.5%), cannabis (9.3%), cocaine (8.8%), amphetamine-like stimulants (6.4%), hallucinogens (5.4%), opioids (3.9%) and inhalants (3.4%) (NACADA, 2022). Employee wellness has gained recognition as a critical factor influencing the performance of healthcare providers. The proponents of employee wellness programmes argue that its execution can improve employee productivity and service delivery to the clients and customers of the organization (Susan, Muchangi & Kiiru, 2021). While some faith-based hospitals have implemented employee wellness programmes, there is limited research on 15 the implication of these programmes on the quality of healthcare service delivery in the Kenyan context. Consequently, there is limited understanding of the extent to which these programmes influence both the physical and mental health of healthcare workers, their job satisfaction, and ultimately the quality of healthcare services provided. Existing literature supports wellness programmes can influence employee performance and quality of service delivery. For instance, Goopy, et al. (2020) researched on activities and programmes for emotional wellness and well-being of refugees and immigrants in Canada and concluded that emotional wellness had a significant effect on refugees and immigrants in Canada. However, the study focused on a case study of Joanna Briggs Institute. Additionally, the study relied on secondary data. Thus, there is a methodological gap. Botha (2013) conducted a study on intellectual wellness and behaviour levels of management team in South African institutions of higher education. The study concluded that intellectual wellness improved academic performance. However, the study was conducted in South Africa while the current study will be conducted in Kenya. Thus, there is a contextual gap. In another study, Ombasyi (2019) studied on mental wellness and its effect on employee performance and concluded that mental wellness impact on performance outcomes of each employee. However, the study only focused on emotional wellness leaving out other employee wellness such as physical, intellectual and occupational wellness. Thus, there is a conceptual gap. The reviewed literature has revealed numerous gaps such as contextual gaps since the studies were conducted in other contexts such as educational institutions, refugee centre and marketing sector which are significantly different from the health sector. Conceptual gaps were also identified where conceptualization differently in these studies which ignored service delivery standards as a function of wellness programmes. The identified conceptual 16 gaps, contextual and research methodological gaps created necessity for this study. This study filled the gaps by investigating the influence of employee wellness programmes on service delivery in faith-based hospitals in Nairobi metropolitan. 1.3 Objectives of the Study 1.3.1 General Objective of the Study The main objective of the study is to investigate the influence of employee wellness programmes and credible leadership on service delivery in faith-based hospitals in Nairobi metropolitan. 1.3.2 Specific Objectives of the Study The study was guided by these specific objectives: i. To assess the influence of employee’s emotional wellness programmes on service delivery in faith-based hospitals in Nairobi metropolitan. ii. To investigate the influence of employee’s intellectual wellness programmes on service delivery in faith-based hospitals in Nairobi metropolitan. iii. To examine the influence of employee’s occupational wellness programmes on service delivery in faith-based hospitals in Nairobi metropolitan. iv. To establish the influence of employee’s physical wellness programmes on service delivery in faith-based hospitals in Nairobi metropolitan. v. To examine the moderating influence of credible leadership on the relationship between employee wellness programmes and service delivery in faith-based hospitals in Nairobi metropolitan. 1.4 Research Hypotheses The study adopted the null hypothesis where: 17 H01: Employee emotional wellness programmes have no significant influence on service delivery in faith-based hospitals in Nairobi metropolitan. H02: Employees intellectual wellness programmes have no significant influence on service delivery in faith-based hospitals in Nairobi metropolitan. H03: Employees occupational wellness programmes have no significant influence on service delivery in faith-based hospitals in Nairobi metropolitan. H04: Employees physical wellness programmes have no significant influence on service delivery in faith-based hospitals in Nairobi metropolitan. H05: Credible leadership has no significant moderating influence on the relationship between employee wellness programmes and service delivery in faith-based hospitals in Nairobi metropolitan. 1.5 Significance of the Study The findings and recommendations that were drawn from this study would be significant and beneficial to several parties: First was the Faith-based hospitals in Nairobi metropolitan and its leadership that would learn on how best to deliver quality services to clients and patients. This is linked to understanding that service delivery is pegged on their employees hence the need to consider their well-being. The thriving and survival of these hospitals is pegged on service delivery and quality services is pegged on its employees hence the need for employee wellness programmes. Secondly, the academia including researchers and authors are likely to benefit from the present study. They can base their studies on the current study as a source of referencing and for citation purposes. This study can also enrich their empirical literature through 18 expanding knowledge on employee wellness programmes and service delivery. It would also share proposed research sites, topics and areas as a guiding line to future researchers. The findings of this study may be incorporated in the body of knowledge while developing curriculum to be taught in Kenyan universities and colleges and even across the globe. Policy makers on the other hand are likely to benefit from this study on designing employee wellness programmes as a means of improving wellbeing of staffs. The policies would be important at organizational level to guide managers on assessing and intervening in staff wellbeing; at industry level to be mimicked by other health facilities and at ministerial level to inform and guide sector players on taking care of employees. Moreover, the study contributed to the body of knowledge by presenting an empirical model that may be used by faith-based hospitals in harnessing their service delivery through employees’ wellness programmes. 1.6 Scope of the Study The study was based on Faith-Based hospitals in Nairobi metropolitan. Faith-Based hospitals were selected because they play a critical role in supplementing the government to provide quality healthcare to the citizens. Faith-Based hospitals are among the biggest and most reliable hospitals in service delivery among vulnerable communities who are often not reached by the government. Additionally, patients (especially middle income) who shun public hospitals often throng Faith-Based hospitals. The study focuses on employee wellness programmes and its influence on service delivery. The employee wellness programmes to be covered in this study included aspects of emotional wellness, intellectual wellness, occupational wellness and physical wellness as independent variables. Credible leadership was assessed as a moderator on the relationship 19 between employee wellness programmes and service delivery in faith-based hospitals in Nairobi metropolitan. The study collected primary data using questionnaires from employees in the hospitals as they explained the adopted employee wellness programmes and service delivery levels. The time scope considered in the study five years starting from 2019 to 2023. Data was corrected in the month of March 2024 and April 2024. 1.7 Limitations of the Study The study collected primary data which was obtained from employees in the hospitals. In an attempt to protect their image and that of the hospital respondents may give erroneous information. The reliability of the results in the study was therefore dependent on the accuracy of the information provided by the respondents. The researcher however, explained to the respondents on the need to give accurate information since the study would be beneficial to the hospitals, practitioners and the country at large. The target respondents in the study had busy schedules which made it difficult to access them to take part in the study. Although the researcher booked appointments to avoid interference with their work schedules it was still difficult for them to honour their appointments due to emergency cases arising. This delayed data collection and in some cases the researcher was forced to use the drop and pick later method to administer the questionnaire. Some respondents were hesitant to share information that they deemed confidential especially on matters of service delivery. To ease their worries and build confidence, the researcher produced the introduction letter from the university and research permit issued by NACOSTI. These documents helped in explaining the purpose of the information and the relevance of providing accurate information. The researcher also assured respondents of confidentiality and keeping their identities secret. 20 1.8 Operational Definition of Terms Employee Wellness Programmes: Initiatives developed by the hospital to holistically work on the physical, social, psychological and spiritual health of health workers (Torres & Zhang, 2021). The programmes and activities are organized by the hospital management to provide health education, test for health risks and share information on how the healthcare workers can change bad health behaviours. Employee Emotional Wellness: Where the faith-based hospital employees are able to manage stress, be adaptable and resilient to changing work situations (Salami, et al., 2019). Employee Intellectual Wellness: The case where employees are free to use their creative abilities, explore their skills and knowledge (Bosire, 2021). Employee Occupational Wellness: Taking opportunities and career options that improve satisfaction, enrichment, value and meaning of work (Torres & Zhang, 2021). Employee Physical Wellness: Physical fitness of employees that enables them to discharge their duties as demonstrated through their psychomotor skills such as movement, coordination, dexterity, strength, flexibility and speed (Reif et al., 2020). Credible Leadership: It is the degree of employee confidence, belief and acceptances towards the leader (Riggio, 2021). Credible leader influences others to engage in the achievement of meaningful shared goals. Service Delivery: Capacity to deliver services that satisfies the clients, there is fast turnaround time, communication that is clear and complete, easy accessibility of service and accurate diagnosis (Dibua & Okoli, 2018). 21 CHAPTER TWO LITERATURE REVIEW 2.1 Introduction The chapter presents review of literature that aligns with the study and its objectives. The chapter consists of theoretical framework that anchors and supports the study variables. It also has a section on empirical literature as per the study constructs and the proposed conceptual framework showing interrelationship between the variables. The chapter concludes with a summary of the research gap that necessitated conducting the current study. 2.2 Theoretical Literature Review The section presents reviews of relevant theories supporting the variables of the study. Specifically, the reviews behavioural decision-making theory that anchors the study and supported by the theory of social exchange and Maslow’s hierarchy theory. The theory concepts and relationship to the study variables is discussed in the subsequent sections. 2.2.1 Behavioural Decision-Making Theory The theory was developed by Ward (1954) with its key concept based on providing insight into how people make decisions and choices based on the prevailing conditions. The theory takes the approach on judgement made on choices during conditions of uncertainty. The perception of uncertainty by the employees would have a significant effect on their judgment. Human behaviour and intentions are linked to the choices made and judgement based on prevailing situation and circumstances. The adopted behaviour is associated with attitudes by evaluating the situation and subjective norms presented to social pressures to take up specific behaviour patterns (Michaelidou & Hassan, 2014). An employee’s behaviour control and planned action to undertake a new behaviour pattern is linked to the 22 choices that s/he makes. The decisions made are hinged on work environment and working conditions and impact on commitment levels and individual outcomes. The working conditions, systems and patterns dictate the commitment levels and hence the management is encouraged to push and invest in programmes and initiatives that impacted wellness of the employee. Haward and Janvier (2015) revealed that self-identity, ethical considerations, organizational factors and past behaviour dictate how employees respond to wellness programmes initiated by the firm. As organizations push for the social, intellectual, emotional and physical wellbeing of employees, it impacts on the working condition and tend to increase dedication, commitment and responsiveness on workers’ role and responsibilities in the organization. Additionally, when an organization does not do a good job at supporting its employees by addressing any concerns that may have in addition to clearly explaining their duty and role in the larger vision of a company, workers views this as uncertainty and their commitment and involvement in the workplace will end up going down. Organizations thus need to be able to create a good organizational structure and workplace condition that will minimize any likelihood of perception of uncertainty by the employees and this would encourage the commitment of their employees and maximize their output (Stingl & Geraldi, 2017). Therefore, the theory explains on structuring wellness programmes that impact on wellbeing of the employees that result in improved commitment. These employee wellness programmes help in creating a conducive workplace, engage employees and ensure they fit to handle their tasks and work responsibilities. The working place is associated with systems, tools, equipment and the people who must be fit to deliver quality services, hence focus on employee wellness programmes in faith-based hospitals in Nairobi metropolitan area. 23 2.2.2 Social Exchange Theory The theory was formulated by Homans (1958). It constitutes that the relationship between two people is based on cost-benefit analysis. The benefits are gained from the effort poured into the relationship and the nature of the relationship could shift from high reward and low costs to low rewards and high costs. The social exchange theory is based on three key factors, namely the cost-benefit analysis, comparison levels and comparison levels with other alternatives. According to social exchange theory, an organization treats its employees in a certain way in the hopes that the employees would indeed be required to reciprocate the firm’s good actions (Cook, Cheshire, Rice & Nakagawa, 2013). The exchange approach is made of aspects covering the economic and the social interactions. An economic exchange partnership, according to Mitchell, Cropanzano and Quisenberry (2012) entails the exchange of financial rewards in exchange for employees’ efforts, and they are frequently based on legally binding contracts. It aims at enhancing commitment levels and improved service delivery by the employees. Social exchanges, on the other hand, are considered as ‘voluntary activities’ that might be triggered by an institution’s handling of its employees in the assumption that the employees were required to return the organization’s good deeds. The management in the hospitals can work to encourage adoption and participation in wellness programmes such as counselling sessions for emotional wellness, reading and trainings for improved intellectual wellness, job characteristics that enhance occupational wellness and exercising, going to the gym, sporting activities and taking healthy foods for physical wellness. The social exchange is based on encouraging employees to voluntarily take part in activities that improve their wellbeing and enhance quality service delivery. Cropanzano, Anthony, Daniels and Hall (2017) noted that the employees therefore anchor themselves to their organizations in 24 exchange for particular benefits or incentives, according to the exchange approach to organizational commitment. The reciprocal interaction between the organization and its workers if well managed can improve performance outcomes at individual and organization level (Cook, et al., 2013). The theory implies that if the faith-based hospitals treat their workers well and show concern for the emotional, mental and physical health; it will make the employees feel motivated and committed to handle their duties and deliver on their organizational goals. The employee wellness programmes can improve employee commitment levels that result in better service delivery in the faith-based hospitals. When the hospitals treat staff well and support them, they gain in terms of better service quality delivered to patients and high- performance outcomes. 2.2.3 Maslow’s Hierarchy of Needs Theory The theory was formulated by Maslow (1943) and it is based on the five categories of human needs that are arranged in hierarchical order. These human needs involve physiological, security, social, self-esteem and self-actualization needs. The theory shared that individuals should first meet the basic needs before they are motivated to satisfy the higher-level needs. This is because if the basic needs are not met, employees’ behaviour was geared towards the satisfaction of these basic needs. After the satisfaction of physiological needs, employees would be motivated to satisfy security needs and this would continue until self-actualization needs are met. Physiological needs are at the foundation of the pyramid and include basic needs necessary for survival such as food, clothing and shelter. The second level of needs is referred to as safety and security needs. These needs are expressed through a desire for safety in one’s job, health and family. These needs are 25 usually attained when employees’ fears and anxieties are low. In the third level of needs, employees work towards the attainment of love and belonging. Employees strive to establish job relationships by building friendships, love and intimacy in order to experience acceptance from other people. The fourth level of needs comprises of self-worth and self- esteem needs. Employees seek to attain self-worth by being accepted and valued by others. At the apex of the pyramid is the need for self- actualization. It refers to the desire for an individual to become whatever they desire by using their full potential, capabilities and talents. The organizations seeking to enhance productivity and service quality must consider the needs of their employees. Jerome (2013) shares that meeting the needs and support schemes and initiatives that can meet the different needs of the employees is a key factor in improving commitment levels and outcomes. Thus, the faith-based hospitals should set programmes and initiatives that can deliver on the various needs of their employees. The hospitals should focus on physiological needs, security and safety factors, social factors at the workplace through socialization and emotional wellbeing; catering to the needs of self- worth or self-care and self-actualization. The employee wellness programmes work to improve service delivery quality in the hospitals and leave patients satisfied and happy. 2.3 Empirical Literature Review The section shares on relevant empirical literature from other researchers on aspects of employee wellness programmes including emotional wellness, intellectual wellness, occupational wellness, physical wellness and credible leadership. These variables are linked to service delivery. 26 2.3.1 Emotional Wellness and Service Delivery Human beings are not robotic or machine-like and thus, it is important for the management of organizations to consider and strategies for the emotional well-being of its employees. Awada and Ismail (2019) noted that emotional wellness is about a good work place that carters to the social, mental and psychological wellbeing of staffs. Emotional wellness covers the aspect of proper management of stress and stressing factors especially in demanding job types and toxicity workplaces. The management can set in place measures of stress management, counselling and mental health programmes. Employees can receive some coaching on maintaining balance between the workplace and family or personal time. Mentorship can also work to improve employee commitment and satisfaction rates, leave the employees feeling comfortable, empowered, focus and ready to handle their work tasks. Baloglu, Busser and Cain (2019) shared that a healthy workforce is able to deliver on the organizational mandate and its objectives. Open communication, open organizational structure, working in teams, training, support services and emotional support groups help to create a stress-free workplace and improve productivity rates. The management of the firms should work to promote psychologically healthy workplace and fair treatment of employees for high quality service delivery. Clabaugh et al. (2021) conducted a study on academic stress and emotional well-being in United States college students following onset of the COVID-19 pandemic. Based on a sample of 295 students, the study collected primary data relating to students’ academic perceptions and emotional well-being after the emergence of COVID-19 pandemic. It was discovered that some students were at higher risk of academic stress and poor emotional well-being due to emergence of the pandemic. Specifically, students reported high levels of uncertainty regarding their academic futures as well as significant levels of stress and difficulty coping with COVID-19 disruptions. Besides, female students reported worse 27 emotional well-being compared to males, and the students of colour reported the significantly higher levels of stress and uncertainty regarding their academic futures compared to White students. However, in this study emotional well-being (wellness) was the receptor variable while in the current study it was an independent variable. Thus, there is a conceptual gap. In another study Morelli et al. (2020) sought to determine the influence of parenting distress and parenting self-efficacy on children’s emotional well-being. Path model in which parenting self-efficacy and parental regulatory emotional self-efficacy mediated the relationship between parents’ psychological distress and both children’s emotional regulation, and children’s negativity was investigated. The study population comprised of 277 parents of children aged between six and thirteen years. the study utilised primary data collected via an online. Structural equation model (SEM) using MPLUS 8.3 was tested. it was discovered that the extent to which parents believe to be competent in managing parental tasks might be a protective factor for their children’s emotional well-being. The study also discovered that the parents influence of psychological distress and parents’ regulatory emotional self-efficacy on children’s emotional regulation and negativity were mediated by parenting self-efficacy. The mediation model was invariant across children’s biological sex and age, and geographical residence area with high or low risk of COVID- 19. The study however adopted structural equation modelling while the current study used least squares regression model. Thus, there is a methodological gap. Ombasyi (2019) studied on mental wellness and its effect on employee performance in Kenya’s brand design development firm. The study focus was on employee wellbeing, stress, and the strategies for mental wellness. Through the use of descriptive research design and targeting 50 employees who took part in the study, the researcher did a census survey. 28 Questionnaires were used to collect primary data and which was analysed through descriptive, correlation and regression methods. Findings revealed positive and significant effects between psychological wellbeing, stress of employees when faced with high job demands at the workplace and mental health and performance outcome. The study also revealed that work happiness, rewarding good work outcome improves mental health of the employees and mental wellness impact on performance outcomes of each employee. The study concluded that mental wellness leads to improved employee performance. The study shows the importance of emotional and psychological wellbeing of employees as management seeks to improve individual employee performance. The improved performance outcome at employee level will reflect positively on overall organizational output. The study covered many elements of employee wellness; hence the need for future studies to concentrate on emotional wellness and service delivery rate. Ali et al. (2021) sought to establish the effect of COVID-19 on mental well-being of nurses in tertiary facilities in Kenya. The study adopted a cross-sectional research design in the study that was carried out between August and November 2020 among nurses recruited from the Aga Khan University Hospital, Nairobi. Study population consisted of 255 nurses from which a sample of 171 nurses was randomly selected. The study relied on primary data collected via structured questionnaire. Multivariable logistic regression analysis was performed to identify factors associated with mental health disorders. Results revealed that Only 1.8% reported a prior history or diagnosis of any mental health disorder however, depression, anxiety, insomnia, distress, and burnout were reported in 45.9%, 48.2%, 37.0%, 28.8% and 47.9% of all nurses. Frontline nurses reported experiencing more moderate to severe symptoms of depression, distress and burnout. Furthermore, females reported more burnout as compared to males. Multivariate logistic regression analysis showed that after 29 adjustment, working in the frontlines was an independent risk variable for depression and burnout. Goopy, et al. (2020) researched on activities and programmes for emotional wellness and well-being of refugees and immigrants in Canada. The study focused on support programmes and emotional wellness of newcomers in settlement schemes in a new region and country. The researchers noted that newcomers faced the challenging issues of social isolation, language and social issues and basic needs service provision of food, clothing, shelter, healthcare and education. In the new setting, the focus is on the settlement agencies capacity, programmes and activities that support the emotional wellness and well-being immigrants. The study was done at the Joanna Briggs Institute by conducting a scoping review of databases of the refugees and immigrants. Some of the reviewed databases included APA PsycINFO, Allied Health Literature Plus, Medline, and Education Research Complete. The researchers relied on published literature and documents that were reviewed and found that some of agencies serving immigrants did not focus on the emotional wellness but rather on provision of basic social amenities. The study provided an assessment of emotional wellness practices employed by settlement agencies. It included social support, placement, language interpreters and social workers giving counselling and guidance on cultural, social and physical practices of the new area. Moon (2021) studied on emotional wellness for promotion of integrated mental health care and social services during the covid-19 pandemic. The pandemic’s effect to the Latino community was great leading to anxiety, depression and stress and hence the study focus was on interventions at community level. Focus was also on the integrated social services for the emotional and mental health and for service delivery to the community members. The study participants included 1,436 people who had been enrolled in the Latino health 30 access emotional wellness program. There were 346 participants who had enrolled in the program pre-covid and 1090 who enrolled during the covid-19 period. The data was assessed using Pearson tests and regression models used to compare factors linked to pre – covid and during the covid-19 period. Finding revealed that there was a significant increment in enrolment to the emotional wellness program during the pandemic period as compared to the pre-pandemic era. There was an expanded age distribution, gender, geographical range and males increasingly participated in the program. The participants got peer support, counselling services, health check-ups, training on disease management, housing and food assistance and supplementary income. The study concluded that emotional health programmes helped community interventions and support for the wellbeing of all members by addressing social needs. The emotional wellness programmes worked to address social inequalities for ethnic minority communities and worked to improve behavioural health needs. The pandemic worsened healthcare provision and highlighted the structural inequalities and the emotional wellness programmes worked to handle social needs as well as mental health. Berry et al. (2020) in a study on return on employee wellness programs. The study reviewed extant literature on hard return on employee wellness programs. The study specifically considered engaged leadership at multiple levels, strategic alignment with the company’s identity and aspirations, broad design that is in scope and high in relevance and quality, broad accessibility, internal and external partnerships as well as effective communications. The study concluded that although some health risk factors, such as heredity, cannot be modified, focused education and personal discipline can change others such as smoking, physical inactivity, weight gain, and alcohol use and by extension, hypertension, high cholesterol, and even depression. The results are worth the effort. However, the study was 31 conducted in the United States while the current study was conducted in Kenya indicating that there is a contextual gap. Varga et al. (2021) conducted a study on employee perceptions of wellness programs in the hospitality industry. The purpose of the study was to examine the impacts of employee wellness programs on employee and organizational outcomes in the hospitality industry. the study relied on primary data collected via a self-administered questionnaire. The questionnaire was distributed on Amazon Mechanical Turk, targeting hospitality employees who have access to employee wellness programs. The inclusion criteria were that participants were required to have been used with an organization that offers wellness programs. Employee wellness programs were evaluated using items from the 2015 Harris Poll-Nielsen survey used in an occupational health study. Collected data analysis was conducted based on descriptive statistics, confirmatory factor analysis and structural equation modelling techniques were used. The study revealed that employee perceptions of wellness programs significantly impacted turnover intention, job stress and perceived organizational support. Perceived organizational support had a significant mediating effect between employee perceptions of wellness programs and job stress. Employee perceptions of wellness programs did not have a significant effect on emotional labour. However, the study focused on employee perceptions of wellness programs on job stress while the current study was sought to determine the impact of employees’ wellness program on employee performance. This indicates that there is a conceptual gap. Additionally, the study was conducted in the hospitality industry while the current study was conducted in in the health sector. Thus, there is a contextual gap. Fink et al. (2020) conducted another study employee perceptions of wellness programs and incentives. The purpose of the study was to explore, by income level, employee perceptions 32 of an employer offered wellness incentive program. The study adopted a descriptive research design in which both qualitative and quantitative methods were used. The study population was employees of Wisconsin hospital in Milwaukee, United States. A census of all the 105 employees was conducted. Primary data was used in the study which was collected via a semi-structured questionnaire with both close-ended and open-ended questions. Quantitative data were analysed using descriptive statistics in Qualtrics and logistic regression in Statistical Analysis System while qualitative data was analysed thematically using content analysis. It was established that 63% of the respondents participated in wellness programs because the because they would be offered a reward by the employer, 52% indicated that they would participate even without a reward, 48% stated that they felt obliged and must participate in all wellness program while 34% felt like they would have to disclose information about their health at or below the current reward level. It was thus concluded that income does not have a significant effect on whether employee’s perception of wellness programmes or whether they feel they must participate or disclose health information. However, income has a significant effect on employee’s beliefs about whether or not employers should play an active role in improving the health of their employees. The study however adopted Qualtrics and logistic regression while the current study used least squares regression analysis. Therefore, there is a methodological gap. Restoule, Hopkins, Robinson and Wiebe (2016) conducted research on mental wellness through partnerships and collaborative efforts in the Canadian communities for mental health. The First Nations program on mental health strategy used the traditional, cultural and mainstream approaches in executing the mental wellness. Effectiveness in delivering mental wellness focused on creation of structural and foundational systems that will impact the First Nations Communities all across Canada. The study reviewed past literature, documents and government databases and found that creation of mutual cooperative and 33 respectful working relationship improved collaborative partnerships. The partnerships between the First Nation, government and local communities led to positive changes at communal level and use of cultural practices to maintain lasting and meaningful changes. The partnerships and collaborative efforts of all partners resulted in improved mental wellness amongst the people of Canada. 2.3.2 Intellectual Wellness and Service Delivery Intellectual wellness is about making better decisions and engaging in activities that bring more fulfilment in life. It also helps in improving the engagement of the mind and creating an opportunity to learn, gain more knowledge and skills. Awareness and adoption of intellectual wellness give an individual the skills to balance between demanding work tasks, personal and family responsibility. It also encourages healthy behaviour for all workers and even students in different learning institutions. There is need to expand opportunities for learning and growing to expand knowledge base and engagement of the mind in thought- processes, critical and creative thinking. Syed et al. (2017) researched on intellectual wellness for teachers of science in universities and the comparisons based on gender. The study focus was on intellectual wellness awareness for teachers of basic science at the medical universities in Karachi, Pakistan. The data was sourced from 3 public universities and 5 private universities in Pakistan and respondents included both male and female teachers. Focus was conducting a comparative analysis based on gender. The findings showed that intellectual wellness awareness was significantly better and more for the male medical and science teachers in both the public and private medical universities. The assessed female teachers recorded lower scores for intellectual wellness awareness and implementation. 34 Botha (2013) research was done on intellectual wellness and the behaviour levels of management team in South African institutions of higher education. The transformations and changes made in the South African’s higher education sector has pushed the demand for intellectual managers to handle the complex challenges. The study focus was on assessing how managers in two South African higher education institutions engage in activities and behaviours stimulate intellectual development, growth and establishment. The survey collected data from 324 managers in the two universities and findings revealed that the managers showed high levels of intellectual wellness. There were some who score lowly on intellectual wellness and hence created a need for interventions including keeping oneself informed on social, political, and economic factors, learning and scientific discoveries. The study concluded that managers had intellectual wellness and there was need to acquire new skills, competencies and knowledge that improves academic performance. The study recommends the need for gaining more skills and knowledge especially from computer and technological applications and systems. Mafumbate et al. (2017) research was on social and intellectual wellness of orphaned children in Masvingo urban area in Zimbabwe. The researcher noted that HIV and AIDs has had a big social cost to the Zimbabwe people and left behind millions of orphaned children. The researcher purposively selected 16 orphaned children, 4 guidance and counselling teachers and reviewed past documents. The study found that children in Masvingo urban were at risk and experienced academic challenges linked to their socialization process. The study also found compromised, inconsistent and inadequate support structure for the orphaned children that had negative effects to their intellectual wellness and academic and learning processes. Further results indicate that female orphans are the most affected and show much distress than their male counterparts. The inadequate social support resulted in poor intellectual wellness that led to bad academic performance 35 amongst the leaders. The study concluded that social and intellectual wellness was poor and affected the learning and academic process of the orphaned children. The study recommended the need for strengthening the provision of social and intellectual wellness for the orphaned children. There is also need for awareness creation and advocacy to eradicate the problem. Wickramarathne et al. (2020) conducted a study the wellness dimension models for purposes of advancing the society. Wellness is a way of life that always involves exploring, searching, asking new questions and discovering new answers, all the while living in the physical, mental and social dimensions. The study focus was on reviewing all wellness dimension models and assessed using the Preferable Reporting Items Systematic Reviews and Meta-Analysis (PRISMA). The findings showed that the wellness dimension model follow the stages of identifying, scanning, and checking the inclusion and eligibility levels of people in the society. The dimensions for wellness covered the social, spiritual, physical, emotional, intellectual and occupational wellness. The study findings shared that recognizing, adopting and practicing these dimensions in both the working places and education and learning institutes helped in creating a better society. Wellness can help create better attitudes and positive personal phenomenon. The policy makers, administrators and entrepreneurs can help in developing efficiencies and effectiveness by doing the right thing, at the right time and with the suitable tools as guided by the suitable model. In a study on fitness and wellness IQ, Milton et al. (2022) set out to measure the influence of recreation fitness and wellness programs on college student learning outcomes in campus. The study adopted experimental research design. The study population consisted of all the 24,000 students in mid-west college. A sample of 243 respondents participated in 36 the fitness and wellness programs which was randomly selected. Primary data was utilised which was collected via the fitness and wellness IQ test. The fitness and wellness IQ test was a series of 25 multiple-choice questions. Each question contained four possible choices, with only one answer serving as the best possible choice. Qualitative data was analysed using descriptive statistics and regression analysis. Results showed that students who participated in selected fitness and wellness programs offered by a certain four-year, public institution of higher education in the Mid-west scored significantly higher on an exam. The study also determined that gender, age, and residence of the respondents produced significant differences in mean scores. Although these findings have important ramifications for campus recreation departments, divisions of student affairs, and institutions of higher education in general based on the impact on student learning from traditionally non-academic institutional programming, the study findings were based on a case study of mid-west college which is in the education sector while the current study was based on faith-based hospitals in the health sector. Thus, there is acontextual gap. The amount of fitness and wellness knowledge that a student, could obtain from participation in a campus recreation program, potentially contributes to overall socialization. However, there are a, number of other benefits to the student that can be derived from this, knowledge. These benefits include the ability to take control of one’s life, manage stress, experience physical fitness gains, and contribute to the economic status of the nation by lowering health care costs and paying fitness and wellness professionals for these services (Hoeger & Hoeger, 2021). Student learning through institutionally provided campus recreation fitness and wellness programs has not been researched though there are a number of benefits to the student by learning about fitness and wellness through participation in these programs. 37 Roslenderet al. (2020) also conducted a study on employee wellness as an intellectual capital. The purpose of the study was to identify employee wellness as a further component of intellectual capital and to illustrate how it might be possible to account for it in ways that depart from accounting’s traditional focus on costs and valuations. The study was qualitative in nature considering a range of ideas relevant to visualising employee wellness as intellectual capital and how to account for it as such. The study concluded that employee wellness a component of primary intellectual capital, being something that employees bring to their organisations together with their experience, expertise, know‐how, leadership skills, creativity. It is also a component of secondary intellectual capital envisaged as initiatives designed to promote greater levels of health and fitness among employees. While it is not possible to place financial valuations on employee wellness, individual or collectively, it is possible to develop metrics that will communicate useful information to a variety of stakeholders. In addition, employee wellness is a suitable topic for the development of self-accounts by organisational participants. However, the study was conducted in the united studies while the current study was conducted in Kenya thus there is a contextual gap. Anderson et al. (2023) conducted a study on the state of the science of health and wellness for adults with intellectual and developmental disabilities. The study was theoretical in nature based on qualitative analysis of extant literature of adults with intellectual and developmental disabilities. It was observed that, historically, people with intellectual and developmental disabilities have experienced health disparities related to several factors such a lack of access to high quality medical care, inadequate preparation of health care providers to meet their needs, the social determinants of health (e.g., poverty, race and gender), and the failure to include people with intellectual and developmental disabilities in public health efforts and other prevention activities. The study identified gaps in the 38 literature including the lack of intervention trials, replications of successful approaches, and data that allow for better comparisons between people with intellectual and developmental disabilities and without intellectual and developmental disabilities living in the same communities. The study however relied on literature review and therefore the results cannot be generalised in the current context. Munyiri (2023) in a study on factors influencing uptake of wellness programmes at AMREF Health Africa, Kenya sought to determine the factors influencing the uptake of employee wellness programs offered at AMREF Health Africa in Kenya. Specifically, the study sought to determine the uptake of the employee wellness program, to determine the effects of staff knowledge on wellness programs, to assess the effects of staff attitude towards wellness programs and to identify strategies to improve the wellness program at AMREF Health Africa. This study adopted mixed methods research design. The target population of this study comprised staff in AMREF Health Africa. This study adopted a stratified random sampling approach to arrive at a sample of 140 employees. In addition, 5 people working in the human resource department were purposefully involved in the study to act as key informants. Therefore, the study had a total sample of 145 respondents. The study used a structured questionnaire and key informant guide to collect data. A pilot study was conducted to establish reliability and validity of instruments. Quantitative data was analysed using descriptive statistics, correlation and regression. Quantitative analysis was conducted using the Statistical Package for the Social Sciences. Results of quantitative analysis were presented using tables. Qualitative data collected in this study was analysed using content analysis. To carry out content analysis the researcher used NVIVO 12 software. The study results were explained using the wellness motivation theory, and the social learning theory. The results of qualitative analysis were presented in a narrative format. The study found that the uptake of the employee wellness program initiatives was 39 low (35%). Employee knowledge was found to have a significant effect on uptake of wellness programs. In regression analysis the employee's attitude was negative and significant. The study was however a case study of AMREF Health Africa while the current study was a survey of faith-based hospitals in Nairobi Metropolitan. Thus, there is a contextual gap. Additionally, the study adopted mixed methods research design while the current study adopted a correlational research design. Therefore, there is a methodological gap. In another study, Mungania et al. (2016) conducted a study on the influence of wellness programs on organizational performance in the banking industry in Kenya. The objective of the study was to determine the influence of wellness programs on organizational performance in the banking industry in Kenya. This study adopted across sectional survey. The target population of the study consisted of 44 registered banks by the central bank of Kenya but 43 banks participated in the study because one of the banks was under receivership at the time of data collection. Primary data was collected using semi structured questionnaires consisting both open ended and close ended questions. The study adopted descriptive statistics such as frequencies, percentages, mean score and standard deviation. In addition, used regression analysis to establish relationships among variables. The study found that wellness programs influence organizational performance. This was through preventive care, education and training on importance of wellness on employees as well as through supportive manager. Rehman (2015) study was on intellectual wellness and mentorship for medical students at the Aga Khan University in Pakistan. The researcher noted that anxiety and stress, the lack of pleasurable events and creative release results in illnesses of people across the globe. Medical students face mental stresses linked to voluminous and stressful academic 40 curriculum. The medical students showed burn-outs, mental exhaustion, depression and suicidal tendencies. The study found that intellectual wellness acquired from group discussions, reading, watching and net surfing can help in withstanding stress and solving mental proficiencies problem. Intellectual wellbeing of the medical students can be based on using cognitive, psychomotor and affective domain resources. The study collected data from medical students and revealed that intellectual wellness of the students can be attained through mentoring programmes and use of mentors. The mentors can offer guidance, help in coping mechanism, reduce stress and lower depression and cases of dementia. The mentors can also work to improve communication, critical and creative thinking. The study recommended that mentors work with medical students by directing them towards realistic and attainable goals; self-criticism, reinforce the need for physical health and set time for hobbies. Waithanji and Ndeto (2023) conducted a study on the effects of welfare programmes on performance of tier one banks in Kenya. Specifically, the study sought to assess the effect of intellectual wellness programmes on performance tier one banks in Kenya. This study adopted a descriptive research design. The unit of analysis was 8 tier one banks in Kenya which included Absa Bank Kenya PLC, KCB Bank, Equity bank, Cooperative Bank, NCBA Bank, Standard Chartered Bank, Stanbic Bank and Diamond Trust Bank (DTB). The unit of observation was 80 senior employees working the human resource departments in these commercial banks. The study used a census. Data was analysed using qualitative and quantitative techniques using SPSS version 28. Inferential analysis included Pearson’s correlation and regression analysis. Results showed that intellectual wellness programmes have a positive and significant influence on performance tier one banks in Kenya. However, the study was conducted among tier one commercial banks while this study was conducted 41 among faith abased hospitals in Nairobi metropolitan region and therefore there is a contextual gap. In another study, Waisiko (2024) sought to determine the effect of remote working on employee wellness among Non-Governmental Organizations in Nairobi City County in Kenya. The study was anchored on a positivist research paradigm and applied a cross- sectional descriptive research design to quantitatively describe the relationships between remote working on employee wellness. From a total population of 80,229 employees in the registered nongovernmental organizations in Kenya, a sample of 398 was selected using stratified sampling technique. Validity and reliability of the research instrument was tested. reliability was tested using Cronbach’s alpha. Data was analysed through SPSS. Regression analysis results indicated a weak relationship between the independent variables: job- related factors, organizational factors and work-life balance and the employee wellness. Similarly, work-life balance had a positive, statistically significant influence on employee wellness. In this study, employee wellness was evaluated a dependent variable while in the current study it was an independent variable. Thus, there is a conceptual gap. Employees wellness programs improve their performance. This postulated by Ng’eno (2020) in a study on the influence of wellness programs on employee performance of commercial banks in Kenya. The study observed that employees who were satisfied with wellies programs performed better in their roles as evidenced by the reduced absenteeism levels, enhanced punctuality, enhanced morale as well as reduced stress and anxiety among the employees. Further, employee characteristics affected employee punctuality, influenced speed at which employees performed their assignments, helped in reducing employee stress, enhanced teamwork and ultimately improved the productivity. In this study, the main objective was to analyse the effect of wellness programs on performance 42 of employees in commercial banks in Kenya. Specifically, the study sought to determine the extent to which employee counselling programmes, drug and substance abuse cessation programmes and provision of recreational facilities affected employee performance within the commercial banks in Kenya. The study was anchored on social comparison, social exchange and hierarchy of needs theories. Positivist philosophy and used alongside descriptive research deign. The target population was 30,903 employees of the 43 commercial banks in Kenya. From this population, a sample of 395 employees was selected using stratified sampling technique. Reliability of the research instrument was tested via Cronbach alpha (α) coefficient. Primary and secondary data were adopted in the study. Primary data was collected using structured questionnaires while secondary data was collected from published sources such as libraries and company websites. Descriptive statistics and regression model were used to analyse quantitative data while content analysis was utilized to analyse qualitative data. 2.3.3 Occupational Wellness and Service Delivery Occupational wellness is a measure of the wellbeing of an individual in terms of psychosocial status and linked to ones’ profession and tasks handled. The person who is able to balance between work, family and leisure time is likely to maintain their wellbeing. Wellness is also about addressing work stresses and hardships, maintaining healthy relationships with co-workers and supervisors and adjusting accordingly with the work demands (Reitz & Scaffa, 2020). The safety, health and wellbeing of the workers serve as motivating elements resulting in improved production levels and better performance outcomes. Ng’eno (2020) noted that workplace hazards, safety concerns, work environment and stress negatively affect occupational wellness and outcome at both individual and organizational level. Stresses lead to inefficiencies, absenteeism and frequent and prolonged sick leaves, while hazards demand compensations that affect profit 43 and earning levels of the firm. These hazards, safety concerns and stressors demotivate workers and create a bad work environment that result is lowered productivity. Song and Baicker (2019) conducted a study on the effect of a workplace wellness program on employee health and economic outcomes. the study sought to evaluate a multicomponent workplace wellness program resembling programs offered by US employers. Using clustered randomized trials, the study targeted a population of 32,974 employees at a large US warehouse retail company. Primary data was collected through a survey form. Data was analysed through descriptive statistics and inferential analysis. It was concluded that workplace wellness programmes resulted in significantly greater rates of some positive self-reported health behaviours among those exposed compared with employees who were not exposed, but there were no significant differences in clinical measures of health, health care spending and utilization, and employment outcomes after 18 months. The study however, conducted clinical trials while the current study is a social science study. This there is a methodological gap. Elsewhere, Sable et al. (2023) evaluated the effectiveness of workplace wellness programs. The study adopted the exploratory research design and sought to determine the effectiveness of wellness screenings, work out schedules, stress the executives’ procedures and ergonomic measures. Additionally, the study considered the effect of authoritative culture, administration backing, and worker commitment on the aftereffects of the program. The study used primary data collected via research questionnaire. Data was analysed descriptively using frequencies and percentages. It was discovered that workplace wellness programmes have positive effect on physical and psychological well-being which eventually improves efficiency and occupation fulfilment. The study was however 44 conducted in the United States of America which is a first would economy and therefore, the results may not be generalised in Kenya. Thus, there is a contextual Gap. In the study by Ungerleider et al. (2017) on promotion of occupation wellness and seeking means of combating burnout in the surgical workforce. The researchers noted that organizations are forced to acknowledge, respond and strategize on the issue of increased burnout, distress and depression, too much work leading to feelings of being overwhelmed, de-personalization and lack of personal touch and health issues stemming from stressful factors. The managers are pushed to address occupational factors that impact their workforce. The study focus was on physician burnout and distress among employees in the surgical profession. The burnout and distress arise from the work volume expected of surgical team, cultural norms and the face and role of current medical education. The study found that wellness at the working space is based on balancing volume of work per employee, creating a conducive working space and engaging professional help in counselling, mentoring and coaching. The study concluded that occupation wellness and strategies put in place improve quality of life, experiences and result in better performance and service delivery by healthcare providers. Walters (2016) conducted a study on occupational wellness in the cannabis industry in Colorado. The research paper focused on ‘is the grass, greener” by concentrating on occupational health and safety and adopting the perspective of occupational health psychology. The study was based on theoretical framework of occupational health psychology for developing and designing the project rationale. The researcher collected data from workers in the cannabis industry and elements of occupational wellness such as potential stressful elements, perception and awareness of physical safety hazards, strenuous work tasks and organizational support to ease the strains and stressors. The study found 45 that the cannabis workers experienced low levels of strain and stressors. The workers also got support from their leaders and organization that worked to improve physical and psychological stressors and hazards. The results also shared showed that health and safety training and awareness creation for policies and regulations in the industry must be done for all the workers of the cannabis sector. The study concluded on presence of occupational wellness that resulted in better working environment and improved performance outcome. Bhattacharyya and Chakrabarti (2016) researched on occupational wellness for workers handling industrial activities in Assam area. The researchers noted that in the past, controlling and handling occupational problems at the workplace relied heavily on understanding the cause of the problem. Scientific approaches were adopted to examine the occupational problem, assess theories and examined the causation factors. This study focussed on the epidemiological approach to handling occupational wellness problems in organizations. The reviewed industrial workers revealed that work-related discomfort, body pains either from doing heavy work tasks or working for long hours and lower back pains for women resulted in challenges in delivering stipulated work outputs. The results also indicate that work output is linked to occupational wellness and hence a point of concern for management in the industries in Assam. The study conclusions were such that occupational wellness is based on factors such as musculoskeletal wellness, stress level, volume of work, body pains, work schedules and timelines and work design. The work- related factors impacted occupational wellness of workers and productivity levels at the firm. Tamadoni, Janbozorgi, Azarbaijani, Ali and Tabatabaei (2017) conducted a study on effectiveness of the training package, group counselling sessions, skilled helper support model on the social, intellectual and occupational wellness of students. The researchers 46 noted that wellness covers the optimal health of the mind, the body, the environment and social aspects. The study focus was on seeking ways to improve wellness of university students through counselling, education and training. Wellness would also create opportunities for the students to thrive in social, intellectual and occupational pathways. Thus, the study assessed the training packages, the group counselling framework for promotion of wellness of the students. The study respondents included 60 students who filled the research tool and the analysis revealed positive and significant effects between the variables. Training package and group counselling led to improved social, environmental, intellectual and occupational wellness. The students who took the training and undertook group counselling showed better scores in social, intellectual and occupational wellness than the students who did not receive any training or attended counselling sessions. The study concludes that training and counselling improved wellness of the students. The cognitive and emotional processes were closely integrated with occupational wellbeing and helped improve general wellness of the university students. Kuye et al. (2022) assessed the determining factors for occupational wellness of cocoa farmers in south-west Nigeria. Occupational wellness is essential for health and productivity of cocoa framers based on amount of time spent on the farms. The researchers adopted a cross-sectional descriptive design in assessing 244 cocoa farmers and purposively selected local government officials. A semi-structured questionnaires was employed in the study to assess the socio-demographic features of the farmers and effect to occupational wellness. The features included age, gender, religion, marital status, geographical location, and farm ownership as related to occupational wellness. The findings showed that lowly educated people and the farm owners had high occupational wellness scores. The results also indicate that occupational wellness was based on occupational factors, social factors, demographic characteristics of the people and 47 geographic factors. Health promotion worked to enhance the general wellbeing of the farmers and this influenced productivity levels in a positive manner. Kariuki and Wamwayi (2023) in a study on the effect of employee wellness programs on employee performance in banks listed at securities exchange in Kenya, sought to determine how employee wellness programs affect employee performance. Specifically, the study sought to determine the influence of social connection and health and safety on employee performance. Social cognitive theory and safety climate theory were used to anchor the study. Descriptive research design, targeting the 23,542 employees in the banking sector was adopted in the study. A sample size of 392 respondents was selected using stratified random sampling technique. Primary data was utilised which was collected using structured questionnaire. The Statistical Package for Social Sciences (SPSS) version 28 software was be used to analyse the data. Quantitative data was analysed using descriptive and inferential analysis. Descriptive statistics such as frequency, percentages, and means were used. Pearson correlation coefficient was used for testing strength and direction between the independent and the dependent variables. A multiple regression model was used to test the significance of the influence of the independent variables on the dependent variable. Results showed that a strong significant relationship between social connection and employee performance while a moderate significant relationship exists between health and safety and employee performance. However, the study was conducted among listed commercial banks which have a significantly different operational environment with faith- based hospitals which was the focus of the current study. Therefore, there is a contextual gap. Additionally, the study relied on correlation analysis to make inferences which the study found inadequate suggesting that there was a methodological gap. The current study relied on both corelation and regression analysis. 48 In another study on the influence of employee wellness programs on employee commitment at KCB Bank Kenya, Kitali (2021) sought to ascertain the influence of employee wellness programs on employee commitment at KCB Bank Kenya. The study considered health and nutrition programs, employee support programs, mental and physical health as well as workplace conditions as measures of employee wellness programs. Descriptive cross- sectional design of research was used. the study targeted KCB Bank employees who had worked in the company on contractual or permanent terms. A census all the 154 employees at KCB Bank Moi Avenue branch in Nairobi County was conducted for the study. The study relied on primary data collected via structured questionnaires consisting of close ended questions through Google forms. Descriptive statistics and inferential analysis were used to analyse the data. Findings showed that health and nutrition programs and employee support programs were statistically significant in explaining the relationship between employee wellness programs and employee commitment. Additionally, the study found that there is need to improve on communication regarding healthy living through their various communication channels, employees did not feel that they had realistic workloads and the stress from work affected their personal relationships with family and friends. Based on the findings of the study regarding workplace conditions further established that the implementing wellness programs broadly helps in enhancing workers’ job satisfaction and commitment to the organization. However, the study was a case study of KCB Bank Moi Avenue branch in Nairobi County. this study was a survey of faith-based hospitals in Nairobi metropolitan. Jeruto and Makhamara (2023) in a study on employees’ wellness programs and management of healthcare costs in Nairobi water and sewerage company in Kenya sought to determine how wellness initiatives affect the control of healthcare expenses. The study was guided by work/family border theory and spillover theory. Descriptive research 49 approach was adopted in which all 404 employees working in the functional departments of the Nairobi County headquarters were considered as the study population. The functional departments selected were human resource department, finance, operations, and commercial activities department. A sample of 121 respondents was selected using a stratified sampling method. Both primary and secondary data were used in the study. Primary data was collected via semi-structured questionnaires consisting of open ended and Likert scales form questions. Secondary data was gathered from the publications on human resources that were readily available. Qualitative data was analysed using thematic analysis, and results were presented in a narrative format. The Statistical Package for Social Sciences (SPSS version 22) was used to analyse quantitative data using inferential and descriptive statistics. Frequency distribution, mean, standard deviation, and percentages are all examples of descriptive statistics. The study concluded that annual medical check-up, work-life balance, health education seminars and employee assistance programs had significant effect on management of health costs in Nairobi Water and Sewerage Company, Kenya. Thus, the research revealed that wellness programs play a crucial role in enhancing the management of health costs. The study was however a case study of one company which makes generalisation of results limited while the current study considered several institutions. Thus, there is a methodological gap. Moreover, a contextual gap exists since the study was based on water and sewerage company while the current study was conducted in the health sector. In a study on corporate wellness programmes, employee efficiency and job performance among the middle level executives of Standard Group Limited in Nairobi Kenya Mulwa et al. (2021), sought to establish the relationship between corporate wellness programmes, employee efficiency and job performance. The study relied on the Maslow’s hierarchy of needs and Herzberg’s dual factor theories to anchor the study. The study targeted all 367 50 employees of the Standard Group Limited in Nairobi. Eleven (11) functional departments at the Standard Group Limited were sampled from which a sample of 124 respondents was identified using stratified random sampling technique. Respondents consisted of all the middle level executives. Quantitative research design was used in the study by conducting a survey. Primary data was utilised which was collected using structured questionnaires. Data analysis was carried out using the Statistical Package for Social Sciences (SPSS). Correlation analysis was conducted using Pearson Product moment correlation coefficient while multiple regression analysis was used to determine the effect of corporate wellness programmes on employee efficiency and job performance. The study established that a strong correlation exists between corporate wellness programmes and employee efficiency. However, there is no significant correlation between corporate wellness programmes and Job performance. The study therefore concluded that corporate wellness programmes increase employees’ efficiency. However, the study was conducted in mass media sector while the current study was conducted in the health sector of the economy. Thus. there is a contextual gap. Studying the influence of employee wellness interventions on employee performance, Waema and Bore (2024) sought to investigate the influence of employee wellness interventions on employee performance in state parastatals in Nairobi City County. The study was guided by system theory and behavioural learning theory. Descriptive research design was adopted in the study since it helps in achievement of measurable findings. The target population was 112 employees working in State corporations in HR Directorates. The sample size was calculated using Taro Yamane sample size technique to arrive at a sample of 87 respondents. Primary data was collected using the semi structured questionnaire. Quantitative data was analysed using descriptive statistics to get frequencies, percentages, tables, graphs and pie charts. Inferential analysis was done using correlation 51 and multiple regression models. The study concluded that flexible working practice has a positive and significant effect on employee performance in state parastatals in Nairobi City County. The study also concludes that line manager training programs have a positive and significant effect on employee performance in state parastatals in Nairobi City County. The study was however, conducted among state corporations while the current study was conducted among Faith based hospitals suggesting that there was a contextual gap. Onunwor (2023) conducted a study on workplace wellness programmes and employee performance at Agip oil company in Port Harcourt. The study examined the relationship between workplace wellness programmes and employee' performance. Specifically, the study examined how dimensions of workplace wellness programmes such as fitness centre, medical service, and cafeteria influence employee performance in terms of timely tasks completion, output level, and innovativeness. Correlational research design was adopted in the study where the population consisted of 450 staff of Nigerian Agip Oil Company, Port Harcourt, while the convenience sampling technique was used to obtain a sample size of 200 respondents. Primary data was used in the study collected via structured questionnaire. Data was analysed through descriptive statistics such as mean score and standard deviation. Additionally, the study used Spearman ranking order correlation to test hypotheses at 0.05 level of significance. Results postulated that Fitness centres have a significant positive relationship with timely task completion, medical services had a significant positive relationship with employee output level while cafeteria has a significant positive relationship with employee’s innovativeness. In conclusion, the study opined that workplace wellness programmes enhance employee performance in Agip Oil producing company in Port Harcourt. The study however considered existence of fitness centres, availability of medical service and availability of cafeteria as measures of occupational wellness programmes. While the current study used regular health risk assessments, regular 52 breaks from work, rewards for healthy behaviours, involve staff in leadership decisions and family-friendly policies as indicators of occupational wellness programmes suggesting there was a conceptual gap. Atieno and Otsyulah (2019) in their study on the influence of employee assistance programs on job satisfaction in Maseno University, Kenya. Sought to investigate the influence of employee assistance programs on job satisfaction. The specific objectives were to assess the influence of health care practices, counselling services, benevolence support and wellness practices on job satisfaction at Maseno University. The study adopted a descriptive survey research design. The target population was 1,540 employees from which a sample of 154 employees was selected using simple random sampling technique. Data was analysed using mean score and standard deviation with the aid of SPSS v23. Regression analysis was used to determine the relationship between employee assistance programs and Job Satisfaction. The study found that a positive relationship existed between health care practices, counselling services and wellness practices on job satisfaction. However, benevolence support had a negative relationship with job satisfaction. Results further showed that health care practices, counselling services, benevolence support and wellness practices had a significant effect on job satisfaction. It was thus concluded that job satisfaction of an employee at a function of assistance and support provided to them. In a study on wellness program in the state health facilities of Oshikoto region, Namibia, Amadhila (2022) sought to develop a model for health professionals to facilitate a wellness program in the state health facilities of Oshikoto Region in Namibia. The study adopted a convergent mixed method research design which involved both quantitative and qualitative methods of data collection and analysis. The study was conducted in four phases. The first phase involved identification and analysis of concepts focusing on assessing the state health 53 facilities in terms of the facilitation of wellness programs, using a checklist, (n=3) which were purposely selected, describing knowledge, practices and experiences of health professionals with regard to the facilitation of a wellness programs, using self-administered questionnaires, nurses (n=147) who were randomly selected through stratified sampling; doctors (n=17) who were conveniently sampled and exploring and describing perceptions of health professional managers regarding facilitation of wellness programs, using in-depth interviews, (n=6) which were purposely selected and all- inclusively sampled. The findings revealed that health professionals are faced with organizational challenges such as unavailability of wellness policies, unavailability of wellness program and lack of consultation for staff recruitment; resource challenges such as staff shortage, inadequate facilities and equipment; psychosocial challenges such as insufficient support from management, stress, scope of practice issues and workload and personal challenges such as inadequate knowledge on wellness program, illnesses and lack of self-care in the work environment that hinder the facilitation of wellness programs. However, the study was conducted in Namibia while the current study was conducted in Kenya. Tus there was a contextual gap. Malatjie and Ncube (2019) conducted a study on perspectives of the University of Johannesburg’s employees on the employee wellness programme. The goal of the study was to understand the perspectives and experiences of the University of Johannesburg employees regarding the employee wellness programme at their disposal. The research method was of a qualitative nature. Non-probability purposive sampling was used for this study to select a sample of ten (10) University of Johannesburg’s employees who had worked for their employer for a period not less than 12 months or one year. Of the ten (10) employees, five (5) had accessed the employee wellness programme at least five months prior to the research, and the other five (5) only had knowledge of its existence. Data were 54 collected using face-to-face semi-structured interviews. Law’s Person-Environment Occupational Model served as the research’s theoretical lens. Although the findings of the study revealed some challenges affecting the utilisation of the University of Johannesburg’s employee wellness programme, they indicated that the programme was predominantly effective in light of its objectives. The study however relied on Person-Environment Occupational Model to measure the effectiveness of employee wellness programmes while the current study relied on ordinary least squares method which indicated presence of methodological gap. On their part, Abong’o and Wekesa (2022) studied the influence of employee assistance programs on employee motivation in public universities in Kenya based on a case study of Rongo university. The main goal of the study was to determine the influence of employee assistance programs on employee motivation in Rongo University. Social exchange theory was used to anchor the study. The study adopted a descriptive survey research design. The target population of the study was the 466 employees of Rongo University comprised of the 115 academic staff, 164 management and administrative staff and 187 support staff. A sample of 215 respondents was selected using the stratified random sampling technique. Primary data was collected using a structured questionnaire. Data was analysed using descriptive statistics and multiple linear regression model. Analysis of Variance (ANOVA) was used in determining the significance of the influence of independent variables on employee motivation. The study findings were that employee assistance programs had positive effect on employee motivation in the university. Specifically, the study determined that indicators that help in enhancing employee assistance programs on motivation as specified in study findings are rehabilitation, wellness and counselling programs. The study also finds that work life balance practices are vital in helping employees strike a balance between work and personal lives. 55 Ndolo and Nzuve (2020) conducted a study on organizational safety support practices and employee performance in the department of health services in Makueni County, Kenya. The goal was to determine the influence of organizational safety support practices on employee performance in Makueni County. The study adopted a descriptive research design which targeted a population of 428 employee in the department of health services in Makueni County. Stratified proportionate sampling technique was used to obtain a sample of 207 respondents from the department. Primary data was used in the study which was collected using structured questionnaires. Both descriptive and inferential statistics were used to analyse data aided by SPSS v25. Study results revealed that the department of health services in the county had embraced various occupational safety practices. Organizational safety support was found to influence 58.8% of the variations in employee performance. Through safety support practices the department had provided a conducive working environment which in turn had translated to high staff productivity. However, the study was conducted in Makueni County while the current study was conducted in the Nairobi metropolitan area. Mutuku and Makhamara (2022) conducted a study titled “welfare programs on the employee performance in the energy and petroleum regulatory authority in Kenya.” The goal of the study was to examine the relationship between staff performance at Nairobi, Kenya's Energy and Petroleum Regulatory Authority and welfare programs. The study relied on spillover theory, compensation theory, and role theory. Descriptive research design was used for this investigation. Where the study population was 160 employees from the directorate of corporate services, petroleum and gas, economic regulations, electricity and renewable energy, public education advocacy, and consumer protection. Stratified random sampling technique was used to select a sample of 101 employees including 17 from corporate services, 15 from petroleum and gas, 20 from economic 56 regulation, 20 from electricity and renewable energy, and 29 from public education, advocacy and consumer protection. To gather information for the sample, the study employed a semi structured questionnaire with both closed- and open-ended questions. The questionnaire was sent to the respondents using a drop-and-pick approach. Quantitative data was analysed using statistical analysis like frequency and percentage. Additionally, correlational and multiple logistic regression analysis were performed to ascertain the relationship between employee and their work-life balance. The study concluded that changes in welfare programs had significant effect on employee performance. However, the study was a case study of Kenya's Energy and Petroleum Regulatory Authority while the current study considered a survey of faith-based hospitals in Nairobi Metropolitan area. 2.3.4 Physical Wellness and Service Delivery Physical wellness is concerned with proper care for the body so as to be able to functional optimally and handle personal and work tasks. It is also about ability to handle sporting activities, occupational duties and daily activities and hence demands that an individual undertakes physical fitness activities on a regular basis. Thomas (2022) revealed that physical wellness can be achieved through proper nutrition, frequent but moderate physical exercises and getting sufficient rest. Many organizations in trying to improve employee performance have invested in physical fitness programmes such as partnering with health clubs and gym, encouraging physical exercises, walking and providing sporting equipment and activities. In some case, the organizations have actively encouraged their staff to participate in sporting activities and even sponsored some sports. There is no worker than can handle their professional engagements without being physically fit, Otenyo and Smith (2017) shared that fitness is associated with performance outcomes. 57 Mthombeni, Coopoo and Noorbhai (2020) study was on physical health status for emergency care providers in South Africa. The services provided by emergency care providers is time-bound, sensitive and utmost care needed hence need the providers to be physically, mentally and emotionally fit. The profession is demanding and pose risks to the emergency care providers and thus need to assess their health status. The study was conducted in north-west province of South Africa by assessing the health parameters and specified anthropometric tests of the emergency care workers. The study was conducted among 91 emergency care providers who voluntarily accepted to be screen tested on health factors such as heart rate, body mass index, waist circumference, blood pressure, blood glucose, total cholesterol, lead body mass and skinfold measurement. Average scores for each health factor that was screened and tested were obtained. The results indicated that a significant number of emergency care providers presented health risk factors such as high blood pressure, obesity, high blood glucose level, abnormal total cholesterol level and high waist circumference. The results also showed presence of cardiovascular health risk factors. The researchers noted that these health risk factors can be attributed to nature of the occupation including irregular work hours, sleep deprivation in some instances, exposure to psychological trauma, poor nutrition and little or no time for exercise. The study recommended the need for stress management and programmes for physical exercises, counselling and psychological matters. Physical wellness is associated with well-structured and formulated employee wellness program. Westby, Klemm, Li and Jones (2016) conducted a study on quality indicators and its role in physical therapy practices and health service delivery. Physical therapy adopts the quality-based care hallmark that sets the acceptable standard of practice. The quality indicators are tools that dictate the standard that is acceptable and threshold of what is accepted or rejected. Quality indicators help in measuring the processes, structures and 58 outcomes as pertains health care service provision and quality of care given to patients. The physical therapists employ the use of quality indicators in guiding the decision-making process in clinical care, the recommendations, evaluated reports on effective treatment and working with the main stakeholders. At the same time, the study is part of the information gathered by rehabilitation managers and senior decision makers to carter for the gaps and lead in improving the initiatives and strategic planning. The article is based on past documented information on the value and use of quality indicator tools that guide physical therapy sector in health service. The study created a framework for the development, selection, reporting and implementation of rehabilitation programmes. The Canadian and American physical therapy associations were able to develop tools that can guide clinical officers in the reporting, access to care and recording effectiveness of the treatment, practice, strength and value of physical therapy. The research focus was on quality indicators and its integration to quality care for physical therapy. Roche and Strobach (2019) study were on effective school-community partnership in addressing student physical and mental health. The partnership works to improve overall wellness of the students’ health. The researchers noted that school – community partnerships are essential and hence many areas in the USA have developed such partnerships like in Oakland, California. The study focussed on nine key elements important for sustenance of effective partnerships that work to improve physical, mental and overall health and wellness of the students. The assessed nine elements include leadership team, needs assessment, shared accountability of the partnership and its outcomes and key figure to take a central role in coordinating activities. The other elements include leveraging on resources for both the school and the community; professional development for leaders, plan for sustainability in the long-run, regular evaluation and assessment and an effective communication plan. These nine elements of enhanced the 59 partnership between the school and community and improved mental and physical health of the students. Mwangi and Rintaugu (2017) research was done in Kenyan public university and focus was linking physical activities and physical fitness attributes for the staff members. The study is based on high healthcare costs incurred by these institutions and hence the need to assess how physical activity is linked health related matters. The study was done among 237 staff members and health related factors was based on blood pressure, resting heart rate, body fat percentage and body mass index. The screening and ratings were based on standards and practices by the World Health Organization recommendations. The findings showed that only 40% of staff were physically active, some enjoyed recreation activities inside and outside of the university. The health factors like blood pressure and resting heart rate were found to be average and significantly affected the physical fitness. The study concluded that most of the university staff members were not physically active and had scores lower than the health and fitness standard. The study recommends the need for education and awareness creation to enhance prevention-based healthcare and provision of fitness facilities for health promotion. The study concludes that physical activities was directly associated with physical fitness of staff members. Mukaro (2018) researched on the determining factors for staff participation in physical activities in the on-site fitness centres. The study was based on case of employees of Kenyatta and African Nazarene University. The researcher noted that many institutions had invested in health and fitness facilities as a way of promoting physical health, productivity and reducing healthcare costs. But the uptake of the services was low and hence the need to assess the determining factors for use of on-site fitness centres. The study used cross- sectional analytical design and sample size was made of 537 respondents consisting of staff 60 members, students, public and the nearby community members. The data was collected using a structured questionnaire, interviews and observation checklist and findings revealed only 25% of staff were physically active. The low uptake was associated with psychological factors, the environment, health status, employment and operational factors of the employees from the two universities. Findings also revealed that job category and, self- rating and operational of the fitness centre determined its uptake and use by the staff. The study concluded that physical fitness and physical activities are correlated and impact on work output. Thus, recommended the need for awareness creation and education on the value of physical activities. The fitness centres should also offer packages for the different clients and compensate for unused days. Heninger et al. (2019) conducted an examination of organizational wellness programs in a study on reward type and performance. The study examined the associations of three different types of incentives including cash, gift cards and tangible rewards with wellness program performance. The study was anchored on individual choice and motivation theories. Study population comprised of 1855 university faculty, staff, and spouses who participated in up to six different challenges. The study relied on primary data that was collected using structured questionnaires. Data analysis was done using descriptive statistics such as frequencies, mean scores and standard deviation. Inferential analysis via correlation analysis and regression analysis. It was established that employees who successfully completed program challenges were associated with greater weight loss. The study also found that participants choosing gift cards were associated with the greatest program success, even though cash rewards were selected more than twice as often as gift cards. Tangible rewards were the least frequently selected reward and were associated with lower performance than gift cards but relatively similar performance to cash. The study was however conducted in the education sector among university faculty staff and their 61 spouses while the current study was conducted in the health sector. Thus, there was a contextual gap. Baid et al. (2021) conducted a study on return on investment of workplace wellness programs for chronic disease prevention. The purpose of this systematic review was to critically review of literature on workplace wellness programs for chronic disease prevention. A total of 4 databases were systematically searched for studies published before June 2019. Methodologic quality was assessed using Consensus for Health Economic Criteria guidelines and the risk for selection bias associated with the study design. Data extraction was followed by a narrative synthesis of worksite wellness programs characteristics and return on investment estimates. A total of 25 relevant studies were identified. These studies found no evidence of a positive return on investment in the short term. The study thus concluded that worksite wellness programs have n significant effect on return on investment within the first few years of initiation. The study however, suffers from generalizability since it was a desktop study and has no contextual backing. In their study, Bodziony and Stetson (2024) sought to determine the associations between sleep, physical activity, and emotional well-being in emerging young adults. Specifically, the study sought to examine sleep, physical activity, and their joint associations with physical functioning. The study population consisted of 108 undergraduates who completed questionnaires assessing sleep, activity levels, emotional well-being and physical health markers. Data was analysed descriptively using frequencies, percentages, means and standard deviation. Participants reported poor sleep quality, suboptimal sleep duration, and inconsistent physical activity. Poor sleep quality was associated with higher fatigue for both active and insufficiently active groups. There was a significant interaction between activity level and sleep duration on negative affect. Students who reported 62 insufficient physical activity and less than 6 hours of sleep had the highest negative affect. It was thus concluded that poor sleep quality was associated with increased fatigue. The study however only focussed on physical wellness while the current study considered other types of employee wellness such as emotional wellness, intellectual wellness and occupational wellness. Thus, there was a conceptual gap. In their study on effectiveness of workplace wellness programmes for dietary habits, overweight, and cardio metabolic health, Peñalvo et al. (2021) conducted a systematic review and meta-analysis aimed at comprehensively studying the effectiveness of multicomponent worksite wellness programmes for improving diet and cardio metabolic risk factors. The researchers conducted a systematic literature review following PRISMA guidelines. The researchers searched PubMed-MEDLINE, Embase, the Cochrane Library, Web of Science, and Education Resources Information Centre, from Jan 1, 1990, to June 30, 2020, for studies with controlled evaluation designs that assessed multicomponent workplace wellness programmes. Investigators independently appraised the evidence and extracted the data. Outcomes were dietary factors, anthropometric measures, and cardio metabolic risk factors. Pooled effects were calculated by inverse-variance random-effects meta-analysis. Potential sources of heterogeneity and study biases were evaluated. The study revealed that workplace wellness programmes are associated with improvements in specific dietary, anthropometric, and cardio metabolic risk indicators. The study was however, a systematic review of literature with no specific context making the results difficult to generalise. The current study was conducted in faith-based hospitals in Nairobi metropolitan area. On their part, Argañosa and Binghay (2024). Conducted a study “he effects of a corporate wellness program on the physical, occupational, socio-emotional, and spiritual wellness of 63 Filipino workers.” The objective was to determine the effects of corporate wellness programs on Filipino workers’ physical, occupational, socio-emotional, intellectual, and spiritual wellness. The study utilized an online survey to examine questions related to the efficacy of such programs, descriptive statistics, correlation analysis to assess the respondents’ socio-demographic profiles, and point biserial correlation to test the association of corporate wellness programs to their wellness status. Results suggested that 90% of the respondents participated in their organization’s corporate wellness programs. The study also showed that overall wellness mean scores were higher in employees who were aware of their wellness programs than those who were not. It was thus concluded that corporate wellness programs were beneficial in improving employees’ overall wellness. However, the study was conducted in Filipino workers while the current study was conducted in Kenya suggesting that there was a contextual Gap. Reif et al. (2020) also conducted a study on the effects of a workplace wellness program on employee health, health beliefs, and medical use in a randomized clinical trial. The purpose of the study was to evaluate the effect of a comprehensive workplace wellness program on employee health, health beliefs, and medical use after 12 and 24 months. This study was a randomized clinical trial of comprising 4834 employees of the University of Illinois at Urbana. In the study 3300 participants received incentives to participate in the workplace wellness program while the control group of 1534 did not participate in the wellness program. The study established that among the 4834 participants of whom 2770 were women showed no significant effects of the program on biometrics, medical diagnoses, or medical use were seen after 12 or 24 months. A significantly higher proportion of employees in the treatment group than in the control group reported having a primary care physician after 24 months. It was thus concluded that workplace wellness program had no significant effects on measured physical health outcomes, rates of medical 64 diagnoses, or the use of health care services after 24 months, but it increased the proportion of employees reporting that they have a primary care physician and improved employee beliefs about their own health. the study was however a clinical trial while the current study was a social science study. Elsewhere, Lowensteyn (2019) sought to evaluate the results of a workplace wellness program that incorporates gamification principles. The study population consisted of all 775 permanent employees of a national company located in Canada. The wellness program included web-based challenges for both teams and individuals incorporating gamification strategies to improve exercise, nutrition, weight reduction, and mental health management behaviours. Primary data was collected from the participants. In this study, primary outcomes were employee participation rates while secondary outcomes were the sustained benefits of the program on physical and mental health measures. It was observed that participation rates in the health screenings were 78% for the baseline, 54% in year 1, and 56% in year 2. It was also noted that there were significant improvements in systolic blood pressure, glycated haemoglobin, weekly physical activity, perceived stress score, insomnia severity index, general fatigue and reductions in the cardiovascular age gap. The study was however a case study of a national company in Canada. While the current study was a survey of faith-based hospitals in Nairobi metropolitan area. Therefore, there was a methodological gap. Besides, Melnyk et al. (2020) conducted a systematic review focused on randomized controlled trials with physicians and nurses that tested interventions designed to improve their mental health, well-being, physical health, and lifestyle behaviours. The study involved a systematic search of electronic databases from 2008 to May 2018 which included PubMed, CINAHL, PsycINFO, SPORTDiscus, and the Cochrane Library from 65 which 2708 participants were selected. The study design was randomized controlled trials design in which samples of physicians and nurses were selected targeting mental health, resiliency, healthy lifestyle behaviours, and physical health. Quantitative and qualitative data were extracted from each study by 2 independent researchers using a standardized template created in Covidence. It was established that mindfulness and cognitive- behavioural therapy-based interventions were effective in reducing stress, anxiety, and depression. Brief interventions that incorporate deep breathing and gratitude may be beneficial. Visual triggers, pedometers, and health coaching with texting increased physical activity. The study however lacks a context and may not be generalised on faith-based hospitals indicating that there was a methodological gap. Lee and Lee (2021) in their study sought to examine how activity tracking technology, prize, and communication affect wellness program participants’ perceived health and their willingness to re-participate in future programs. The study was a case study of an annual walking challenge program implemented for seven years by a major U.S. university. Primary data was utilised in the study. Results showed that activity tracking technology and prize opportunity had a significant positive effect on perceived health improvement. Perceived health improvement in turn had a significant positive effect on re-participation intention and word-of-mouth. It was thus concluded that wearable activity tracking technology can increase employees’ repeated participation in workplace wellness programs. As such organizations should encourage, support, and incentivise employees’ use of the technology. The study was however conducted in the United States while the current study was conducted in Kenya indicating that there was a contextual gap. In another study, Mohammad et al. (2024) in their study on health and wellness characteristics of employees enrolled in a workplace wellness study in the United Arab 66 Emirates aimed to describe the health and well-being status of a cohort of employees. A descriptive research design was adopted aimed at describing the demographic characteristics, body composition, cardiovascular fitness, functional fitness, biological age, and well-being of employees from a large health sector company enrolled in a workplace wellness study in the UAE. Descriptive statistics were used to describe the employees' distribution. It was established that of the 123 selected employees, 116 participated in the study. The mean age of participants was 39.2 years old. Results showed that the prevalence of overweight, obesity, hypercholesterolemia, hyperlipidaemia, prediabetes, and diabetes was 35%, 29%, 34%, 79%, 30%, and 7%, respectively. Almost half of the participants (47%) were pre hypertensive for systolic blood pressure (BP), 80% had the fitness category of poor-very poor, and the majority (60%) reported exercising less than 150 minutes per week. The mean functional fitness score was 12.2 points, which indicated an increased risk of injury with physical activity. The study concluded that introduction of comprehensive health and wellness programs at a broader scale holds the potential to facilitate the adoption of healthier lifestyle behaviours, thereby contributing to improvements in the overall quality of life across the population. The study was however conducted in the United Arab Emirates while the current study was conducted in Kenya presenting a contextual gap. Wamukoya et al (2019) in their study on the role of physical activity in the development of national goals sought to review literature on physical activity, exercise and wellness in its contribution to SDG, MDG and the Kenyan context of the Big Four Agenda. The study involved a systematic literature review of secondary data in which the search was performed in electronic reference databases such as PubMed/ MEDLINE, IFLA Library, ProQuest and IJSR publications up to March 2019. The searched term composed of: ‘physical activity’, ‘wellness’, ‘exercise’, ‘Sustainable development goal’, ‘vision 2030, inclusion and exclusion. Results showed that 87 articles were Identified through the 67 systematic literature search; 69 titles and abstracts were identified after the exclusion of 18 duplicated articles. 20 studies were excluded because of not fulfil the criteria of health- related goal. Further, 63 studies were excluded and at last six studies were included for systematic review and meta-analysis as it met the inclusion criteria. The study established that regular physical activity has beneficial effects and prevents the progression of a number of chronic diseases while insufficient physical activity is one of the leading risk factors for death worldwide. The study was however a systematic literature review which lacks a contextual backing and therefore there is a contextual gap. Physical activity plays a critical role in preventing and reducing risks of many diseases while at the same time maintaining physical and mental health. This was observed by Matilda et al. (2020) in their study on the status of participation in physical activity by employees in Kenyan universities at onsite fitness centres in Kenya. The objective of the study aimed at establishing the status of participation in physical activity physical activity at onsite fitness centres among Kenyan university employees. The research design adopted was cross-sectional analytical design. Study population consisted of 499 employees from two institutions (a private and public university) that were purposefully selected on the basis of their well-equipped physical fitness facilities. University employees were randomly stratified according to their, age, gender, type of university and designation (non- teaching, teaching and management staff), while respondents in each stratum were selected using systematic random sampling technique. Data was collected using a closed-ended questionnaire. Descriptive statistics were used to summarise the results of the study with the help of the Statistical Package for Social Sciences (SPSS) version 20.0. The study established that 25% of the employees were physically active. The most active group were employees below the age of 30 years. Both male and female employees recorded a similar status in participation in physical activity which was low. The study however sought to 68 determine the prevalence of physical activity but did not show the influence of physical wellness on employee performance. In a study on improving access to facilities for exercise among formal sector employees in Kenya Ongwae (2019) conducted a systematic review of literature on the challenges of lack of access to facilities for exercise among employees working in the formal sector in Kenya. A systematic approach was used in conducting literature review. The selection criteria for the papers were based on relevance of the paper and applicability to the context of study. The investigations were limited to Pubmed and Hinari academic data bases for academic journals on the subject. Additionally, google and google scholar provided relevant articles. In order to get the best results which are relevant to the policy brief subject, terminologies and key words were used in the search. The search yielded 122 records of which 85 records remained after duplicates were removed. 60 records were screened and at the end 25 records were included in the final analysis. The study established that obesity can have a huge impact in workplaces because it affects employees' productivity. The study as however a systematic review of literature and the results may not be contextualised. Thus, there is a contextual gap. Coronary heart disease is a significant public health problem globally, especially given the rapid changes in lifestyle, which has contributed to the increased occurrence of such non- communicable diseases. To address this issue Sande (2023) in a study on lifestyle changes and psychological wellness among patients with coronary heart disease at Mater Hospital in Nairobi County, Kenya sought to determine lifestyle changes and psychological wellness of adult patients with coronary heart disease in Mater Hospital. A descriptive cross- sectional study design was used for data collection. The target population for the study were adults between 18-69 years diagnosed with coronary heart disease. Purposive sampling was 69 used to select the health facility. Probability simple random sampling was used by creating a list of all the patients and selecting them until the desired sample size was achieved. The Yamane Taro (1967) formula was used to calculate the sample total of 272 respondents captured in the study. A questionnaire was used in the collection of data. The questionnaires were personally administered by the researcher. SPSS version 25 was used for analysis which involved descriptive statistics via the use of frequencies, means, and percentages. The differences captured among the study population were determined through the use of Pearson chi-square tests. Regression analysis was conducted to determine the association between the independent and dependent variables. The results showed that the respondents experienced a number of psychological distresses that predisposed them to issues such as difficulty sleeping, experiencing disturbing dreams and being unaware of where they were. In relation to the lifestyle related factors, the results showed that patients were feeling physical fit and had exercised often over the last 12 months, checking the weight and eating less than three servings of fruit. The study was however a case study of Mater Hospital in Nairobi County while the current study was conducted in Nairobi metropolitan area. In another study, Noah (2022) conducted a study on hotel managers ‘membership in health and fitness clubs and its influence on their work productivity based on star rated hotels within Mombasa County in Kenya. The purpose of the study was to examine whether managers’ participation in health and fitness activities in health and fitness clubs in star rated hotels within Mombasa County increased their work productivity. Other objectives of the study were to determine the extent to which participation in physical activities found within health and fitness clubs in star rated hotels in Mombasa County enhanced managers’ work productivity, to find out the extent to which participation in psychological activities offered in health and fitness clubs in star rated hotels in Mombasa County enhanced managers’ work productivity, and to establish the extent to which participation in social 70 activities offered in health and fitness clubs in star rated hotels in Mombasa County enhanced managers’ work productivity. The researcher adopted the Six Dimensions of Wellness Model by Hettler (1976). Cross-sectional research design was used in the study and made use of a questionnaire administered to 99 managers of star-rated hotels. Descriptive analysis, correlation, and linear regression analysis, were used to analyse data. The study revealed that, the majority of managers taking part in physical activities improved their physical performance while on duty, improved their physical fitness while on duty, improved their endurance during busy long days, improved their muscle flexibility; and improved their reflexes alertness while working. Health benefits of being physically active are well documented and accepted as a remedy for many non-communicable diseases. Yet many people are reluctant to make lifestyle adjustments to adopt available fitness programs sustainably. In this regard, Mwangi et al. (2023) conducted a study on physical activity status of gyms and outdoor based group fitness program participants as a sustainable health model. The study assessed physical activity status among young adults in Nairobi County who participate in gym-based group fitness programs and outdoor based group fitness programs to a sustainable health model guided by the 3rd SDG. The objective was to assess physical activity status between gym- based group fitness programs and outdoor based group fitness programs participants and across socio-demographic characteristics. The study used a cross-sectional analytical survey research design and primary data was collected via questionnaire. Descriptive statistics, Cross tabulations, independent T-test and chi-square were used in the study. The findings showed a significant difference where outdoor had more participants than gym. Muthangya (2019) conducted a study on psychosocial challenges affecting the wellness of widows based on a case of selected churches in Nakuru County. The purpose of the study 71 was to determine the psychosocial challenges that affect the widow’s wellness and explore the coping and intervention mechanisms adopted by the widows in selected churches in Nakuru County. specific objectives of the study were to identify the psychological and social challenges affecting the wellness of widows and explore the coping and intervention mechanisms that the widows adopt to deal with the psychosocial challenges and improve widow wellness within the selected churches in Nakuru County. The study adopted descriptive research design using a qualitative approach. The target population was all widows who attended church services in the selected churches in Nakuru County. Data collection methods were in-depth individual widow interviews and focused group discussions. The data were analysed thematically and presented in verbatim. Study findings indicated that spousal death results into psychosocial challenges such as depressive symptoms, fear of taking up family responsibilities, threats and fear of own life and feelings of regret; while the social challenges included poverty and financial stress, conflicts, isolation and rejection by the in-laws and the community, loneliness among others. To achieve wellness widows engaged in various coping and intervention mechanisms such as the use of divine intervention, social support, acceptance, avoidance and embracing change. The study was however conducted in Nakuru County while the current study was conducted in Nairobi metropolitan area. Karthi (2024) studied employee wellness as a strategy for influencing organizational performance. based on the social cognitive theory, the study examined the influence of employee wellness on organizational performance in the IT industry in Bangalore. Primary data was gathered through a structured questionnaire and 240 samples were taken for the study. Simple random sampling technique was used to collect the data. Binary logistic regression was used for analysing the data. In this study, employee wellness was an independent variable and organizational performance was a dependent variable. The 72 independent variables are “Flexitime, Counselling, Periodical Health check-ups, Employee assistance programs, Work at home, Wellness workshops, Mental health support and Inclusiveness”. Among the aforementioned variables, Counselling, Periodic health check- ups and Employee assistance programs significantly influenced organizational performance. The study was however conducted in the IT industry in Bangalore while the current study was conducted in the health sector in Nairobi metropolitan area. 2.3.5 Employee Wellness Programmes Credibility Leadership and Service Delivery The government is tasked with delivery of essential services to the people and also working to create a conducive environment for the private sector and non-governmental organizations to deliver services to the masses. Wetterberg, Brinkerhoff and Hertz (2016) shared that the government through policies and regulations works with other interested parties to deliver quality services to the general public. In keeping with international standards, the Kenyan government has made reforms in its ministries, departments and institutions for improved service delivery. Some of the policy reforms include human resource management system that shifted to digital records and online based performance measurement and payment schemes. Wagana (2017) shared that based on the 2010 Kenyan constitution focus is on service delivery by the governments at the national and county level. The county and national government are seeking means of promoting quality and accessible services to the general public, through the public service commission that handles the appointment of human resources. Wahida (2016) research was on what determinants affect effective service delivery in the public sector. The study was a case study of the Huduma centre programmes within Mombasa County. The researcher noted unsatisfactory service delivery in the public sector unlike the private sector. There are long queues in government offices, poor services and 73 ineffective and insufficient service delivery and hence the need to assess what determining factors influence service delivery. Service delivery was based on factors of strategic locations of the offices and service points, role of strategic decision making as they handle the red tapes, institutional factors, monitoring and evaluation and structural factors in public service delivery. The study collected data from 111 respondents working Huduma centres across the county of Mombasa. The respondents filled the questionnaires thereafter correlation analysis was conducted revealing the relationship between the variables. The study established positive relations between strategic location, institutional factors and management and monitoring and evaluation and service delivery. But strategic decision making had negative correlation to service delivery. The study concluded that these factors helped in improving quality of services delivered to the people. There was need for policy makers to enhance these determining factors as the drivers of effective service delivery Koehler (2018) study was on policy perceptions and responsibilities for devolving the decision making for water service delivery across the 47 counties. The researcher noted that gaining public support is based on improving service delivery on key areas such as water. The article is based on the constitution stipulation on water as part of human rights and policies set to ensure its distribution and access. The study collected data from county water ministers in interviews and gained information on climatic changes and risk, urbanization, water budget, poverty levels and citizen engagement and satisfaction rates. The policy makers must assess these elements when discussing measures and responsibility in provision of clean and safe water. The findings showed increased political responsibility in policy formulation for access of quality and quantity water for all people in both poor and rich neighbourhoods. The policies address the issues of affordability, accessibility, quality, quantity and continuous supply of water to the general public. The policies also 74 cover the issue of climatic changes and risks as linked to sources of water and need for strong regulation for improved water service delivery. Kimutai and Aluvi (2018) study was on good governance as an influencing factor to service delivery by considering citizen participation in Kisumu County. Policies and principles of democratic governance is based on provision of quality services and opportunities for growth and development. Service delivery is embedded in the constitution and the responsibility of both levels of government and this is enhanced by the policies and recommendations for citizen participation. Engagement and participation of citizens helps in sharing control, deciding on public resource utilization and accountability and evaluation processes. The service delivery based on citizen engagement is anchored on the legal framework of the nation. The citizen participation policies enforce areas where government shares information, consults with the public and regularly gets feedback from the people. The study focus was on available avenues and extent of citizen participation and challenges in participation for good governance and service delivery. The study used 112 respondents and found that public participation was entrenched in most areas of government functioning in Kisumu County. The study established that participate enhanced public ownership of government projects and enhanced governance and accountability. Results noted that participation was hampered by low turnout, lack of interest, inadequate understanding of government procedures and political interference. The study concluded that citizen participation is one of the policies for good governance that improved service delivery in Kisumu County. The study recommended on civic education to scale up public participation that improves service delivery. The mainstream media in Kenya, Africa, and the world is full of scandalous information that questions the credibility of leaders who were thought to be effective. This is observable 75 across all organization sectors from the religious, public sector, political and even the private sector and includes such practices as corruption, manipulation of data and financial information, leadership wrangles, sexual harassment, among other such accusations of sexual misconduct which touches on prominent and perceived effective leaders. In light of these allegations Angana (2021) conducted a study on sustaining credible leadership in organizations to explore and understand credible leadership in an organizational context. Specifically, the study sought to review extant theoretical, and empirical literature on credible and authentic leadership, to identify emerging knowledge gaps from the review on credible and authentic leadership and to propose a suitable theoretical model for advancing research in sustaining credible leadership. Through, extant literature review, the study noted that leaders can be able to project and consistently improve their competence by engaging in consistent practices such as creating clarity of vision for the organization’s future, based on its strategic focus. Angana (2021) noted that organization leaders can also lose credibility if they are engaged in unethical practices that project them as untrustworthy. Discussions focus on the development of credible leadership and the practices that were critical for leaders to build and sustain credibility and authenticity based on literature from the last two decades. The two perspectives of practices described were trustworthiness and competence which provided significant applications for leaders in the current dynamic organization context. The study was conducted among media houses while the current study was conducted in the health sector. Credibility and authenticity have gained much interest in today’s world which is full of many challenges, opportunities as well as chaos. Majaliwa (2022) in a study on practical implications of credible and authentic leadership in organizations sought to explore the 76 conceptualization of credible and authentic leadership, to explore the contextual factors that influence credible and authentic leadership and to explore the impact of credible and authentic leadership to leader-follower relationship. The study context was two non- governmental organizations (NGOs) in Mwanza, Tanzania A qualitative study was conducted where thematic analysis was used to analyse the findings. The findings revealed the subjective nature of authentic leadership. Authenticity was found to be difficult to measure because it was hidden within the person. It was also revealed that employees who perceived their leaders to have credibility and authenticity tend to have a high level of organizational commitment, motivation and trust. Also, it was found out that culture, societal demands, as well as life experiences were contextual factors which influenced authenticity and credibility of leaders. The study was however conducted in Tanzania while the current study was conducted in Kenya. Thus, there was a contextual gap. According to Rigii et al. (2019) Strategic leadership is an important concept as it enables leaders to empowers teams through envisioning, anticipating and creation of changes strategically. However, the key challenge in the African context, with regard to political leaders, is that when they assume their state offices, they fail to follow through the promises they made to the electorate. In their study on strategic leadership and service delivery, the researchers sought to determine the influence of strategic leadership on service delivery by County Governments in Kenya. The study was based on the upper echelon theory. This study used positivism research philosophy where quantitative approaches were utilized in a cross-sectional survey. The unit of analysis was the 47 Counties in Kenya. Six respondents were purposively selected from six key departments in the counties and thus the study had a sample size of 282. The study used primary data collected using questionnaires. Data analysis was through descriptive and inferential statistics. The study regression results showed that strategic leadership had a significant influence on service 77 delivery. The results were however based on county Governments while the current study was conducted in the private sector. In a study on exploring the paradox of gender preferred leadership in Kenya Anaya (2023) conducted a study on gender egalitarianism and women in leadership aimed at exploring gender gaps, values and practices in a Sub-Saharan African (SSA) country, specifically to identify gender inequality in Kenyan leadership and propose suggestions for advancing gender equity. The study replicated the research design of the Global Leadership and Organizational Behaviour Effectiveness Project for gathering country data. The study sampled middle and upper management in the commercial sector comprising the finance and agriculture and added the civic sectors of health care and education, using quantitative research. 267 managers in over 100 organizations and qualitative research design where 30 interviewees from 23 organizations were selected. The findings indicated that gender parity had no apparent effect on leadership attributes nor on preferred modes of leadership. Statistical and thematic analysis revealed conflicting values and behaviours regarding gender equality and leadership. A high cultural dimension score on practices reflects a traditional leadership approach for male dominance, referred to as the Bwana Kubwa model. However, a high value score for gender equality reflects a more contemporary perspective, identified as the Inspirational Idealist. The gender gap presents a cultural paradox and a leadership constraint. The study was conducted in the financial sector while the current study was conducted in the health sector indicating that there was a contextual gap. The success of health services in hospitals depends on the work engagement of medical and non-medical personnel in providing quality services for patients. Engaged employees will be more proactive, take the initiative to collaborate with others, and are committed to 78 achieving high-quality performance. In a study on organizational culture as a mediator of credible leadership influence on work engagement, Srimulyani and Hermanto (2022) conducted an empirical study in private hospitals in East Java, Indonesia aimed to analyse the influence of leadership credibility and organizational culture on work engagement by sampling medical and non-medical personnel at two private hospitals in Madiun City. Hypothesis was tested using Structural Equation Modeling (SEM) and path analysis. The results of hypothesis testing showed that credible leadership has a significant positive influence on organizational culture, organizational culture has a significant positive influence on work engagement and organizational culture is the perfect mediator of credible leadership influences on work engagement. This study’s results confirm that leaders’ role in shaping a positive organizational culture through good credible leadership practices, while organizational culture can increase employee work engagement. The study was however conducted in Indonesia while the current study was conducted in Kenya indicating that there was a contextual gap. With the current global changes and emerging trends in the business environment, credible and authentic leadership is indeed the next organization's unique competitive advantage further, credibility and authenticity in leadership are crucial values that determine both the leader's and follower’s effectiveness. In a study by Kamau (2022) on credible-authentic leadership principles, the author sought to elucidate various principles that enable leaders to develop credibility and authenticity. Through extant literature review, the study established that the influence a leader has on his/her followers is dependent on their personal credibility. The study also stated that credible and authentic leadership has a significant effect on a leader’s effectiveness as well as that of his/her followers. Further, leaders who intend to develop their credibility and authenticity need to take an interest on their daily experiences and make learning their constant habit. It takes humility for a leader 79 to desire to learn from the constituents. Acknowledging human limitations and accepting feedback from other people is crucial. Finally, the study observed that developing and strengthening leadership credibility and authenticity is an ongoing process. The study was however, a theoretical literature review study and its findings may not be generalised in any context. Thus, there is a contextual gap. 2.4 Conceptual Framework The conceptual framework presents a pictorial edition of the relationship between the study variables. The framework shows each variable and its measurement indicators as it interacts with one another. The conceptual framework is as shown in figure 2.1 80 Employees Emotional Wellness Programmes Moderating Variable  Stress management programmes  Mental health programmes Credible Leadership  Promote support services  Honesty  Provide mindfulness training  Inspiration  Regular inspiration  Accountability  Forward-looking Employees Intellectual Wellness  Competence Programmes  Professional development classes  On the job training  Brainstorming Sessions Service Delivery  Collaboration opportunities  Customer Satisfaction  Creative and innovative thinking  Turnaround Time Employees Occupational Wellness  Accessibility of services Programmes  Assurance  Regular health risk assessments  Reliability  Regular breaks from work  Rewards for healthy behaviours  Involve staff in leadership decisions  Family-friendly policies Employees Physical Wellness Programmes.  Physical exercise  Partnerships with health clubs  Walking and use of stairs  Organize fitness challenges  Provide sporting activities Dependent Variable Independent Variable Figure 2. 1: Conceptual Framework Source: Researcher (2024) 2.5 Summary of the Research Gaps The reviewed studies under the empirical literature section have shown there are some gaps that necessitated the need for the present study. Some of the reviewed created contextual gaps as they were based on different background sectors or covered different sectors and industries. For instance, Goopy, et al. (2020) was done amongst refugees and immigrants in Canada, Moon (2021) was done in community mental health centres in the USA; Walters (2016) study was based on Colorado –USA. There were also some studies were done in 81 Africa like the case of Botha (2013) that covered the higher education institutions in South Africa, Mafumbate, et al. (2017) in Zimbabwe, Okoe, et al. (2016) in Ghana, and Kuye, et al. (2022) researched on occupational wellness of cocoa farmers in Nigeria. The context was also based on sector and industry such as the studies by Mwangi and Rintaugu (2017) and Mukaro (2018) that was based on the Kenyan universities, Wulandari (2018) was done on the financial service firms in Indonesia and Heydari and Lai (2019) covered the hospitality industry in China. The reviewed studies also created conceptual gaps as noticed in the studies by Ombasyi (2019) whose focus was on employee performance and did not consider service delivery in the organization; Wickramarathne, et al. (2020) research was on wellness dimension in the society and not focusing on the wellness programmes and service delivery quality and Tamadoni, et al. (2017) study combined three wellness aspects of the social, intellectual and occupation and need to assess each program individually. Roche and Strobach (2019) study addressed physical and mental health of students for academic excellence and did not concentrate on workers and outputs and Koitalek (2016) assessed only the compensation policy and did not consider other credible leadership that may influence service delivery. The reviewed studies created methodological gaps since some were case studies like Wahida (2016) who only covered Huduma centres in Mombasa County and Mukaro (2018) covered the case of employees working in two Kenyan universities namely Kenyatta and African Nazarene. Case studies may limit applicability of findings as they are stated as specific to the organization or sector or market. There were some studies that used secondary data that is based on accuracy of the information and it might be skewed to cover the specific needs of the researcher. This includes researches by Walters (2016), Goopy, et al. (2020) who reviewed databases, Wickramarathne, et al. (2020 and Westby, et al. (2016). 82 The research gaps in the reviewed studies were in context, concept and methodological and created a need to be fill. It is these gaps that necessitated the researcher to conduct the present study. This study focused on employee wellness programmes and its effect to service delivery in Kenyan faith-based hospitals. 83 CHAPTER THREE RESEARCH METHODOLOGY 3.1 Introduction The Research methodology that was used to carry out this study is discussed in this chapter. Precisely, the chapter outlines the research philosophy, research design, target population, sample size and sampling technique, data collection instrument and procedure, pilot testing, operationalization of variables, data analysis and presentation and ethical considerations. 3.2 Research Philosophy A research philosophy is a framework that guides how research should be conducted based on ideas about reality and the nature of knowledge (Collis and Hussey, 2014). The research philosophy enables clarity in the research design, guiding the researcher to identify the suitable design that should work. The selection of a suitable paradigm lays the ground for the intent, inspiration and expectations of research (Tsung, 2016). There are several research philosophies that exist in social sciences which include positivism, pragmatism, realism and interpretivism. The choice of research philosophy to be adopted depends on ontology and epistemology. Ontology is based on the nature of reality. It is classified on the basis of objectivism and subjectivism. Objectivism portrays the position that social objects persist in reality external to social actors. Subjectivism is concerned with the social phenomena which emerge from perceptions and consequences of those social actors concerned with their existence. On the other hand, epistemology relates to the acceptable knowledge of a particular area of study. Epistemology is therefore classified as positivism, realism and interpretivism in the domain of research philosophy (Saunders, Lewis & Thornhill, 2012). Positivism originated in the natural sciences and focuses on scientific testing of hypothesis and finding logical or 84 mathematical proof that derives from statistical analysis (Collis & Hussey, 2014). The core feature of realism pertains to disclosing the truth of reality and the existence of the objects is prevalent independently of the human mind. Interpretivism is focused on the assessment of the differences between humans as social actors (Babbie, 2010). The research philosophy adopted in this study was positivism. The positivism strategy is approached on the basis of data collection and hypothesis development. The hypotheses are tested and confirmed which can be used for further research. Further, this strategy allows the researcher to follow a highly structured methodology in order to facilitate the hypothesis. Also, positivism works on quantifiable observations and accordingly statistical analysis is obtained. Positivism philosophy is also suitable for this study because it allows for the use of large sample sizes and produces precise, objective and quantitative data. 3.3 Research Design The study adopted the descriptive and correlational research designs. Descriptive research design aims to systematically obtain information to describe a phenomenon in the population. It assists to answer the what, when, where, and how questions regarding the research problem rather than the why (Creswell, 2014). When using this design, the researcher does not control or manipulate any variables. Instead, the variables are only identified, observed, and measured. Also, descriptive research involves the collection of quantifiable and systematic data that can be used for the statistical analysis of the research problem. The data obtained in descriptive research provides a base for further research as it helps obtain a comprehensive understanding of the research question so that it can be answered appropriately (Cooper & Schindler, 2014). Hence, this design is suitable in investigating the influence of employee wellness programmes on service delivery in faith-based hospitals 85 in Nairobi metropolitan area. Besides the design allows for utilization of both qualitative and quantitative data as is envisaged in this study. The study used primary collected from employees of Faith based hospitals in Nairobi metropolitan. Correlational research design examines the statistical relationship between two or more variables without manipulating them. This design seeks to establish the degree of association or correlation between two or more variables (Palys & Atchison, 2014). Surveys are a common method used in correlational research. Researchers collect data by asking participants to complete questionnaires or surveys that measure different variables of interest. Surveys are useful for exploring the relationships between variables such as personality traits, attitudes, and behaviours (Patton, 2015). Correlational research allows the researcher to explore the relationships between variables in a natural setting without manipulating any variables. Hence, it is appropriate in investigating the influence of employee wellness programmes on service delivery in faith-based hospitals in Nairobi metropolitan area. 3.4 Target Population The study was conducted in faith-based hospitals in Nairobi Metropolitan. Nairobi Metropolitan Area consists of five counties namely: Nairobi County, Kajiado County, Kiambu County, Machakos County and Murang’a County. Nairobi Metropolitan Area was selected because it hosts most and the largest faith-based hospitals in Kenya. The study was based faith-based hospitals classified as either level four or five. According to the ministry of health there were 32 level four and five faith-based hospitals in Nairobi Metropolitan area as of December 2022. The number of hospitals was summarised in Table 3.1. 86 Table 3.1: Faith-Based Hospitals in Nairobi Metropolitan Area County Number of Hospitals Percentage Nairobi County 14 43.8% Kiambu County 12 37.5% Murang’a County 3 9.4% Kajiado County 2 6.3% Machakos County 1 3.1% Total 32 100.0% Source: MoH (2023) The study targeted Human resource officers and medical staff in the faith-based hospitals. Human resource officers and medical staff were selected because they are the service providers and direct recipients of wellness programmes. The unit of analysis shall therefore be the faith-based hospitals while the unit of observation was the staff in the selected faith- based hospitals. Out of the 32 faith-based hospitals, all hospitals in Murang’a, Machakos and Kajiado Counties were selected owing to their small number. 50% of hospitals in Nairobi and Kiambu Counties were randomly selected to bring the total number of selected hospitals to 19 hospitals. The population distribution is a shown in Table 3.2. 87 Table 3.2: Target Population County Selected of HR officers Medical staff Total Hospitals Population Nairobi County 7 121 411 532 Kiambu 6 92 325 417 County Murang’a 3 64 50 114 County Kajiado County 2 11 52 63 Machakos 1 3 25 28 County Total 19 291 863 1154 Source: Human Resources Records (2023) 3.5 Sample Size and Sampling Procedure Sampling frame is the source where the sample is drawn. The sampling frame for this study was all the human resource officers and medical staff in the faith-based hospitals in Nairobi metropolitan. The study used stratified random sampling to select the respondents. In stratified random sampling the population is divided into subgroups and then a sample is drawn randomly. Each subgroup or stratum consists of items that have common characteristics. The primary purpose of this technique is to ensure that the total sample is a blend of all the different kinds of items in the population. This mix guarantees that the whole population is closely replicated in the sample (Creswell, 2014). Yamane (1967) formula was used to determine the sample size in respect to the population under study. n = N/ 1+ N(e)2 Where; n is the required sample size from the population under study 88 N is the whole population that is under study e is the precision or sampling error which is usually 0.05 n = 1154/ 1+1154(0.05)2 n = 1154/3.885 = 297 The study sample size was 297 respondents, this is 25.7% of the of the population. Mugenda and Mugenda (2009) recommended a sample of between 10 to 30% of the study population. The sample size distribution is a shown in Table 3.3. Table 3.3: Sample Size County Total HR sample Medical sample Total Population officers (HR) staff medical Sample staff Nairobi 532 121 31 411 106 137 County Kiambu 417 92 24 325 84 107 County Murang’a 114 64 16 50 13 29 County Kajiado 63 11 3 52 13 16 County Machakos 28 3 1 25 6 7 County Total 1154 291 75 863 222 297 Source: Researcher (2024) 89 3.6 Data Collection Instruments The study obtained primary data using a semi-structured questionnaire. A questionnaire consists of a series of questions used to gather information form the respondents. The questionnaire had both closed ended and open-ended questions. Closed-ended questions have multiple choice answer options from where the respondents choose from (Babbie, 2010). On the other hand, open-ended questions allowed respondents to provide their responses without feeling restricted. Questionnaires have advantage of uniformity since all respondents are asked exactly the same questions, cost-effectiveness, possibility to collect the primary data in shorter period of time, no bias from the researcher during the data collection process, there is adequate time for respondents to think before answering questions and it is easy to reach respondents in distant areas through online questionnaire (Kothari, 2014). The questionnaires were structured in line with the study objectives. The questionnaires had seven sections. Section one covered demographic information, section two to five covered questions on independent variables. Section six covered questions on moderating variable and section seven covered questions on dependent variables. 3.7 Data Collection Procedure A letter of introduction was obtained from Karatina University. The letter was used to introduce the researcher to the respondents. A research permit from NACOSTI was obtained, this allowed for data collection. Once the research permit is obtained, the researcher visited the targeted hospitals and inform them of the intention to collect data from the facilities and also explain the purpose of the study. This helped to agree on the time for data collection. The researcher also introduced enumerators the management. Enumerators were required to wear their badge and a reflector jacket for ease of identification. 90 The questionnaires were self-administered by the researcher with the help of trained research assistants. Where the respondents are not available to respond to the research instrument immediately, the drop and pick method was used to enhance the response rate. The drop and pick-up method are an effective means to reduce potential nonresponse bias through increased response rate. Emailing method allowed data collection for respondents who would not be reached physically. The respondents participated in the study in the study voluntarily. 3.8 Pilot Testing According to Cooper and Schindler (2014) pilot testing is a small test prior the actual data collection. It helps in determining the flaws, weaknesses or limitations of the study instrument so as to make the needed revisions before going to the field to collect data. Piloting helps to check the clarity and understanding of research questions so as to ascertain whether the expected results were achieved. Piloting is also meant to test for data collection instruments validity and reliability. The pilot test was conducted with 30 randomly selected respondents in medium sized private hospitals in Nairobi County. 3.8.1 Validity of the Research Instrument Validity ascertains whether the instruments measures what it is supposed to measure and also the accuracy of the obtained results (Joppe, 2010). Mugenda (2008) note that validity is the inferences accuracy and meaningfulness, drawn on the basis of study results. Validity is ascertained when data measure what it is intended to measure. Validity methods that were adopted are construct and content validity. To ensure construct validity, the questionnaire had different sections which addressed the study specific objectives. The sections related to the conceptual framework. Also, content validity of the research 91 instrument was determined through careful operationalization of the variables on the basis of the reviewed literature. In addition, opinion of the supervisors and other subject experts was sought to determine if the research instrument validly collected the intended data. Mugenda (2008) noted that the usual procedure in assessing content validity of a measure is to use a professional or expert in a particular field. The suggestions made facilitated the necessary revision and modification of the research instrument thereby enhancing its validity. Based on the review of the research instrument by the supervisors and subject experts, the research instrument was revised until it was considered to be valid. Thus, at the time of data collection, the questionnaire was considered valid. 3.8.2 Reliability of the Research Instrument Reliability is the extent to which the results reproduced over time are consistent and accurate and highly represents the population being studied. An instrument is said to be reliable when the study results can be achieved using the same methodology. Consistent of measured items determine the reliability (Joppe, 2010). The results consistency, the degree to which a measuring tool produces the same result every time it is used under similar conditions in the same case, implies the repeatability, stability or internal consistency of a questionnaire. Cronbach’s alpha method was adopted to determine reliability of the instrument. Cronbach’s alpha is used to measure a large number of items at particular intervals. Once administered it provides a unique, quantitative estimate of the internal consistency of a scale (Cooper & Schindler, 2014). Creswell (2014); Gall, Gall and Borg, (2007) suggest that a Cronbach alpha of 0.7 indicates that the data was reliable. Castillio (2009) provided the following rules of thumb: >0.9 – Excellent, >0.8 – Good, >0.7 – Acceptable, >0.6 – Questionable, >0.5 – Poor and <0.5 – Unacceptable. The acceptable 92 value of 0.7 was used as a cut-off of reliability for this study. The results of reliability test were summarised in table 3.4. Table 3.4: Reliability Statistics Scale Cronbach's Alpha Emotional Wellness programmes 0.815 Intellectual Wellness programmes 0.821 Occupational Wellness programmes 0.774 Physical Wellness programmes 0.923 Credible Leadership 0.875 Service Delivery 0.863 Aggregate 0.848 The results in Table 3.4 indicated that the aggregate Cronbach's alpha was 0.848 suggesting that the research instrument had overall reliability. Individually, emotional wellness programmes had a reliability statistic of 0.815, intellectual wellness programmes had 0.821, occupational wellness programmes had 0.774, physical wellness programmes had 0.923, credible leadership had 0.875 while service delivery had a statistic of 0.863. This means that individually all the variables were reliable since the Cronbach's alpha > 0.7. 93 3.9 Operationalization of Variables The variables were operationalized as shown in Table 3.4. Table 3.5: Operationalization of Variables Variables Operationalization Indicators Measurement in the questionnaire Employees It is the ability to  Stress management Likert scale Emotional manage stress, be programmes Open ended Wellness adaptable and  Mental health questions Programmes. resilient and generate programmes (Independent) emotions that can  Promote support lead to good feelings. services  Provide mindfulness training Employees It is about recognition  Professional Likert scale Intellectual of creative abilities of development classes Open ended Wellness an individual and  On the job training questions Programmes. encouraging them to  Brainstorming Sessions (Independent) expand their skills  Collaboration and knowledge base. opportunities Employees It allows an employee  Regular health risk Likert scale Occupational to explore career assessments Open ended Wellness options that enhance  Regular breaks from questions Programmes. their satisfaction, work (Independent) enrichment and  Rewards for healthy meaning of work behaviours based on the tasks  Involving staff in and assignments they leadership decisions. handle  Family-friendly policies Employees It covers energy  Physical exercise Likert scale Physical Wellness levels at the work and  Partnerships with Open ended Programmes. it is caused by health clubs questions (Independent) healthy behaviours  Walking and use of exercised by the stairs employees and  Organize fitness encouraged or challenges supported by the management Credible It is the ability of a  Honesty Likert scale Leadership leader to carry out a  Inspiration Open ended (Moderating) task successfully or  Accountability questions efficiently is critical  Forward-looking to every organization.  Competence Service Delivery It refers to effective  Customer Satisfaction Likert scale (Dependent) rendering of services  Turnaround Time Open ended to the clients in a  Accessibility of questions manner that meets services industry standards of  Assurance quality  Reliability 94 3.10 Diagnostic Tests Diagnostic were conducted to ensure that the results of the multiple regression analysis are reliable and also ensure that results are unbiased, consistent and efficient. Tests are concerned about violation of the basic assumptions relating to autocorrelation, normality, linearity, multicollinearity and homoscedasticity were conducted. 3.10.1 Autocorrelation Test Autocorrelation refers to the degree of correlation of the same variables between two successive time intervals. That is values of a variable in a particular period affects values in successive periods. In linear regression, one of the assumptions is that there should be little or no autocorrelation in the data utilized. Autocorrelation occurs when the residual values are not independent of one another from one period to the other (Cooper & Schindler, 2013). Autocorrelation was examined using the Durbin-Watson test in a linear regression model. For the Durbin-Watson's tests, the null hypothesis is that the residuals are not linearly auto correlated. The d value is a number that spans from 0 to 4; if it is determined to be between 0 and 2, it indicates that there is no autocorrelation. If the d values are more than 2.0 the data has autocorrelation. 3.10.2 Multicollinearity Multicollinearity refers to the linear inter-correlation between variables in a study that looks at the level of correlation amid predictor variables and the correlation coefficient between variables, as shown in the SPSS regression outcomes. Multicollinearity raises the standard errors of the coefficients, making some variables statistically insignificant despite the fact that they should be. The Variance Inflation Factor (VIF) was used to test multicollinearity. If VIF is less than 5, it indicates absence of multicollinearity. If VIF is greater than 5 but 95 less than 10, there is considerable multicollinearity present. If VIF is more than ten, it means there is a lot of multicollinearities (Shrestha, 2020). 3.10.3 Normality Normality refers the attribute in the data which means that the data obtained follows a normal distribution. That is the data is symmetrically dispersed about the centre of all scores and forms a bell shape when plotted on a graph (Knief & Forstmeier, 2021). Normality test in this study was conducted through Shapiro-Wilk test following the recommendations of Khatun (2021). In order to establishing whether the variables were normally distributed, the study relied on the P-values of the test statistics. If the P-value was greater than 0.05, then the variable is normally distributed. 3.10.4 Linearity The term linearity refers to the relationship between the dependent and independent variables. If the relationship between the variables is linear, multiple linear regressions can effectively predict the relationship. When data on a graph is represented by a straight line, it indicates that the data is linear. Correlation coefficient was used to indicate whether the dependent and independent variables have a linear relationship. If the correlation coefficient differs from zero then it means a linear relationship exists (Maulud & Abdulazeez, 2020). 3.10.5 Heteroscedasticity Test Homoscedasticity exists where the variance of the response variable error is the same across the data. Heteroscedasticity is the polar opposite. According to Field (2009), heteroscedasticity occurs when the error term has variance. It occurs when the variance of errors fluctuates based on the values of the independent variables. When the residuals are not uniformly distributed around the horizontal line, heteroscedasticity arises. The Breusch- 96 Pagan test was used to determine heteroscedasticity. The null hypothesis in the Breusch- Pagan test is homoscedasticity. If the null hypothesis is rejected, it was concluded that there is heteroscedasticity in the data. If the level of significance is less than 0.05, the null hypothesis is rejected. 3.11 Data Analysis and Presentation Data collected from the field was checked for completeness and edited. The SPSS version 23.0 was used for data coding. The descriptive and inferential statistics was used to analyse data. Descriptive statistics included frequencies, mean, standard deviation and percentages. Descriptive statistics helps to describe, show or summarize data in a meaningful way. The inferential statistics comprised of the correlational and regression analysis. Correlational analysis was used to determine the relationship between the independent and dependent variables. A correlation coefficient is an important value in correlational analysis that indicates whether the inter-relationship between two variables is positive, negative or non-existent. The strength of a correlation between quantitative variables is typically measured using a statistic called Pearson’s Correlation Coefficient (or Pearson’s r). A positive correlation is indicated by a value of 1.0, a perfect negative correlation is indicated by a value of -1.0 while zero correlation is indicated by a value of 0.0 (Patton, 2015). The study also carried out a regression analysis to determine the level of association of the study variables. The coefficient of determination R square was used to test for the significance of the model. The F-statistic at 95% confidence level was used to determine whether there is a significant relationship between the variables. The data was presented using graphs, pie charts and tables. 97 3.12 Empirical Models for Data Analysis An empirical model is an expression for studying the relationship existing between the study variables (Field, 2013; Wandiga et al., 2019). This study used simple and multiple regression analysis to determine the relationship existing between the research variables. 3.12.1 Empirical Model for Direct Relationship To determine the direct relationship existing between employee wellness programmes (emotional wellness; intellectual wellness; occupational wellness; physical wellness) on service delivery in faith-based hospitals in Nairobi metropolitan area, the study conducted simple linear regression models. Coefficient of determination (R2) was used to determine the predictive power of the models. F-statistic was compared with F-critical to determine the fitness of the models in predicting service delivery while P-value was used to determine the significance of study variables at 0.05 significance level. To assess the influence of employee’s emotional wellness programmes on service delivery in faith-based hospitals in Nairobi metropolitan area, the study regressed service delivery on employee’s emotional wellness programmes. The model is stated in equation 1: SD = β0 + β1EW+ ε……………………………………………………………Equation 1 To investigate the influence of employee’s intellectual wellness programmes on service delivery in faith-based hospitals in Nairobi metropolitan area the study regressed service delivery on employee’s intellectual wellness programmes. The model is stated in equation 2: SD = β0 + β2IW+ ε ……………………………………………………………Equation 2 98 To examine influence of employee’s occupational wellness programmes on service delivery in faith-based hospitals in Nairobi metropolitan area, the study regressed service delivery on employee’s occupational wellness programmes. The model is stated in equation 3: SD = β0 + β3OW+ ε ……………………………………………………………Equation 3 To establish the influence of employee’s physical wellness programmes on service delivery in faith-based hospitals in Nairobi metropolitan area, the study regressed service delivery on employee’s physical wellness programmes. The model is stated in equation 4: SD = β0 + β4PW+ ε ……………………………………………………………...Equation 4 3.12.2 Empirical Model for Moderated Relationship To examine the moderating influence of credible leadership on the relationship between employee wellness programmes on service delivery in faith-based hospitals in Nairobi metropolitan area, the study adopted the two-step model recommended by (Fairchild & MacKinnon, 2009). In the first step, the study service delivery in faith-based hospitals was regressed on employee wellness programmes to determine if there exists a significant relationship to be moderated and the value of R21 observed. The model was stated as expressed in equation 5; SD = β0 + β1WP + ε …………………………………………………………… Equation 5 In the second step, credible leadership was introduced in the model and service delivery in faith-based hospitals was regressed on employee wellness programmes, credible leadership 99 and the interactive term between employee wellness programmes and credible leadership. The value or R22 was observed again. The model was stated as shown in equation 6: SD = β0 + β1WP+ β2WP*CL + β3CL + ε ……………………………………Equation 6 The decision on the significance of the moderated relationship was based on the recommendations of Fairchild and MacKinnon (2009). The change in R2 (R22- R 2 1) represents the moderation effect of credible leadership on the relationship between employee wellness programmes on service delivery in faith-based hospitals in Nairobi metropolitan area. The significance of the moderated relationship was determined by P- values at 0.05 significance level. If p < 0.05, the H0 was rejected and if p > 0.05, H0 was accepted and it was concluded that there is a significant moderating influence of credible leadership on the relationship between employee wellness programmes and service delivery in faith-based hospitals in Nairobi metropolitan area. 3.13 Test of Hypothesis The empirical models were used to test for the hypotheses. This is as presented in Table 3.5. Table 3.6: Test of Hypothesis Objective Hypothesis Statistical Test Interpretation To assess the H01: Employee SD = β0 + β1EW+ ε Linear regression influence of emotional wellness SD-service delivery analysis employee’s emotional programmes have no EW-emotional - R2 wellness programmes significant influence wellness - F –test on service delivery in on service delivery in - t-test faith-based hospitals faith-based hospitals 100 in Nairobi in Nairobi P≤0.05 reject null metropolitan area. metropolitan. hypotheses To investigate the H02: Employees SD = β0 + β2IW+ ε Linear regression influence of intellectual wellness SD-service delivery analysis employee’s programmes have no IW-intellectual - R2 intellectual wellness significant influence wellness - F –test programmes on on service delivery in - t-test service delivery in faith-based hospitals P≤0.05 reject null faith-based hospitals in Nairobi hypotheses in Nairobi metropolitan . metropolitan area. To examine influence H03: Employees SD = β0 + β3OW+ ε Linear regression of employee’s occupational wellness SD-service delivery analysis occupational wellness programmes have no OW-occupational - R2 programmes on significant influence wellness - F –test service delivery in on service delivery in - t-test faith-based hospitals faith-based hospitals P≤0.05 reject null in Nairobi in Nairobi hypotheses metropolitan area. metropolitan. To establish the H04: Employees SD = β0 + β4PW+ ε Linear regression influence of physical wellness SD-service delivery analysis employee’s physical programmes have no PW-physical wellness - R2 wellness programmes significant influence - F –test on service delivery in on service delivery in - t-test faith-based hospitals faith-based hospitals P≤0.05 reject null in Nairobi in Nairobi hypotheses metropolitan area. metropolitan. 101 To examine the H06: Credible Step 1 Linear regression moderating influence leadership has no SD = β0 + β1WP + ε analysis of credible leadership significant - R2 on the relationship moderating influence Step2 - F –test between employee on the relationship SD = β0 + β1WP + - t-test wellness programmes between employee β2WP*CL + β3CL + P≤0.05 reject null on service delivery in wellness programmes ε hypotheses faith-based hospitals on service delivery in WP– wellness in Nairobi faith-based hospitals program metropolitan area in Nairobi CL- credible metropolitan. leadership 3.14 Ethical Considerations Ethical considerations are guidelines and principles which must be adhered while carrying out research. Ethics in research is important because they promote research objectives, including avoidance of error, truth, and knowledge. Ethics prohibit false interpretations and misrepresentation of facts in deriving conclusions from any research undertaking. Also, ethical considerations are necessary to promote trust, collaboration, and mutual respect since research usually involves cooperation between researchers and people from different dispositions (Cooper & Schindler, 2014). The study adhered to the ethical considerations. The informed consent of the respondents was sought. The participants participated in the study voluntarily. Also, the anonymity of the respondents was ensured as they were not required to indicate their names in the questionnaire. The participants identities and information were protected and would not be accessed by unauthorised persons. 102 CHAPTER FOUR DATA ANALYSIS AND DISCUSSIONS 4.1 Introduction This chapter presents analysis and discussion of data obtained from faith-based hospitals in Nairobi metropolitan area. Specifically, the chapter consists of the response rate, demographic information analysis, descriptive analysis, validity and reliability of research instrument, diagnostic tests, correlation analysis, regression analysis, test of study hypothesis and analysis of qualitative data. 4.2 Bio Data analysis 4.2.1 Response Rate The study targeted 297 respondents drawn from 19-based hospitals in Nairobi metropolitan from which 7 hospitals were selected from Nairobi County (137), 6 from Kiambu County (107), 3 Murang’a County (29), 2 Kajiado County (16) and 1 hospital from Machakos County (7). Of the 297 questionnaires distributed to the target respondents, 244 of the questionnaires were filled and returned. Thus, there was a response rate of 82%. The response was as distributed in table 1. According to Holtom et al (2022) response rate in a survey is considered adequate if it is greater than 25%. Based on this recommendation, the study determined that the response rate was adequate. 103 Table 4.1: Response Rate County Target HR Medical Total Rate Response officers staff Response Nairobi County 137 25 96 121 88% Kiambu County 107 18 80 98 92% Murang’a 29 11 2 13 45% County Kajiado County 16 2 7 9 56% Machakos 7 1 2 3 43% County Total 297 57 187 244 82% From the results the results in table 4.1 above, the highest response rate was obtained in Kiambu County with a response of 98(92%) followed by Nairobi City County with a response of 121 (88%), Kajiado County 9(56%) and Murang’a County with 13(45%) whiles Machakos County had the least response rate with a response of 3(43%). The study sought to analyse the demographic characteristics of the respondents. The exact information sought was gender of the respondents, number of years the respondents had worked in their current hospital and their highest level of education. 4.2.2 Gender of Respondents The study sought to determine the gender of the respondents. The results obtained were summarised in Figure 4.1. 104 Gender of Respondents Male Female 44% Male 56% Female Figure 4.1: Gender of the Respondents From the results in Figure 4.1, it was established that of the 244 respondents, 107(44%) were male while 137(56%) were female. These results suggest that the labour force faith- based hospitals in Nairobi metropolitan area is female dominated. It was also deduced that there was gender diversity in the in faith-based hospitals in Nairobi metropolitan area. This is so because the study focused on employees and human resource officers which were found to be mainly women. These results concurred with the observations of Thomas and Reimann (2023) that the HR profession is dominated by women with women occupy almost 69% of human resource jobs globally. Similarly, Gittleman, Lettau and Phipps (2023) reported that 71% of HR professionals are female in the UK. Elsewhere, the United States Bureau of Labor Statistics (BLS) stated that on average 72% of HR managers are women with the number increasing to 86% in 2023 (Green, 2024). These statistics clearly demonstrate the dominance of women in the HR profession globally. 105 4.2.3 Number of Years Worked by Respondents The study sought to determine the number of years respondents had worked in the current hospital. Results were summarised in Table 4.2 Table 4.2: Demographic Analysis Results Years Worked Frequency Percentage Less than 1 year 27 11.1% 1-5 years 63 25.8% 6-10 years 128 52.5% Over 10 years 26 10.7% Total 244 100.0% Regarding the number of years, the results in Table 4.2 showed that respondents had worked in the current hospital, the study established that 128 respondents representing 52.5% had worked in their current workstations for between 6 to 10 years, 25.8% (63) had worked in the current hospital for between 1 to 5 years, 11.1% (27) had worked in the hospital for less than a year while only 10.7% (26) had worked in the current hospital for over 10 years. The observation made therefore is that among the faith-based hospitals in Nairobi metropolitan area most Hr professionals and other staffs in the department had worked in their current hospital for approximately 6 to 10 years. Consequently, the study considered the respondents to have worked long enough to provide requisite information on the existence of employee wellness programmes and their influence on service delivery. Results obtained on this element were consistent with those of Magstadt (2023) that there is high labour turnover in hospitals with an average annual turnover rate of 27.1% United States. In Kenya, Achiambo, Oloko and Deya (2024) reported that labour turnover in the Kenyan hospitals stood at 8.42%, most of which was in private and faith-based hospitals. 106 4.2.4 Number of Years Worked by Respondents The study further sought to establish the highest level of education of the respondents. Results were summarised in Table 4.3. Table 4.3: Highest Level of Education Education Frequency Percentage PhD 13 5.3% Master's 55 22.5% Undergraduate 107 43.9% Diploma 69 28.3% Total 244 100.0% From the results in Table 4.3, it was established that 13(5.3%) of the respondents had a Doctor of Philosophy (PhD) degree, 55(22.5%) of the respondents had at least a master's degree, 107(43.9%) of the respondents had at least an undergraduate degree as their highest level of education while 69(28.3%) at least a diploma as their highest level of education. Based on these results, it was observed that most of the respondents had at least an undergraduate degree as their highest level of education. Consequently, it was deduced that respondents had enough knowledge in the area of study and thus understanding of the relationship existing between the study variables. 4.3 Descriptive Statistics The study also sought to descriptively analyse the study variables to help describe and summarize data. The specific descriptive statistics analysed included frequencies, mean, standard deviation and percentages. Descriptive statistics were presented in the order of variables as follows: Emotional wellness programmes, intellectual wellness programmes, 107 occupational wellness programmes, physical wellness programmes, credible leadership and service delivery. 4.3.1 Emotional Wellness Programmes The study sought to determine the influence of employee’s emotional wellness programmes on service delivery in faith-based hospitals in Nairobi metropolitan area. Accordingly, respondents were requested to indicate their opinion on provided statements regarding employee’s emotional wellness programmes in their hospitals. Responses required were on Likert scale where 1 represented strongly disagree, 2 represented disagree, 3 represented moderate, 4 represented agree and 5 represented strongly agree. Results were summarised in Table 4.4. Table 4.4: Descriptive Statistics on Employee’s Emotional Wellness Programmes N Min Max Mean Std. Dev Mental health programmes ensure reduced stress among 244 1 5 4.31 1.190 employees and allows them to focus on their tasks Our organization promote support services to help 244 1 5 3.73 1.141 employees cope with stress and anxiety Our organization provides stress management 244 2 5 3.62 .676 programmes for its employees Stress management programmes helps to promote 244 1 5 3.58 1.153 positivity and a healthy workplace Our organization provides mindfulness training to 244 1 5 3.14 1.173 enhance their skills 108 Our organization provides mental health programmes 244 1 5 2.48 1.142 Mindfulness training help our employees to become 244 1 5 2.48 1.113 more aware of their own emotions and reactions, as well as those of their colleagues The support services in our organization help employees 244 1 4 2.14 .896 to cope with setbacks and challenges at work Aggregate 3.173 1.061 Result in table 4.4 exhibited that the aggregate mean score for employee’s emotional wellness programmes was 3.173 indicating that there was moderate emphasis on employee’s emotional wellness programmes among the faith-based hospitals in Nairobi metropolitan area. Consequently, it was deduced that overall, the management of faith- based hospitals in Nairobi metropolitan area considered employee’s emotional wellness to be of moderate relevance in achieving organizational goals. The standard deviation of 1.061 suggest that there were considerable deviations in deployment of employee’s emotional wellness programmes suggesting that while some hospitals highly emphasised on these wellness programmes as shown by a maximum of 5, others were less concerned about employee’s emotional wellness as shown by a minimum of 1. Specifically, the study established that respondents agreed that mental health programmes ensure reduced stress among employees and allows them to focus on their tasks (Mean = 4.31; Std. Dev =1.190). Further, it was established that respondent agreed that their hospitals promoted support services to help employees cope with stress and anxiety (Mean = 3.73; Std. Dev =1.141), they provided stress management programmes for its employees (Mean = 3.62; Std. Dev =0.676) and that stress management programmes helps to promote 109 positivity and a healthy workplace (Mean = 3.58; Std. Dev =1.153). Besides, respondents were of the opinion that their hospitals provided mindfulness training to enhance their skills (Mean = 3.14; Std. Dev =1.173), their hospitals provided mental health programmes (Mean = 2.48; Std. Dev =1.142) and that mindfulness training helped employees in their hospitals to become more aware of their own emotions and reactions, as well as those of their colleagues (Mean = 2.48; Std. Dev =1.113). However, respondents disagreed that their hospitals had support services that helped employees to cope with setbacks and challenges at work (Mean = 2.14; Std. Dev =0.896) These findings support the postulates of Awada and Ismail (2019) who noted that emotional wellness at work place carters for social, mental and psychological wellbeing of staffs by emphasises on proper management of stress and stressing factors especially in demanding job types and toxicity in workplaces. Also, the results were consistent with the findings of Ombasyi (2019) who observed that emotional wellness as reflected through psychological wellbeing, stress free work environment and mental health as a positive influence on employee performance in Kenya’s brand design and development firms. Besides, Moon (2021) observed that in times of adversity such as Covid-19, there is need for emotional wellness program for interventions and support for the wellbeing of all employees by addressing social needs. This may be achieved through peer support, counselling services, health check-ups, training on disease management. 4.3.2 Intellectual Wellness Programmes On this variable, the study sought to investigate the influence of employee’s intellectual wellness programmes on service delivery in faith-based hospitals in Nairobi metropolitan area. The respondents were required to indicate their opinion on provided statements regarding employee’s intellectual wellness programmes in their hospitals. Responses were 110 on a five-point Likert scale where 1 represented strongly disagree, 2 represented disagree, 3 represented moderate, 4 represented agree and 5 represented strongly agree. Results were summarised in Table 4.5. Table 4.5: Descriptive Statistics on Employee’s Intellectual Wellness Programmes N Min Max Mean Std. Dev Our organization offer its employees professional 244 1 5 4.14 1.198 development classes On-the-job training is important for our employees 244 1 5 3.93 .844 because it provides firsthand knowledge and experience in the workplace Brainstorming sessions help our employees in problem 244 1 5 3.84 .800 solving as they undertake their tasks Our organization encourages collaboration 244 1 5 3.82 1.142 opportunities among the employees Collaboration opportunities ensures that tasks in our 244 1 5 3.62 1.246 organization are linked to achieve the set goals Our organization encourages brainstorming sessions to 244 1 5 3.44 .934 enhance service delivery Our organization provide employee with the on-the-job 244 1 5 3.44 1.115 training programmes 111 Professional development classes allow our employees 244 1 5 2.62 1.114 to perform better and prepares them for positions of greater responsibility Aggregate 3.61 1.049 Results in table 4.5 indicated that the aggregate mean score for employee’s intellectual wellness programmes was 3.61 alluding that employees agreed there were employee’s intellectual wellness programmes in their hospitals. These results postulate that the management of faith-based hospitals in Nairobi metropolitan area considered employee’s intellectual wellness programmes to be important in delivering quality services to their patients. The standard deviation of 1.049 indicated that there were high deviations on the existence of such programmes suggesting that while some hospitals had elaborated intellectual wellness programmes others had none. The range of responses from 4 with a minimum of 1 to a maximum of 5 also suggest disparity in the opinion of the respondents on the existence of employee’s intellectual wellness programmes. On individual attributes of intellectual wellness programmes, it was established that majority of hospitals offered their employees professional development classes as shown by a mean score of 4.14 and a standard deviation of 1.198. It was also noted that respondents agreed that their hospitals considered on-the-job training as important for their employees to provide firsthand knowledge and experience in the workplace (mean = 3.93; Std. Dev = 0.844), brainstorming sessions help employees in problem solving as they undertake their tasks (mean = 3.84; Std. Dev = 0.800), hospitals encouraged collaboration opportunities among the employees (mean = 3.82; Std. Dev = 1.142) and collaboration opportunities 112 ensured that tasks in their hospitals were linked to achieve the set goals (mean = 3.62; Std. Dev = 1.246). On the other hand, it was established that respondents were indifferent on the fact that their hospitals encouraged brainstorming sessions as a means of enhancing service delivery (mean = 3.44; Std. Dev = 0.934) implying that while some hospitals encouraged brainstorming sessions others did not perceive it as important in improving service delivery. Results also suggested that despite the fact that the management acknowledged that brainstorming sessions helped employees in problem solving, some hospitals did not encourage such sessions. Similarly, respondents were indifferent on the fact that their hospitals provided employee with the on-the-job training programmes (mean = 3.44; Std. Dev = 1.115). This implies that although the management of faith-based hospitals in Nairobi metropolitan area considered on-the-job training programmes important in provide firsthand knowledge and experiences to employees, many did not have such programmes. Respondents were also indifferent on the fact that professional development classes allowed employees to perform better and prepares them for positions of greater responsibility (mean = 2.62; Std. Dev = 1.114). This alluded to the fact that possession of professional development course was not a major factor for consideration to such opportunities. The results concurred with the declaration of Botha (2013) who stated that intellectual wellness was positively associated with performance and therefore there is need to keep oneself informed on social, political, and economic factors, learning and scientific discoveries. Additionally, Rehman (2015) revealed that intellectual wellness of the students through mentoring programmes can help in developing coping mechanism, reduce stress and lower depression and cases of dementia. Besides, Wickramarathne, Phuoc and Albattat 113 (2020) concluded that intellectual wellness creates better attitudes and positive personality and that recognizing, adopting and practicing intellectual wellness in both the working places and education and learning institutes helped to creating a better society. 4.3.3 Occupational Wellness Programmes In this section, the study sought to determine the influence of employee’s occupational wellness programmes on service delivery in faith-based hospitals in Nairobi metropolitan area. Hence, respondents were requested to indicate their opinion on provided statements regarding employee’s occupational wellness programmes in their hospitals. The statements required responses on a five-point Likert scale where 1 represented strongly disagree, 2 represented disagree, 3 represented moderate, 4 represented agree and 5 represented strongly agree. Results were summarised in Table 4.6. Table 4.6: Descriptive Statistics on Employee’s Occupational Wellness Programmes N Min Max Mean Std. Dev. Our organization offer employees regular health risk 244 2 5 4.17 .866 assessments Health risk assessments engage employees' health and 244 1 5 3.97 1.122 promotes the prevention of diseases. Employee involvement in leadership decisions help 244 2 5 3.96 .862 them feel that their contribution is valued in the organization Our organization encourages regular breaks from work 244 1 5 3.92 1.134 to reduce fatigue 114 Our organization has a set of family-friendly policies to 244 1 5 3.91 1.016 enhance employee productivity In our organization employees are involved in 244 1 5 3.80 1.274 leadership decisions Family friendly policies help employees to maintain a 244 1 5 3.72 1.160 successful work-life balance Rewards for healthy behaviours encourages employees 244 1 5 3.65 1.168 to practice good relations with their colleagues Regular breaks give employees a chance to rest, 244 1 5 3.15 1.045 promote clearer thinking and greater productivity. In our organization rewards for healthy behaviours are 244 1 5 2.22 1.214 provided Aggregate 3.65 1.086 From the results in Table 4.6 it was observed that the aggregate mean score for employee’s occupational wellness programmes was 3.65 with an associated standard deviation of 1.086. These results indicate that there was general agreement among the respondents on the adoption of employee’s occupational wellness programmes among faith-based hospitals in Nairobi metropolitan area. The results thus postulated that the management of these hospitals generally considered occupational wellness as determinant of quality service delivery. However, the standard deviation of 1.086 of suggest that while some hospitals highly emphasised on occupational wellness as shown by a maximum of 5, others had low regard for the same as shown by a minimum of 1. 115 Particularly, the study noted that respondents agreed that to a great extent hospitals offered their employees regular health risk assessments (mean = 4.17; Std. Dev = 0.866), health risk assessments engage employees' health and promotes prevention of diseases (mean = 3.97; Std. Dev = 1.122), employee involvement in leadership decisions help them feel that their contribution is valued in the organization (mean = 3.96; Std. Dev = 0.862), faith-based hospitals encourage regular breaks from work to reduce fatigue (mean = 3.92; Std. Dev = 1.134), hospitals had a set of family-friendly policies to enhance employee productivity (mean = 3.91; Std. Dev = 1.016), employees were involved in leadership decisions (mean = 3.80; Std. Dev = 1.274), family friendly policies helped employees to maintain a successful work-life balance (mean = 3.72; Std. Dev = 1.160), and that rewards for healthy behaviours encouraged employees to practice good relations with their colleagues (mean = 3.65; Std. Dev = 1.168). On the other hand, respondents were indifferent on giving employees regular breaks to give employees a chance to rest, promote clearer thinking and greater productivity as shown by a mean score of 3.15 and a standard deviation of 1.045. This means that, although the management of faith-based hospitals encouraged regular breaks from work to reduce fatigue, they rarely gave employees break during their working hours leaving employees with the options of taking off days and annual leave to rest. Moreover, respondents disagreed that faith-based hospitals provided rewards for healthy behaviours as indicated by a mean score of 2.22 and a standard deviation of 1.214. This means that in most of the faith-based hospitals there is no recognition for healthy behaviours. Results posted on this variable were in line with the postulates of Ng’eno (2020) who noted that workplace hazards, safety concerns, work environment and stress negatively affect occupational wellness and outcomes at both individual and organizational level. 116 Additionally, Ungerleider et al. (2017) concluded that occupation wellness and strategies improve the quality of life, experiences and result in better performance and service delivery by healthcare providers. Furthermore, Bhattacharyya and Chakrabarti (2016) concluded that occupational wellness operationalised through stress level, volume of work, body pains, work schedules and timelines and work design impacted workers productivity. 4.3.4 Physical Wellness Programmes In this section, the study sought to determine the influence of employee’s physical wellness programmes on service delivery in faith-based hospitals in Nairobi metropolitan area. Henceforth, respondents were requested to express their level of agreement with statements provided regarding employee’s physical wellness programmes in their hospitals. The statements required responses on a five-point Likert scale where 1 represented strongly disagree, 2 represented disagree, 3 represented moderate, 4 represented agree and 5 represented strongly agree. Results were summarised in Table 4.7. Table 4.7: Descriptive Statistics on Physical Wellness Programmes N Min Max Mean Std. Dev. Our organization encourages physical exercise among the 244 1 5 4.65 1.274 employees to remain fit Fitness challenges helps in ensuring that employees are 244 1 5 4.54 .937 physically fit Our organization organize fitness challenges to help 244 1 5 3.91 1.009 employee compete for a prize Our organization encourages staff walking and use of stairs 244 1 5 3.85 1.326 117 Walking and use of stairs helps in ensuring that the 244 1 5 3.58 1.181 employees are physically fit. Our organization provides sporting activities like football 244 1 5 3.55 1.208 matches and races. Physical exercise helps the employees to refresh their minds 244 1 5 3.46 1.082 so that they can perform their tasks better. Our organization has partnered with health clubs to help 244 1 5 3.42 1.178 employees gain healthy living tips. Partnering with health clubs shows that our organization 244 1 5 3.25 1.084 promotes healthy behaviours. Aggregate 3.80 1.142 Results in Table 4.7 demonstrated that there was agreement among the respondents on the existence of employees’ physical wellness programmes among the faith-based hospitals in Nairobi metropolitan area as indicated by a mean score of 3.80. This observation suggested that the management in faith-based hospitals valued employee’s physical fitness as a means of delivering quality services to their customers. However, there were discrepancies in emphasis on physical wellness programmes in the faith-based hospitals as shown by a standard deviation of 1.142. This is further illustrated by the minimum of 1 and a maximum of 5 on the statements presented. On individual statements, the study noted that majority of the respondents strongly agreed that most faith-based hospitals encouraged physical exercise among the employees to remain fit (mean = 4.65; Std. Dev = 1.274) and that fitness challenges helps in ensuring that employees are physically fit (mean = 4.54; Std. Dev = 0.937). Likewise, most 118 respondents agreed that faith-based hospitals organize fitness challenges to help employee compete for a prize (mean = 3.91; Std. Dev = 1.009), faith-based hospitals encouraged staff to walk and use of stairs (mean = 3.85; Std. Dev = 1.326), walking and use of stairs helps in ensuring that the employees are physically fit (mean = 3.58; Std. Dev = 1.181) and faith- based hospitals provided sporting activities like football matches and races (mean = 3.55; Std. Dev = 1.208). However, majority of the respondents were indifferent on the fact that physical exercise helps employees to refresh their minds so that they can perform their tasks better (mean = 3.46; Std. Dev = 1.082) suggesting that while some believed that physical exercise helps employees to refresh their minds other had a contrary opinion. Besides, respondents were indifferent on the fact that their hospital had partnered with health clubs to help employees gain healthy living tips (mean = 3.42; Std. Dev = 1.178). This implies that while some hospitals had partnered with health clubs for their staff to do physical exercise in their clubs, some especially, those that had not emphasised on physical fitness had no such partnerships. Moreover, respondents were also indifferent on the management believe that partnering with health clubs showed their commitment to promotes healthy behaviours (mean = 3.25; Std. Dev = 1.084) since most hospitals had partnered with any health club. The findings on this variable corresponded with the postulates of Thomas (2022) that physical wellness focuses on proper care for the body so as to be able to functional optimally. Accordingly, physical wellness can be achieved through proper nutrition, frequent and moderate physical exercises and getting sufficient rest. The findings also match those of Otenyo and Smith (2017) who alluded that physical fitness is associated with better performance outcomes. Furthermore, Mthombeni et al. (2020) concluded that physical fitness reduced health risk factors such as high blood pressure, obesity, high blood 119 glucose level, abnormal total cholesterol level and high waist circumference. Mwangi and Rintaugu (2017) also observe that lack of physical exercises significantly contributed to high blood pressure and resting heart rate which affected performance of staff members in public universities in Kenya. 4.3.5 Credible Leadership The study also sought to determine the moderating role of credible leadership on the relationship between employee wellness programmes and service delivery in faith-based hospitals in Nairobi metropolitan. The study thus aimed to determine the extent to which the management of the company was credible. To do so, respondents were presented a number of on credible leadership and were required to express their opinion on the credibility of their management on a five-point Likert scale where 1 represented strongly disagree, 2 represented disagree, 3 represented moderate, 4 represented agree and 5 represented strongly agree. Results were summarised in Table 4.8. Table 4.8: Descriptive Statistics on Credible Leadership N Min Max Mean Std. Dev. Our leaders encourage team work 244 2 5 3.79 0.771 Our organizational leaders are problem solvers 244 1 5 3.58 1.073 The leadership in our hospital considered honest 244 1 5 3.48 1.079 Our leaders inspire employees to offer best services 244 1 5 3.31 1.019 Our organizational leaders are forward-looking 244 1 5 3.18 1.027 Our organization has competent leaders 244 1 5 2.91 1.170 120 Our organizational leaders are accountable 244 1 5 2.85 1.084 Our organizational leaders are role models 244 1 5 2.72 1.143 Aggregate 3.23 1.046 The results in table 4.8 suggest that majority of the respondents believed that their leaders had moderate credibility as shown by a mean score of 3.23. This implies that respondents had moderate faith on the leadership of faith-based hospitals in Nairobi metropolitan However, the study also noted that there were disparities in the opinion of the respondents in regard to credibility of their leaders (standard deviation = 1.046) where some believed that their leaders had high levels of credibility as shown by a maximum of 5 while others believed that their leaders had very little credibility as shown by a minimum of 1. Separately, the study observed that respondents agreed that leaders in faith-based hospitals encouraged team work (mean = 3.79; Std. Dev = 0.771) and that leaders in faith-based hospitals are problem solvers (mean = 3.58; Std. Dev = 1.073). On the other and, respondents indicated that their leaders moderately inspired employees to offer best services (mean = 3.31; Std. Dev = 1.019), were forward-looking (mean = 3.18; Std. Dev = 1.027), were competent (mean = 2.91; Std. Dev = 1.170), were accountable (mean = 2.85; Std. Dev = 1.084) and that their leaders were role models (mean = 2.72; Std. Dev = 1.143). This suggests that leaders in faith-based hospitals had low levels of inspiration, forward- looking, competence, accountability and acting as role models. Wahida (2016) observed that organizational leadership was key in helping the firm to improve services delivery to the public. Additionally, Koehler (2018) showed that increased political responsibility in policy formulation influences access to quality water 121 for the people in both poor and rich neighbourhoods. Kimutai and Aluvi (2018) concluded that leader’s accountability and citizen participation in policy formulation improved service delivery in Kisumu County. Besides, Wagana (2017) postulated that credible leadership is key to quality and accessible services to the general public. 4.3.6 Service Delivery The sixth variable in the study was service delivery. In this section the study sought to determine the respondent’s level of agreement on some statements on service delivery in faith-based hospitals in Nairobi metropolitan area. The statements required responses on a five-point Likert scale where 1 represented strongly disagree, 2 represented disagree, 3 represented moderate, 4 represented agree and 5 represented strongly agree. Results were summarised in Table 4.9. Table 4.9: Descriptive Statistics on Service Delivery N Min Max Mean Std. Dev. Our medical staff demonstrate confidence at all times. 244 2 5 4.25 .912 We always ensure that we are consistent in delivery of 244 1 5 4.16 1.025 services. We create a personal relationship with our customers. 244 1 5 3.95 .901 Our medical staff are encouraged to convey hope to 244 2 5 3.65 .869 our patients. We have enough staff so that customers get services 244 1 5 3.41 1.025 quickly. 122 Our patients are able to consult our staff on phone for 244 1 5 3.39 .986 review. There has been an increase in accessibility of services. 244 1 5 3.20 1.096 There has been increase in customer satisfaction 244 1 5 3.09 1.254 We always have short queues in our facilities. 244 1 5 2.73 .871 Customers always come back because they are 244 1 5 2.61 1.162 satisfied with our services. Aggregate 3.55 0.910 The results in Table 4.9 showed that respondents agreed that there was quality service delivery in faith-based hospitals in Nairobi metropolitan as shown by a mean score of 3.55. However, there were dispersions in the responses as shown by a standard deviation of 0.910. This is further depicted by a maximum of 5 and a minimum of 1. Therefore, while some hospitals had extemporary service delivery, others had low levels of service delivery. On individual statements, the study established that there was agreement among respondents that medical staff in faith-based hospitals demonstrated confidence at all times (mean = 4.25; Std. Dev = 0.912), there was increased customer satisfaction (mean = 4.15; Std. Dev = 0.254), there was consistency in service delivery (mean = 4.16; Std. Dev = 1.025), faith-based hospitals created a personal relationship with their customers (mean = 3.95; Std. Dev = 0.901) and that medical staff were encouraged to convey hope to patients (mean = 3.65; Std. Dev = 0.869). Conversely, it was established that to a moderate extent, faith-based hospitals in Nairobi metropolitan area had enough staff so that customers get services quickly (mean = 3.41; 123 Std. Dev = 1.025), customers always come back because they are satisfied with services offered (mean = 3.39; Std. Dev = 0.986), there has been an increase in accessibility of services (mean = 3.20; Std. Dev = 1.096) and that there are short queues in faith-based hospitals (mean = 2.73; Std. Dev = 0.871). Furthermore, respondents stated that to a moderate extent patients are able to consult hospital staff on phone for review (mean = 2.61; Std. Dev = 1.162). this suggest that while some hospitals were open to review on phone, perhaps for critical cases and palliative care, others were unavailable and patients had to present themselves to the hospital. 4.4 Diagnostic Tests The study conducted diagnostic tests to test the assumptions of linear regression analysis. Specifically, the study tested for autocorrelation, multicollinearity, normality linearity and heteroskedasticity test. The results were as follows. 4.4.1 Autocorrelation Test The study sought to determine whether the residual values are independent of one another over time. Existence of autocorrelation is problematic because it means that the study observations are not independent of each other thus affecting regression results. To do so the Durbin-Watson test was used. The decision on existence of autocorrelation was based on d-value where a d-value of less than 2 indicates absence of autocorrelation while a d- value more than 2 indicates that the data has autocorrelation. Durbin-Watson test results were summarised in Table 4.10. 124 Table 4.10: Durbin-Watson Test Results Model R R Square Adjusted R Std. Error of the Durbin-Watson Square Estimate 1 .703a .494 .492 .518 1.915 a. Predictors: (Constant), Wellness Programmes b. Dependent Variable: Service Delivery The results in Table 4.10 showed that the Durbin-Watson test statistic(d) was 1.915. According to Cooper and Schindler (2013), If the d value is less than 2, it indicates that there is no autocorrelation. Since the d<2 it was concluded that there is no form autocorrelation. 4.4.2 Multicollinearity Test The study sought to determine if the independent variables were inter-correlated. Existence of multicollinearity raises the standard errors of the coefficients, making some variables statistically insignificant despite the fact that they should be. Multicollinearity in the study which was tested using VIF. The decision on the presence of multicollinearity was based on the value of the VIF. If the VIF value was less than 5, it indicates absence of multicollinearity. Results were summarised in Table 4.11. 125 Table 4.11: Multicollinearity Results Collinearity Statistics Tolerance VIF (Constant) Emotional Wellness .883 1.132 Intellectual Wellness .570 1.754 Occupational Wellness .440 2.272 Physical Wellness .462 2.164 a. Dependent Variable: Service Delivery The results in Table 4.11 showed that emotional wellness had a tolerance value of 0.883 and a VIF value of 1.132, intellectual wellness had a tolerance value of 0.570 and a VIF value of 1.754, occupational wellness had a tolerance value of 0.440 and a VIF value of 2.272 while emotional wellness had a tolerance value of 0.462 and a VIF value of 2.164. based on the recommendations of Shrestha (2020), if VIF value is less than 5, it indicates absence of multicollinearity. Thus, since all the independent variables had a VIF value is less than 5, it was concluded that there was no multicollinearity. 4.4.3 Test for Normality The study sought to determine if the data obtained follows a normal distribution. Regression analysis assumes that data is obtained from a normal distribution. Lack of normality in the data means that there may be extreme outliers which may affect the significance of study coefficients. To test for normality of the data the Shapiro-Wilk test was conducted following the recommendations of Khatun (2021) that if the P-value for test statistic was greater than 0.05, then the variable is normally distributed. The normality test result was summarised in Table 4.12. 126 Table 4.12: Normality Test Result Variable Shapiro-Wilk Decision Statistic df Sig. Emotional Wellness programmes .940 244 .103 Normal Intellectual Wellness programmes .905 244 .173 Normal Occupational Wellness programmes .917 244 .219 Normal Physical Wellness programmes .973 244 .084 Normal Credible Leadership .959 244 .097 Normal Service Delivery .957 244 .132 Normal a. Lilliefors Significance Correction From the results in Table 4.12 showed that the Shapiro-Wilk test statistic for emotional wellness programmes was 0.940 with a P-value of 0.103, intellectual wellness programmes had a statistic of 0.905 and a P-value of 0.173, occupational wellness programmes had a statistic of 0.917 and a P-value of 0.219, physical wellness programmes had a statistic of 0.973 and a P-value of 0.084, credible leadership programmes had a statistic of 0.959 and a P-value of 0.097 while service delivery had a statistic of 0.957 and a P-value of 0.132. According to Khatun (2021), if the P-value for test statistic is greater than 0.05, then the variable is normally distributed. Since all the P-values for all variables were more than 0.05, the study concluded that the data was normally distributed. 4.4.4 Linearity Test The study sought to determine if a linear relationship existed between the dependent variable (service delivery) and the independent variables (emotional wellness programmes, intellectual wellness programmes, occupational wellness programmes and physical wellness programmes) and the moderating variable (credible leadership). Correlation 127 analysis results were used to determine if a relationship exists. Linearity enables the regression model to effectively predict future values of the dependent variable given values of the independent variable. The results were as shown in table 4.13. Table 4.13: Linearity Test Results Service Emotional Intellectual Occupational Physical Credible Delivery Wellness Wellness Wellness Wellness Leadership Service Pearson 1 Delivery Correlation Sig. (2-tailed) N 244 Emotional Pearson .324** 1 Wellness Correlation Sig. (2-tailed) .000 N 244 244 Intellectual Pearson .519** .140* 1 Wellness Correlation Sig. (2-tailed) .000 .029 N 244 244 244 Occupational Pearson .666** .247** .602** 1 Wellness Correlation Sig. (2-tailed) .000 .000 .000 N 244 244 244 244 Physical Pearson .539** -.001 .593** .673** 1 Wellness Correlation Sig. (2-tailed) .000 .984 .000 .000 N 244 244 244 244 244 Credible Pearson .663** .358** .560** .616** .536** 1 Leadership Correlation Sig. (2-tailed) .000 .000 .000 .000 .000 N 244 244 244 244 244 244 **. Correlation is significant at the 0.01 level (2-tailed). *. Correlation is significant at the 0.05 level (2-tailed). The results in table 4.13 showed that a positive relationship exist between service delivery and emotional wellness programmes (r= 0.324), service delivery and intellectual wellness 128 programmes (r= 0.519), service delivery and occupational wellness programmes (r= 0.666), service delivery and physical wellness programmes (r= 0.539) and service delivery and credible leadership (r= 0.663). It was observed that the correlation coefficient between service delivery and all other variables was greater than zero (0) indicating that a positive linear relationship existed between the variables. 4.4.5 Heteroskedasticity Test Results The study sought to determine if the variance of the response variable error term is constant across the data. Heteroscedasticity occurs when the variance of errors fluctuates based on the values of the independent variables. Existence of heteroscedasticity lowers the precision of regression results causing the estimated coefficients to be far away from the actual population values. To test for existence of heteroscedasticity, the study used the Breusch- Pagan test. The decision on existence heteroscedasticity was based on the P-value. Where the P-value was greater than 0.05, it was concluded that there is no heteroscedasticity. Results were as summarised in Table 4.14. Table 4.14: Heteroskedasticity Test Results LM Sig BP 5.103 .468 Koenker 7.492 .135 From the results in Table 4.14 it was determined that the test statistic for Breusch-Pagan test was 5.103 with an associated significance level of 0.468. since the P-value was greater than 0.05, the study concluded that there was no heteroscedasticity. 129 4.5 Correlation Analysis In this section the study sought to determine the direction and strength of the relationship existing between the study variables. To do so the Pearson’s product moment correlation analysis was used. the strength of the relationship was based on Dancey and Reidy (2004) criterion where a correlation coefficient of 0 indicated that there was no correlation, a correlation of 1 indicated a perfect correlation, a coefficient of 0.7 to 0.9 indicated that there is a strong correlation, 0.4 to 0.6 indicated a moderate correlation while 0.1 to 0.3 indicated a weak correlation. The decision on the significance of the relationship was based on P- values at 0.05 significance level. The results were summarised in table 4.15. Table 4.15: Correlation Analysis Results Service Emotional Intellectual Occupational Physical Credible Delivery Wellness Wellness Wellness Wellness Leadership Service Delivery Pearson 1 Correlation Sig. (2-tailed) N 244 Emotional WellnessP earson .324** 1 Correlation Sig. (2-tailed) .000 N 244 244 Intellectual Pearson .519** .140* 1 Wellness Correlation Sig. (2-tailed) .000 .029 N 244 244 244 Occupational Pearson .666** .247** .602** 1 Wellness Correlation Sig. (2-tailed) .000 .000 .000 N 244 244 244 244 Physical Wellness Pearson .539** -.001 .593** .673** 1 Correlation Sig. (2-tailed) .000 .984 .000 .000 N 244 244 244 244 244 Credible Pearson .663** .358** .560** .616** .536** 1 Leadership Correlation Sig. (2-tailed) .000 .000 .000 .000 .000 N 244 244 244 244 244 244 **. Correlation is significant at the 0.01 level (2-tailed). *. Correlation is significant at the 0.05 level (2-tailed). 130 It is observed from the results in table 4.15 that a significant weak positive correlation existed between service delivery and emotional wellness programmes (r=0.324; p=0.000<0.05), a significant moderate positive correlation existed between service delivery and intellectual wellness programmes (r=0.519; p=0.000<0.05), a significant moderate positive correlation existed between service delivery and occupational wellness programmes (r=0.666; p=0.000<0.05), a significant moderate positive correlation existed between service delivery and physical wellness programmes (r=0.539; p=0.000<0.05) and a significant moderate positive correlation existed between service delivery and credible leadership (r=0.663; p=0.000<0.05). These results correlated those of Awada and Ismail (2019) who noted that emotional wellness positively affected employee performance. Similarly, Baloglu, Busser and Cain (2019) alluded that emotionally healthy workforce is able to deliver on the organizational mandate and its objectives. Further, Syed et al, (2017) concluded that intellectual wellness significantly influenced performance of teachers in both the public and private medical universities. On their part, Mafumbate (2017) concluded that intellectual wellness significantly affected academic performance of orphaned children in Zimbabwe. Elsewhere, Ng’eno (2020) noted that workplace hazards, safety concerns, work environment and stress negatively affect occupational wellness and outcome at both individual and organizational level. Additionally, Ungerleider et al (2017) concluded that occupation wellness improves the quality of life and result in better performance and service delivery by healthcare providers. 131 4.6 Hypothesis Testing The study sought to investigate the influence of employee wellness programmes and credible leadership on service delivery in faith-based hospitals in Nairobi metropolitan area. To do the study tested the following hypotheses: H01: Employee emotional wellness programmes have no significant influence on service delivery in faith-based hospitals in Nairobi metropolitan. H02: Employees intellectual wellness programmes have no significant influence on service delivery in faith-based hospitals in Nairobi metropolitan. H03: Employees occupational wellness programmes have no significant influence on service delivery in faith-based hospitals in Nairobi metropolitan. H04: Employees physical wellness programmes have no significant influence on service delivery in faith-based hospitals in Nairobi metropolitan. H05: Credible leadership has no significant moderating influence on the relationship between employee wellness programmes and service delivery in faith-based hospitals in Nairobi metropolitan. To test the hypotheses, the study conducted linear regression analysis and the results used to determine the significance of the independent variables in influencing service delivery. The predictive power of the model was determined using the coefficient of determination (R2), the fitness of the model was based on the significance of the F-statistic in the Analysis of Variance (ANOVA) at 5% significance level while the significance of the influence was based on P-values at 95% confidence level. 132 4.6.1 Test of Hypothesis One The first objective of the study was to assess the influence of employee’s emotional wellness programmes on service delivery in faith-based hospitals in Nairobi metropolitan. The associated null hypothesis was that employee emotional wellness programmes have no significant influence on service delivery in faith-based hospitals in Nairobi metropolitan. To test the hypothesis, service delivery was regressed on employee emotional wellness programmes and the model summary results were as shown in Table 4.16. Table 4.16: Model Summary Results for Emotional Wellness Programmes Std. Error of the Model R R Square Adjusted R Square Estimate 1 .324a .105 .101 .689 a. Predictors: (Constant), Emotional Wellness Results in Table 4.16 indicated that correlation coefficient (r) was 0.324 suggesting that there exists a weak positive relationship between service delivery and employee emotional wellness programmes. This implies that although there exists a positive relationship between the two variables, employee emotional wellness programmes have a low effect on service delivery in faith-based hospitals in Nairobi metropolitan area. This is further indicated by the adjusted R square (R2) of 0.101 meaning that emotional wellness programmes only predicted 10.1% of all variations in service delivery in the faith-based hospitals and the other 89.9% was influenced by other factors. To this extent there is need for the management of faith-based hospitals to invest more in the emotional wellbeing of their employees. 133 To determine the fitness of the model as constructed in predicting service delivery in the faith-based hospitals the study conducted the analysis of variance and the results were as shown in table 4.17. Table 4.17: ANOVAa for Emotional Wellness Programmes Model Sum of Squares df Mean Square F Sig. 1 Regression 13.447 1 13.447 28.341 .000b Residual 114.818 242 .474 Total 128.265 243 a. Dependent Variable: Service Delivery b. Predictors: (Constant), Emotional Wellness The study established that the F-statistic for the model was 28.341 which was less that the F-critical (for df 1, 242= 28.341>3.880). This indicated that the model was significant. Further, the study established that the P-value for the F-statistic 0.000<0.05 confirming that the model was significant. To determine the significance of emotional wellness programmes in influencing service delivery, the study conducted the student t-test and the results were as summarised in Table 4.18. 134 Table 4.18: Coefficient Results for Emotional Wellness Programmes Unstandardized Standardized Coefficients Coefficients Model B Std. Error Beta t Sig. 1 (Constant) 1.637 .343 4.776 .000 Emotional Wellness .582 .109 .324 5.324 .000 a. Dependent Variable: Service Delivery Results in Table 4.18 indicated that the model constant was 1.637 indicting that in the absence on emotional wellness programmes, service delivery in faith-based hospitals in Nairobi metropolitan area would be 1.637. This relationship was however significant (t= 4.776; P=0.000<0.05). additionally, the standardized beta coefficient of emotional wellness programmes was 0.324 indicating that holding all other factors constant, a unit increase in emotional wellness programmes would increase service delivery in faith-based hospitals in Nairobi metropolitan area by 32.4%. This relationship was also found to be significant (t= 5.324>0.525; P=0.000<0.05). Thus, it was established that emotional wellness programmes had a significant influence on service delivery in faith-based hospitals in Nairobi metropolitan. These results were consistent with the qualitative data obtained from the open-ended questions. Most respondents indicated that emotional wellness programmes influenced service delivery in the hospitals. In their explanations, it was established that the emotional health of workers gave them peace of mind which enabled them to perform their duties better. One respondent had this to say: 135 “When I am emotionally stable, I am able to work better because I am able to concentrate on my work. Besides when I am emotionally okay, I am able to think through to find solution to the problem at hand as opposed to when I am stressed.” Another respondent stated that when they are emotionally well, they are in a better mood to do their job. This is what they stated: “When I am emotionally well, I have less mood swings which enables me to work better with my colleagues which facilitates good work flow.” It was established that when employees are emotionally stable, they are likely to assist others. One respondent had this to say: “Sometimes, stress make people angry and mentally disturbed to the extent that they want to be left alone and they don’t want to assist others. I have also observed that when people are emotionally unstable, they contribute less in meetings.” Another respondent stated that when employees are not mentally stable, they tend to absent themselves from work and have suicidal intentions which negatively affects service delivery. In addition, the study established that emotional related illnesses lead to drug and substance abuse and poor performance of the employees. These results were consistent with the descriptive results which showed that emotional wellness programmes were moderately implemented in the in faith-based hospitals in Nairobi metropolitan area which suggest that although emotional wellness programmes such as stress management programmes, mental health programmes, support services, mindfulness training and regular inspiration are considered important in employees performance, faith-based hospitals in Nairobi metropolitan did not put a lot of efforts to 136 emphasize on deployment of such programmes leading to stress and drug abuse among hospital employees such as medical staff as reported by KMA (2021) and NACADA (2022). The results also correlated with correlation analysis results which indicated that emotional wellness programmes had a weak positive correlation with service delivery suggesting that although there is a positive relationship between emotional wellness programmes and service delivery, emotional wellness programmes only contributed dismally to service delivery in these hospitals. The results obtained on this variable were similar to those of Ombasyi (2019) who concluded that emotional wellness as reflected through psychological wellbeing, stress free work environment and mental health as a positive influence on employee performance in Kenya’s brand design and development firms. Similarly, Baloglu, Busser and Cain (2019) alluded that emotionally healthy workforce is able to deliver on the organizational mandate and its objectives. Additionally, Awada and Ismail (2019) concluded that emotional wellness at work place carters for social, mental and psychological wellbeing of staffs. Besides, the study findings were in line with the conclusion reached by Goopy et al. (2020) that emotional wellness affected the performance of employees at the Joanna Briggs Institute. In addition, the study findings supported the postulates of Behavioural Decision-Making Theory developed by Ward (1954) which suggested that people make decisions and choices based on the prevailing conditions. As a result, employee wellness programmes help in creating a conducive workplace, engage employees and ensure they fit to handle their tasks and work responsibilities. Therefore, there is need to structure wellness programmes that impact on wellbeing of the employees that result in improved productivity (Stingl & Geraldi, 2017). The findings also support the tenets of Maslow’s hierarchy of needs theory 137 formulated by Maslow (1943) which states that individuals should first meet their basic needs before they are motivated to satisfy the higher-level needs. Consequently, if the basic needs are not met, employees’ behaviour was geared towards the satisfaction of these basic needs. In the second level of needs, employees are concerned about their safety and security needs expressed through a desire for safety in one’s job, health and family, if the need are not met, employees develop fears and anxieties leading to low productivity. 4.6.2 Test of Hypothesis Two The second objective of the study was to investigate the influence of employee’s intellectual wellness programmes on service delivery in faith-based hospitals in Nairobi metropolitan. To achieve the objective, the study tested the null hypothesis that employee’s intellectual wellness programmes have no significant influence on service delivery in faith- based hospitals in Nairobi metropolitan. To test the hypothesis, service delivery was regressed on employee intellectual wellness programmes and the model summary results were as shown in Table 4.19. Table 4.19: Model Summary Results for Intellectual Wellness Programmes Std. Error of the Model R R Square Adjusted R Square Estimate 1 .519a .270 .267 .622 a. Predictors: (Constant), Intellectual Wellness The results in Table 4.19 indicated that the corelation coefficient between service delivery and employee intellectual wellness programmes was 0.519 indicating that there was a moderate positive relationship between the two variables. The results also showed that the adjusted R square was 0.267 indicating that employee intellectual wellness programmes predicted 26.7% of service delivery in faith-based hospitals in Nairobi metropolitan area. 138 The results thus suggest that there are other variables contributing to service delivery in faith-based hospitals accounting for 73.3%. To determine the fitness of the model in predicting service delivery, the study conducted the Analysis of Variance (ANOVA) test. the results were as shown in table 4.20. Table 4.20: ANOVA Results for Intellectual Wellness Programmes Model Sum of Squares df Mean Square F Sig. 1 Regression 34.599 1 34.599 89.391 .000b Residual 93.666 242 .387 Total 128.265 243 a. Dependent Variable: Service Delivery b. Predictors: (Constant), Intellectual Wellness Results in table 4.20 indicated that the F-statistic for the model was 89.391>3.880. Additionally, the study established that the P-value for the model statistic was 0.000<0.05. based on these results, the study concluded that the model was significant in predicting service delivery. To determine the significance of employee intellectual wellness programmes in predicting service delivery in faith-based hospitals in Nairobi metropolitan, the study conducted the student t-test and the results were as summarised in Table 4.21. 139 Table 4.21: Coefficients Results for Intellectual Wellness Programmes Unstandardized Standardized Coefficients Coefficients Model B Std. Error Beta t Sig. 1 (Constant) .593 .304 1.948 .003 Intellectual Wellness .795 .084 .519 9.455 .000 a. Dependent Variable: Service Delivery The results in Table 4.21 indicated that the model constant was 0.593 indicating that holding employee intellectual wellness programmes constant at zero, service delivery in faith-based hospitals in Nairobi metropolitan area would be equal to 0.593. This relationship was found to be constant (P= 0.003<0.05). The results further showed that the standardized coefficient for employee intellectual wellness programmes was 0.519 indicating that, holding all other factors constant a unit increase in employee intellectual wellness programmes would increase service delivery in faith-based hospitals in Nairobi metropolitan area by 51.9%. The study also observed that the t-static for employee intellectual wellness programmes was 9.455>0.525 while the P-value for the variable was 0.000<0.05. It was therefore established that employee intellectual wellness programmes were significant in predicting service delivery in faith-based hospitals in Nairobi metropolitan area. The results were consistent with qualitative data. Most respondents indicated that intellectual wellness influence service delivery in their hospital. In their explanation, it was determined that being allowed time to enhance their skills enables them to perform better. A respondent stated that: 140 “When employees are allowed to pursue higher education, they gain better skills which enable them to discharge their duties better.” Another respondent stated that possession of professional skills makes employees make better decisions at work. Further the study established that having the right skills for the job gives employees some level of security in the job. “When you have the minimum qualifications for the position you hold it is unlikely that you would be removed from the job because you have the qualifications and you are able to do your job well.” The study further established that providing relevant training to employees enable them to do their work better. “The seminars and workshops attended impact relevant skills on the emerging issues especially on new drugs and equipment to diagnose diseases which helps to provide better services. Personally, I am a beneficially of the trainings offered.” Anter respondent stated that: “I think intellectual wellness is important because it promotes proactive thinking which is necessary for decision making.” To enhance service delivery, most respondents supported that employees should be willing to seek further training and the management to facilitate more training by paying for seminars and organizing workshops. The obtained results were consistent with descriptive results which indicated that to a great extent employees agreed there were employee’s intellectual wellness programmes in their 141 hospitals. Accordingly, it was determined that the management of these hospitals considered employee intellectual wellness as a critical variable in offering quality services. The results on this variable were also consistent with correlation results which indicated that a moderate positive correlation existed between employee’s intellectual wellness programmes and service delivery in faith-based hospitals in Nairobi metropolitan. Moreso, the results on tis variable were consistent with existing empirical literature which showed that intellectual wellness was positively associated with performance (Botha, 2013). Further, Wickramarathne et al. (2020) concluded that intellectual wellness creates better attitudes and positive personality and that recognizing, adopting and practicing intellectual wellness in both the working places and education and learning institutes helped to creating a better society. Furthermore, Mafumbate (2017) found that compromised, inconsistent and inadequate support structure had negative effects to their intellectual wellness and academic performance supporting the fact that intellectual wellness affects productivity. The findings also support the postulated of the theoretical framework anchoring the study. Specifically, the results of the study supported the tenets of Social Exchange Theory developed by Homans (1958) which states that human actions are based on cost-benefit analysis. Accordingly, the way an organization treats its employees is reciprocated in their actions. Thus, when a company treats their employees well expects that the employees will indeed reciprocate the firm’s good actions (Cook et al., 2013). Thus, a company that offers opportunities for its employees in form of professional development classes, on the job training, brainstorming sessions, collaboration opportunities and encouraging creative and innovative thinking expects that their employees was more productive and offer quality services. 142 4.6.3 Test of Hypothesis Three The third objective of the study was to examine the influence of employee’s occupational wellness programmes on service delivery in faith-based hospitals in Nairobi metropolitan area. The associated null hypothesis was that: Employees occupational wellness programmes have no significant influence on service delivery in faith-based hospitals in Nairobi metropolitan. To test the hypothesis, service delivery was regressed on employee occupational wellness programmes and the model summary results were as show in Table 4.22. Table 4.22: Model Summary Results for Occupational Wellness Programmes Std. Error of the Model R R Square Adjusted R Square Estimate 1 .666a .444 .442 .543 a. Predictors: (Constant), Occupational Wellness The results in table 4.22 showed that the correlation coefficient (R) between service delivery and employee occupational wellness programmes was 0.666 indicating that a moderate correlation existed between the two variables. Additionally, the study established that the adjusted R square (R2) was 0.442 suggesting that employee occupational wellness contributed 44.2% of all the variations in service delivery in faith-based hospitals in Nairobi metropolitan area. This implies that the remainder of 55.8% of variations in service delivery of faith-based hospitals was predicted by other factors other than employee occupational wellness programmes. The study also sought to determine the fitness of the model in predicting service delivery in faith-based hospitals in Nairobi metropolitan. To achieve this goal the study conducted the Analysis of Variance test and the results were as summarised in Table 4.23. 143 Table 4.23: ANOVA Results for Occupational Wellness Programmes Model Sum of Squares df Mean Square F Sig. 1 Regression 56.953 1 56.953 193.272 .000b Residual 71.312 242 .295 Total 128.265 243 a. Dependent Variable: Service Delivery b. Predictors: (Constant), Occupational Wellness From the results in Table 4.23, it was established that the F-statistic for the model was 193.272 which was greater than the F-critical value of 3.880. It was also established that the P-value for the F-statistic was 0.000<0.05. The study therefore determined that the model was significant in predicting service delivery in faith-based hospitals in Nairobi metropolitan. The study further sought to determine if employee occupational wellness programmes were significant in influencing service delivery in faith-based hospitals in Nairobi metropolitan area. The study conducted student t-test and the coefficient results were summarised in Table 4.24. Table 4.24: Coefficient Results for Occupational Wellness Programmes Unstandardized Standardized Coefficients Coefficients Model B Std. Error Beta t Sig. 1 (Constant) .243 .268 .910 .004 Occupational Wellness 1.011 .073 .666 13.902 .000 a. Dependent Variable: Service Delivery 144 The results in Table 4.24 indicated that the coefficient of model constant was 0.243 suggesting that holding employee occupational wellness programmes constant at zero, service delivery in faith-based hospitals in Nairobi metropolitan would be 0.243. the coefficient was however in significant since t=0.910 > 0.525 and P=0.004<0.05. The results also showed that the standardized coefficient of employee occupational wellness programmes was 0.666 indicating that holding all other variables constant, an increase in employee occupational wellness programmes by one unit would increase service delivery in faith-based hospitals in Nairobi metropolitan by 66.6%. This relationship was also significant since the t statistic was equal to 13.902> 0.525 and P=0.00<0.05. based on these results, it was determined that employee occupational wellness programmes significantly influenced service delivery in faith-based hospitals in Nairobi metropolitan. The qualitative data obtained supported the assertions made on the variable. It was established that most respondents agreed that occupational wellness influenced service delivery in their hospitals. In their explanation, most respondents indicated that work conditions influenced their service delivery. One respondent indicated that: “Working for very long hours makes one very tired and you cannot do your work effectively.” Another respondent indicated that: “Medical staff should not work for many hours because when they get fatigued, they can misdiagnose patients.” “Employees should be aware of their health status so that they are able to work effectively. Employees should be screened regularly to detect diseases in advance.” 145 The study also established that organizational policies should be favourable so that employees can be able to offer quality services. “Hospitals should have favourable policies that should allow flexible times for employees which enables them to have enough rest” The results reported on this variable also tarried with the descriptive results which showed that the aggregate mean score for employee’s occupational wellness programmes was 3.65 indicating that respondents agreed to the fact that employee’s occupational wellness programmes were implement in the hospitals. However, the adoption of occupational wellness programmes leads to moderate improvement in service delivery as shown by the descriptive results in service delivery (mean =3.55). Corelation analysis results also showed that a significant moderate correlation existed between service delivery and occupational wellness programmes (r=0.666; p=0.000<0.05). The results obtained also corroborated with the existing empirical literature which indicated that workplace hazards, safety concerns, work environment and stress negatively affect occupational wellness and outcome at both individual and organizational level (Ng’eno, 2020). Additionally, the findings in the study agreed with conclusion by Ungerleider et al. (2017) that strategies such a balancing volume of work per employee, creating a conducive working space and engaging professional help in counselling, mentoring and coaching improved employees’ productivity. Besides, Bhattacharyya and Chakrabarti (2016) concluded that occupational wellness for workers impacted productivity levels at the firm. The results also supported the theoretical anchorage of the study. Precisely, the study findings supported the doctrines of social exchange theory developed by Homans (1958) who suggested that employee’s performance is a function of how the company treats them. 146 Accordingly, employees make decisions based on a trade-off balance between the benefits they are likely to realise visa vee the cost (contribution)they would need to incur. As a result, a company that that invests in proper occupational wellness programmes is more likely to offer better services to their customers because employees will perceive the benefits associated with working in the company to outweigh the cost of offering quality services. 4.6.4 Test of Hypothesis Four The fourth objective of the study was to establish the influence of employee’s physical wellness programmes on service delivery in faith-based hospitals in Nairobi metropolitan. The study formulated a null hypothesis that: Employees physical wellness programmes have no significant influence on service delivery in faith-based hospitals in Nairobi metropolitan area. To test the hypothesis, the study relied on regression analysis where service delivery in faith-based hospitals in Nairobi metropolitan was regressed on employee’s physical wellness programmes. The model summary results were a shown in Table 4.25. Table 4.25: Model Summary Results for Physical Wellness Programmes Std. Error of the Model R R Square Adjusted R Square Estimate 1 .539a .291 .288 .613 a. Predictors: (Constant), Physical Wellness From the results in the Table 4.25, study established that the R=0.539 indicating that there was a moderate correlation between employees’ physical wellness programmes and service delivery in faith-based hospitals in Nairobi metropolitan .The study also determined that the coefficient of determination as indicated by the adjusted R square (R2) was 0.288 147 indicating that the employees’ physical wellness programmes predicted 28.8% of all variations in service delivery in faith-based hospitals in Nairobi metropolitan. The results alludes that there were other factors affecting service delivery in faith-based hospitals in Nairobi metropolitan which accounted for 71.2%. To determine the fitness of the model as conceptualised in predicting service delivery in faith-based hospitals, the study conducted F-test in ANOVA and the results were shown in Table 4.26. Table 4.26: ANOVA Results for Physical Wellness Programmes Model Sum of Squares df Mean Square F Sig. 1 Regression 37.325 1 37.325 99.324 .000b Residual 90.940 242 .376 Total 128.265 243 a. Dependent Variable: Service Delivery b. Predictors: (Constant), Physical Wellness The results in Table 4.26 showed that the F-statistic was 99.324 which was greater than the F-critical value of 3.880. The study also identified that the P-value for the F-value was 0.000<0.05. These findings suggested that the model was fit in predicting service delivery in faith-based hospitals in Nairobi metropolitan. Student t-test was conducted to determine the significance of employees’ physical wellness programmes in influencing service delivery. The coefficient results were as presented in Table 4.27. 148 Table 4.27: Coefficient Results for Physical Wellness Programmes Unstandardized Standardized Coefficients Coefficients Model B Std. Error Beta t Sig. 1 (Constant) .434 .305 1.426 .001 Physical Wellness .925 .093 .539 9.966 .000 a. Dependent Variable: Service Delivery Coefficient results shown in Table 4.27 illustrated that the model constant had a coefficient of 0.434 with an associated t value of 1.426>0.525 and a P value of 0.004<0.05. Therefore, it was the opinion of the study that the constant was significant. On the other hand, the study identified that the standardized coefficient of employees’ physical wellness programmes was 0.539 alluding that holding all other factors constant and increasing employees’ physical wellness programmes by one unit would result in 53.9% increase in service delivery in faith-based hospitals in Nairobi metropolitan. The coefficient was significant (t=1.426>0.525; P=0.000<0.05). The study thus established that employees’ physical wellness programmes significantly influenced service delivery in faith-based hospitals in Nairobi metropolitan. These results were in line with qualitative data. In their response, respondents indicated that physical wellness affected service delivery in faith-based hospitals. They further indicated that being physically fit enabled them to be flexible which is crucial in service delivery. One respondent stated that: “When your body is unwell, even your mind will not be settled which will negatively affect your productivity” 149 It was also noted that physical fitness improves focus on task and positive thinking. A respondent indicated that: “Physical fitness is paramount because when you are physically fit, you are able to focus on the work you are doing and you are also able to think fast as unlike when you are not fit” In addition, respondents indicated that physical fitness increases body strength which is required to work and at the same time reduce the risk of lifestyle diseases. “Being physically fit is very important for hospital workers because it gives you strength. People who are not physically fit get tired quickly which reduces their productivity.” Another respondent indicated that: “Physical fitness also reduces the risk of diseases meaning that physically fit employees get sick less often and are therefore able to offer better services” These results were consistent with descriptive results which indicated that respondents agreed that there existed of employees’ physical wellness programmes in the faith-based hospitals in Nairobi metropolitan as indicated by a mean score of 3.80. The results further showed that respondents agreed that there was quality service delivery in faith-based hospitals in Nairobi metropolitan as shown by a mean score of 3.55. Based on these results it was construed that as a result of moderate adoption of employees’ physical wellness programmes there was moderate service delivery in faith-based hospitals in Nairobi metropolitan. The results were also in collaboration with the correlation results which indicated that there existed a significant moderate positive correlation existed between 150 service delivery and physical wellness programmes. Therefore, a direct relationship exists between the two variables. The results of the study further aligned with the empirical literature which revealed that physical wellness achieved through proper nutrition, frequent but moderate physical exercises and getting sufficient rest directly affects employee performance (Thomas, 2022). Moreover, the results of the study concurred with those of Mthombeni (2020) who concluded that physical health directly affects employee’s productivity. Additionally, the results were in line with those of Mwangi and Rintaugu (2017) who concluded that physical activities which directly associated with physical fitness of employees affected their performance. The results of the study also supported the creeds of behavioural decision- making theory that structuring wellness programmes impact on wellbeing of the employees that result in improved productivity. Further the theory states that employee wellness programmes help in creating a conducive workplace, engage employees and ensure they fit to handle their tasks and work responsibilities. 4.6.5 Testing for the Moderated Relationship The fifth objective of the study was to examine the moderating influence of credible leadership on the relationship between employee wellness programmes and service delivery in faith-based hospitals in Nairobi metropolitan. The associated hypothesis was that: Credible leadership has no significant moderating influence on the relationship between employee wellness programmes and service delivery in faith-based hospitals in Nairobi metropolitan area. To test the hypothesis, the study used two step regression analysis. In the first step, service delivery in faith-based hospitals in Nairobi metropolitan was regressed on each indicator of employee wellness programmes and the value of R21 observed in each case. In the second step, the study introduced credible leadership in the 151 model and the interactive term between each element of employee wellness programmes and credible leadership. Service delivery in faith-based hospitals in Nairobi metropolitan area was then regressed on each element of employee wellness programmes, credible leadership and their interactive terms. 4.6.5.1 Moderating Influence of Credible Leadership on emotional wellness programmes and Service Delivery The study sought to determine the moderating influence of credible leadership on the relationship between emotional wellness programmes and service delivery in faith-based hospitals in Nairobi metropolitan area. In the first step, service delivery in faith-based hospitals in Nairobi metropolitan area was regressed on emotional wellness programmes to determine if a significant relationship existed to be moderated. The results were as summarised in Tables 4.16, 4.17 and 4.18. The results showed that a significant relationship existed to be moderated (R2=0.101; F=28.341>3.88; β=0.324; P=0.000<0.05). In the second step, the study introduced credible leadership in the model and the interactive term between emotional wellness programmes and credible leadership. Service delivery in faith-based hospitals in Nairobi metropolitan area was then regressed on emotional wellness programmes, credible leadership and the interactive term. The model summary results were as summarised in Table 4.28. Table 4.28: Model Summary for EWP*CL, Emotional Wellness, Credible Leadership Model R R Square Adjusted R Square Std. Error of the Estimate 1 .710a .505 .498 .515 a. Predictors: (Constant), EWP*CL, Emotional Wellness, Credible Leadership 152 The results in table 4.28 showed that the adjusted R square (R22) was 0.498 indicating that emotional wellness programmes, credible leadership and their interactive term explained 49.8% of all the variations in service delivery in faith-based hospitals in Nairobi metropolitan area. This suggests that the model predicted approximately half of the variations in service delivery but there were other variables not included in the model that accounted for 51.2% of the variations in service delivery. The study also conducted analysis of variance to determine the fitness of the model in predicting service delivery in faith-based hospitals. The results of the test were as shown in Table 4.29. Table 4. 29: ANOVAa for EWP*CL, Emotional Wellness, Credible Leadership Model Sum of Squares df Mean Square F Sig. 1 Regression 64.728 3 21.576 81.499 .000b Residual 63.537 240 .265 Total 128.265 243 a. Dependent Variable: Service Delivery b. Predictors: (Constant), EWP*CL, Emotional Wellness, Credible Leadership. The results in Table 4.29 indicated that the F-statistic value 81.499 which was greater than the F-critical value of 2.6422. Similarly, the P-value for the model was 0.000<0.05. Thus, the study concluded that the model was fit in predicting service delivery in faith-based hospitals in Nairobi metropolitan area. To determine the significance of study variables in influencing service delivery, the study conducted student t-test and the results were as shown in Table 4.30. 153 Table 4.30: Coefficients for EWP*CL, Emotional Wellness, Credible Leadership Model Unstandardized Standardized t Sig. Coefficients Coefficients B Std. Error Beta 1 (Constant) 3.861 .512 7.541 .000 Emotional Wellness .137 .028 .126 4.893 .000 Credible Leadership .246 .103 .178 2.388 .010 EW*PCL .244 .037 .218 6.595 .000 a. Dependent Variable: Service Delivery Results in Table 4.30 showed that the model constant was 3.861 implying that holding all other variables constant at zero, service delivery in faith-based hospitals in Nairobi metropolitan area would be equal to 3.861. The constant was significant (t=7.541>1.9698 and p=0.000<0.05). The study further noted that the standardized beta coefficient for emotional wellness programmes was 0.126 indicating that holding all other factors constant, a unit increase in emotional wellness programmes would lead to a 12.6% increase in service delivery in faith-based hospitals in Nairobi metropolitan area. The coefficient was found to be significant (t=4.893>1.9698; P=0.000<0.05). The standardized beta coefficient for credible leadership was 0.178 indicating that holding all other factors constant, a unit increase in credible leadership would increase service delivery in faith-based hospitals in Nairobi metropolitan area by 17.8%. Credible leadership was also found to be significant (t=2.388>1.9698; P=0.010<0.05). Additionally, the study determined that the standardized beta coefficient for the interactive term between emotional wellness programmes and credible leadership was 0.218 which indicated that holding all other factors constant, a unit increase in the interactive term would increase service delivery 154 in faith-based hospitals in Nairobi metropolitan area by 21.8%. The interactive term was found to be significant (t=6.595>1.9698; P=0.000<0.05). The moderating influence of credible leadership on the relationship between emotional wellness programmes and service delivery in faith-based hospitals in Nairobi metropolitan area was determined through the change in R2 (R2 -2 R 2 1) and the significance of the interactive terms between emotional wellness programmes and credible leadership. Results obtained on the hypothesis indicated that R2 - 22 R 1 = 0.397 (0.498-0.101). This change in R 2 suggested that there was a moderating influence of credible leadership on the relationship between emotional wellness programmes and service delivery in faith-based hospitals in Nairobi metropolitan area. The significance of the moderating effect of credible leadership on the relationship between emotional wellness programmes and service delivery in faith-based hospitals in Nairobi metropolitan area was based on the P-value of the interactive term (P<0.05). Since the interactive term between emotional wellness programmes and credible leadership was significant, the study determined that credible leadership had a significant moderating effect on the relationship between emotional wellness programmes and service delivery in faith-based hospitals in Nairobi metropolitan area. Similar results were obtained by Kimutai and Aluvi (2018) who concluded that good leadership was an influencing factor to service delivery. Although the study was conducted in Kisumu County involving the general public, the results of the study were concurrent with the results of this study in a different context suggesting that it can be generalised that credible leadership influences service delivery. The results of the study also concurred with the findings of Angana (2021) who conducted a study on sustaining credible leadership in organizations. The study concluded that organization leaders can also lose credibility if 155 they are engaged in unethical practices that project them as untrustworthy which affects their service delivery. 4.6.5.2 Moderating Influence of Credible Leadership on Intellectual Wellness Programmes and Service Delivery The study sought to determine the moderating influence of credible leadership on the relationship between intellectual wellness programmes and service delivery in faith-based hospitals in Nairobi metropolitan area. The two steps model recommended by Fairchild and MacKinnon (2009) was adopted. In the first step, service delivery in faith-based hospitals in Nairobi metropolitan area was regressed on intellectual wellness programmes to determine if a significant relationship existed to be moderated. The results were as summarised in Tables 4.19, 4.20 and 4.21. The results showed that a significant relationship existed to be moderated (R2=0.267; F=89.391>3.880>3.88; β=0.519; P=0.000<0.05). In the second step, the study introduced credible leadership in the model and the interactive term between intellectual wellness programmes and credible leadership. Service delivery in faith-based hospitals in Nairobi metropolitan area was then regressed on intellectual wellness programmes, credible leadership and the interactive term between intellectual wellness programmes and credible leadership. The model summary results were as summarised in Table 4.31. Table 4.31: Model Summary for IWP*CL, Intellectual Wellness, Credible Leadership Model R R Square Adjusted R Square Std. Error of the Estimate 1 .700a .490 .483 .522 a. Predictors: (Constant), IWP*CL, Intellectual Wellness, Credible Leadership 156 The results in table 4.31 showed that the adjusted R square was 0.483 indicating that, combined, intellectual wellness programmes, credible leadership and the interactive term predicted 48.3% of service delivery in faith-based hospitals in Nairobi metropolitan area. The results thus suggest that there are other variables contributing to service delivery in faith-based hospitals accounting for 51.7%. To determine the fitness of the model in predicting service delivery, the study conducted the Analysis of Variance (ANOVA) test. the results were as shown in table 4.32. Table 4.32: ANOVA for IWP*CL, Intellectual Wellness, Credible Leadership Model Sum of Squares df Mean Square F Sig. 1 Regression 62.815 3 20.938 76.780 .000b Residual 65.450 240 .273 Total 128.265 243 a. Dependent Variable: Service Delivery b. Predictors: (Constant), IWP*CL, Intellectual Wellness, Credible Leadership From the results in Table 4.32, it was established that the F-statistic for the model was 76.780 which was greater than the F-critical value of 2.6422. It was also established that the P-value for the F-statistic was 0.000<0.05. The study therefore determined that the model was significant in predicting service delivery in faith-based hospitals in Nairobi metropolitan area. The study also sought to determine if intellectual wellness programmes, credible leadership and the interactive term were significant in influencing service delivery in faith-based hospitals in Nairobi metropolitan area. The study conducted student t-test and the coefficient results were summarised in Table 4.33. 157 Table 4.33: Coefficients for IWP*CL, Intellectual Wellness, Credible Leadership Model Unstandardized Standardized t Sig. Coefficients Coefficients B Std. Error Beta 1 (Constant) 4.142 1.278 3.241 .001 Intellectual Wellness .691 .158 .594 4.373 .000 Credible Leadership .435 .142 .417 3.063 .002 IWP*CL .271 .092 .255 2.937 .004 a. Dependent Variable: Service Delivery Results in Table 4.33 showed that the model constant was 4.142 suggesting that holding all other factors constant at zero, service delivery in faith-based hospitals in Nairobi metropolitan area would be equal to 4.142. The constant was significant (t=3.241>1.9698 and p=0.001<0.05). The study also noted that the standardized beta coefficient for intellectual wellness programmes was 0.594 indicating that holding all other factors constant, a unit increase in intellectual wellness programmes would lead to a 59.4% increase in service delivery in faith-based hospitals in Nairobi metropolitan area. The coefficient was found to be significant (t=4.373>1.9698; P=0.000<0.05). The study further noted that the standardized coefficient for credible leadership was 0.417 indicating that holding all other factors constant and increasing credible leadership by a single unit would result in 0.417 increase in service delivery in faith-based hospitals in Nairobi metropolitan area. It was further determined that this relationship was significant (t=3.063>1.9698; P=0.002<0.05). The standardized beta coefficient for the interactive term between intellectual wellness programmes and credible leadership was 0.255 which indicated that holding all other factors constant, a unit increase in the interactive term would increase service delivery in faith-based hospitals in Nairobi metropolitan area by 25.5%. 158 The interactive term was found to be significant (t=2.937>1.9698; P=0.000<0.05). Thus, the interactive term was significant in predicting service delivery in faith-based hospitals in Nairobi metropolitan area. The moderating influence of credible leadership on the relationship between intellectual wellness programmes and service delivery in faith-based hospitals in Nairobi metropolitan area was determined through the change in R2 (R2 -2 R 2 1) and the significance of the interactive term. Results obtained on this hypothesis indicated that R2 - 22 R 1 = 0.216 (0.483- 0.267). This change in R2 suggested that there was a moderating influence of credible leadership on the relationship between intellectual wellness programmes and service delivery in faith-based hospitals in Nairobi metropolitan area. The significance of the moderating effect of credible leadership on the relationship between intellectual wellness programmes and service delivery in faith-based hospitals in Nairobi metropolitan area was based on the P-value of the interactive term (P<0.05). Since the interactive term between intellectual wellness programmes and credible leadership was significant, the study established that credible leadership had a significant moderating effect on the relationship between intellectual wellness programmes and service delivery in faith-based hospitals in Nairobi metropolitan area. Results posted on this variable were consistent with those of Rigii et al. (2019) who posited that strategic leadership is important because it enables leaders to empowers teams through envisioning, anticipating and creation of changes strategically. The study further opined that strategic leadership had a significant influence on service delivery. Additionally, Roslenderet al. (2020) concluded that employee wellness is a critical component of primary intellectual capital since employees brings experience, expertise, know‐how, leadership skills and creativity to their organisations which positively influences their service delivery. 159 Moreover, Waithanji and Ndeto (2023) showed that intellectual wellness programmes have a positive and significant influence on performance tier one banks in Kenya. 4.6.5.3 Moderating Influence of Credible Leadership on Occupational Wellness Programmes and Service Delivery In this section, the study sought to determine the moderating influence of credible leadership on the relationship between occupational wellness programmes and service delivery in faith-based hospitals in Nairobi metropolitan area. In the first step, service delivery in faith-based hospitals in Nairobi metropolitan area was regressed on occupational wellness programmes to determine if a significant relationship existed to be moderated. The results were as summarised in Tables 4.22, 4.23 and 4.24. The results showed that a significant relationship existed to be moderated (R2=0.442; F=193.272>3.880>3.880; β=0.243; P=0.000<0.05). In the second step, the study introduced credible leadership in the model and the interactive term between occupational wellness programmes and credible leadership. Service delivery in faith-based hospitals in Nairobi metropolitan area was then regressed on occupational wellness programmes, credible leadership and the interactive term. The model summary results were as summarised in Table 4.34. Table 4.34: Model Summary for OWP*CL, Occupational Wellness, Credible Leadership Model R R Square Adjusted R Square Std. Error of the Estimate 1 .754a .569 .564 .480 a. Predictors: (Constant), OWP*CL, Occupational Wellness, Credible Leadership 160 The results in table 4.34 showed that the adjusted R square (R2) was 0.564 suggesting that occupational wellness programmes, credible leadership and the interactive term contributed 56.4% of all the variations in service delivery in faith-based hospitals in Nairobi metropolitan area. This implies that the remainder of 53.6% of variations in service delivery of faith-based hospitals was predicted by other factors other than those included in the model. The study also sought to determine the fitness of the model in predicting service delivery in faith-based hospitals in Nairobi metropolitan. To achieve this goal the study conducted the Analysis of Variance test and the results were as summarised in Table 4.35. Table 4.35: ANOVA for OWP*CL, Occupational Wellness, Credible Leadership Model Sum of Squares df Mean Square F Sig. 1 Regression 73.011 3 24.337 105.710 .000b Residual 55.254 240 .230 Total 128.265 243 a. Dependent Variable: Service Delivery b. Predictors: (Constant), OWP*CL, Occupational Wellness, Credible Leadership The study results in Table 4.35 indicated that the F-statistic for the model was 105.710 which was greater than the F-critical value of 2.6422. It was also established that the P- value for the F-statistic was 0.000<0.05. The study therefore determined that the model was significant in predicting service delivery in faith-based hospitals in Nairobi metropolitan area. The study also sought to determine the significance of occupational wellness programmes, credible leadership and the interactive term in influencing service delivery in faith-based 161 hospitals in Nairobi metropolitan area. To do so, the study conducted the student t-test and results were summarised in Table 4.36. Table 4.36: Coefficients for OWP*CL, Occupational Wellness, Credible Leadership Model Unstandardized Standardized t Sig. Coefficients Coefficients B Std. Error Beta 1 (Constant) 4.392 1.321 3.324 .001 Occupational Wellness .206 .036 .199 5.722 .000 Credible Leadership .496 0.174 .464 2.851 .005 OW*PCL .345 .098 .295 3.535 .000 a. Dependent Variable: Service Delivery results in Table 4.36 illustrated that the model constant was 4.392 indication that in absence of all other factors, service delivery in faith-based hospitals in Nairobi metropolitan area would be 4.392. The constant was significant (t=3.324>1.9698 and p=0.001<0.05). Additionally, occupational wellness programmes had a standardized beta coefficient of 0.199 suggesting if all other factors were held constant and occupational wellness programmes increased by one unit, there would be a 19.9% increase in service delivery in faith-based hospitals in Nairobi metropolitan area. This relationship was significant (t=5.722>1.9698; P=0.000<0.05). The study therefore determined that occupational wellness programmes alongside credible leadership and their interactive term remained significant in predicting service delivery in faith-based hospitals in Nairobi metropolitan area. The standardized beta coefficient for the interactive term between occupational wellness programmes and credible leadership was 0.464 which indicated that holding all other 162 factors constant, a unit increase in the interactive term would increase service delivery in faith-based hospitals in Nairobi metropolitan area by 46.4%. The interactive term was significant (t=2.851>1.9698; P=0.005<0.05). Thus, the interactive term was significant in predicting service delivery in faith-based hospitals in Nairobi metropolitan area. The moderating influence of credible leadership on the relationship between occupational wellness programmes and service delivery in faith-based hospitals in Nairobi metropolitan area was determined through the change in R2 (R2 - 22 R 1) and the significance of the interactive term at 0.05 significance level. Results obtained on this hypothesis indicated that R2 - R22 1 = 0.122 (0.564-0.442). This change in R 2 is an indication that there was a moderating influence of credible leadership on the relationship between occupational wellness programmes and service delivery in faith-based hospitals in Nairobi metropolitan area. The significance of the moderating effect of credible leadership on the relationship between occupational wellness programmes and service delivery in faith-based hospitals in Nairobi metropolitan area was based on the P-value of the interactive term (P<0.05). Since the interactive term between occupational wellness programmes and credible leadership was significant, the study established that credible leadership had a significant moderating effect on the relationship between occupational wellness programmes and service delivery in faith-based hospitals in Nairobi metropolitan area. These results were consistent with the postulations of Srimulyani and Hermanto (2022) who observed that organizational leadership that credible leadership influences employees work engagement. According to authors, credible leaders inculcate a culture of team work, and engage them which makes them more proactive, take the initiative to collaborate with others and are committed in providing quality services for patients. In another study Anaya 163 (2023) on women in leadership indicated that organizational leadership whether male or female determines organizational outcomes. 4.6.5.4 Moderating Influence of Credible Leadership on Physical Wellness Programmes and Service Delivery In this section, the study sought to determine the moderating influence of credible leadership on the relationship between physical wellness programmes and service delivery in faith-based hospitals in Nairobi metropolitan area. In the first step, service delivery in faith-based hospitals in Nairobi metropolitan area was regressed on Physical wellness programmes to determine if a significant relationship existed to be moderated. To test the hypothesis, service delivery in faith-based hospitals in Nairobi metropolitan was regressed on physical wellness programmes. The results were as summarised in Tables 4.25, 4.26 and 4.27. from the results in Table 4.25, the study determined that the adjusted R square (R2) was 0.288. Coefficient results showed that the standardized coefficient of physical wellness programmes was 0.539 which was significant (t=1.426>0.525; P=0.000<0.05). Thus, the study determined that a significant relationship existed to be moderated. In the second step, the study introduced credible leadership and the interactive term between physical wellness programmes and credible leadership in the model. Service delivery in faith-based hospitals in Nairobi metropolitan area was then regressed on physical wellness programmes, credible leadership and the interactive term between physical wellness programmes and credible leadership. The model summary results were as summarised in Table 4.37. 164 Table 4.37: Model Summary for PWP*CL, Physical Wellness, Credible Leadership Model R R Square Adjusted R Square Std. Error of the Estimate 1 .717a .514 .508 .510 a. Predictors: (Constant), PWPCL, Physical Wellness, Credible Leadership The results in table 4.37 showed that the adjusted R square was 0.508 indicating that, combined, physical wellness programmes, credible leadership and the interactive term predicted 50.8% of variations in service delivery in faith-based hospitals in Nairobi metropolitan area. The results thus suggest that there were other variables contributing to service delivery in faith-based hospitals accounting for 49.2%which were not included in the model. To determine the fitness of the model in predicting service delivery, the study conducted the Analysis of Variance (ANOVA) test. the results were as shown in table 4.38. Table 4.38: ANOVA for PWP*CL, Physical Wellness, Credible Leadership Model Sum of Squares df Mean Square F Sig. 1 Regression 65.921 3 21.974 84.590 .000b Residual 62.344 240 .260 Total 128.265 243 a. Dependent Variable: Service Delivery b. Predictors: (Constant), PWP*CL, Physical Wellness, Credible Leadership Results in Table 4.32 showed that the F-statistic for the model was 84.590 which was greater than the F-critical value of 2.6422. It was also determined that the P-value for the F-statistic was 0.000<0.05. The study therefore determined that the model was significant in predicting service delivery in faith-based hospitals in Nairobi metropolitan area. 165 The study also sought to determine the significance of the variables in influencing service delivery in faith-based hospitals in Nairobi metropolitan area. The study conducted student t-test and the coefficient results were summarised in Table 4.39. Table 4.39: Coefficients for PWP*CL, Physical Wellness, Credible Leadership Model Unstandardized Standardized t Sig. Coefficients Coefficients B Std. Error Beta 1 (Constant) 4.687 1.236 3.792 .000 Physical Wellness .385 .103 .304 3.738 .000 Credible Leadership .291 .112 .247 2.598 .011 PWP*CL .402 .110 .366 3.653 .000 a. Dependent Variable: Service Delivery Results in Table 4.39 showed that the model constant was 4.687 suggesting that holding all other factors constant at zero, service delivery in faith-based hospitals in Nairobi metropolitan area would be equal to 4.687. The constant was significant (t=3.792>1.9698 and p=0.000<0.05). The study also noted that the standardized beta coefficient for physical wellness programmes was 0.304 indicating that holding all other factors constant, a unit increase in physical wellness programmes would lead to 0.304 increase in service delivery in faith-based hospitals in Nairobi metropolitan area. The coefficient was found to be significant (t=3.738>1.9698; P=0.000<0.05). The study further noted that the standardized coefficient for credible leadership was 0.247 indicating that holding all other factors constant and increasing credible leadership by a single unit would result in 0.247 increase in service delivery in faith-based hospitals in Nairobi metropolitan area. It was further determined that this relationship was significant 166 (t=2.598>1.9698; P=0.011<0.05). The standardized beta coefficient for the interactive term between physical wellness programmes and credible leadership was 0.366 which indicated that holding all other factors constant, a unit increase in the interactive term would increase service delivery in faith-based hospitals in Nairobi metropolitan area by 0.366. The interactive term was found to be significant (t=3.653>1.9698; P=0.000<0.05). Thus, the interactive term was significant in predicting service delivery in faith-based hospitals in Nairobi metropolitan area. To determine the moderating influence of credible leadership on the relationship between physical wellness programmes and service delivery in faith-based hospitals in Nairobi metropolitan area, the study observed the change in R2 (R2 - 22 R 1) while the significance of the interactive term at 0.05 significance level was used to determine the significance of the moderated relationship. Results obtained showed that R2 - R22 1 = 0.220 (0.508-0.288). This change in R2 indicated that there was a moderating influence of credible leadership on the relationship between physical wellness programmes and service delivery in faith-based hospitals in Nairobi metropolitan area. The significance of the moderating effect of credible leadership on the relationship between physical wellness programmes and service delivery in faith-based hospitals in Nairobi metropolitan area was based on the P-value of the interactive term (P<0.05). Since the interactive term between physical wellness programmes and credible leadership was significant, the study established that credible leadership had a significant moderating effect on the relationship between physical wellness programmes and service delivery in faith-based hospitals in Nairobi metropolitan area. The results posted on the variable were consistent with those of Kimutai and Aluvi (2018) who concluded that organizational leadership influences service delivery in an 167 organization. Similarly, Mthombeni et al. (2020) in a study on physical health status of employees concluded that physical wellness significantly affected employee performance. Further, the results coincided with those of Mwangi and Rintaugu (2017) who observed that health factors such as blood pressure and resting heart rate significantly affected the physical fitness which in turn affected employee performance. Moreover, Wahida (2016) concluded that strategic leadership inorganizations helped in improving quality of services delivered to the people. The qualitative data obtained from open ended questions also supported this claim in that. When the management of the institution is concerned with the wellbeing of its employees, they will support wellness programmes. A respondent indicated that: “Some managers who do not see the need to maximise the welfare of employees may consider investment in employee wellness as a waste of resources.” Another respondent indicated that: “Some managers take wellness programmes seriously and which inspires employees to also take programmes such as physical fitness seriously. Personally, I started walking to work after my boss challenged me to do so due to heavy weight.” 168 CHAPTER FIVE SUMMARY, CONCLUSIONS AND RECOMMENDATIONS 5.1 Introduction This chapter presented a summary of data analysis and discussions thereof. The chapter further presented the conclusions reached based on data analysis and the recommendations of the study. 5.2 Summary of the Study The main objective of the study is to investigate the influence of employee wellness programmes on service delivery in faith-based hospitals in Nairobi metropolitan area. Specific objectives were to assess the influence of employees emotional wellness programmes on service delivery in faith-based hospitals in Nairobi metropolitan area, to investigate the influence of employees intellectual wellness programmes on service delivery in faith-based hospitals in Nairobi metropolitan area, to examine influence of employees occupational wellness programmes on service delivery in faith-based hospitals in Nairobi metropolitan area, to establish the influence of employees physical wellness programmes on service delivery in faith-based hospitals in Nairobi metropolitan area and to examine the moderating role of credible leadership on the influence of employee wellness programmes on service delivery in faith-based hospitals in Nairobi metropolitan area. To achieve the objectives, the study was anchored on behavioural decision-making theory supported by the theory of social exchange and Maslow’s hierarchy theory. The study adopted the descriptive survey and correlational research designs with the target population comprising of employees in the faith-based hospitals in Nairobi metropolitan area. The study used stratified random sampling to select the respondents among the faith-based 169 hospitals in Nairobi metropolitan area. The selected sample size for the study was 194 respondents. Descriptive statistics (frequencies, mean, standard deviation and percentage) as well as inferential statistics (Correlational analysis and regression analysis) were used to analyse data. Correlational analysis was used to determine the strength of the relationship between the independent and dependent variables. While regression analysis was used to determine the nature of the relationship. Regarding employee’s emotional wellness programmes, descriptive results showed that there was moderate emphasis on employee’s emotional wellness programmes among the faith-based hospitals in Nairobi metropolitan area, respondents agreed that mental health programmes ensure reduced stress among employees and allows them to focus on their tasks, hospitals promoted support services to help employees cope with stress and anxiety and provided stress management programmes for its employees. Additionally, the study established that that stress management programmes helped to promote positivity and a healthy workplace, hospitals provided mindfulness training to enhance their skills, hospitals provided mental health programmes and that mindfulness training helped employees in their hospitals to become more aware of their own emotions and reactions. However, respondents disagreed that their hospitals had support services that helped employees to cope with setbacks and challenges at work. Correlation analysis results showed that a significant weak positive correlation existed between service delivery and emotional wellness programmes while hypothesis testing results showed that emotional wellness programmes had a significant influence on service delivery in faith-based hospitals in Nairobi metropolitan area. On employee’s intellectual wellness programmes, the study determined that there were employee’s intellectual wellness programmes in their hospitals. Specifically, it was 170 established that majority of hospitals offered their employees professional development classes and respondents agreed that their hospitals considered on-the-job training as important for their employees to provide firsthand knowledge and experience in the workplace, brainstorming sessions help employees in problem solving as they undertake their tasks, hospitals encouraged collaboration opportunities among the employees and that collaboration opportunities ensured that tasks in their hospitals were linked to achieve the set goals. On the other hand, it was established that respondents were indifferent on the fact that their hospitals encouraged brainstorming sessions as a means of enhancing service delivery, hospitals provided employee with the on-the-job training programmes and that professional development classes allowed employees to perform better and prepares them for positions of greater responsibility. Correlation results showed that a significant moderate positive correlation existed between service delivery and intellectual wellness programmes while hypothesis analysis results showed that intellectual wellness programmes had a significant influence on service delivery in faith-based hospitals in Nairobi metropolitan area. In relation to employee’s occupational wellness programmes, descriptive results showed that there was general agreement among the respondents on the adoption of employee’s occupational wellness programmes among faith-based hospitals in Nairobi metropolitan area. Precisely, the study determined that respondents agreed that hospitals offered their employees regular health risk assessments, health risk assessments engage employees' health and promotes prevention of diseases, employee involvement in leadership decisions helped them feel valued in the organization, faith-based hospitals encourage regular breaks from work to reduce fatigue, hospitals had a set of family-friendly policies to enhance employee productivity and family friendly policies helped employees to maintain a successful work-life balance. However, respondents were indifferent on giving employees 171 regular breaks to give employees a chance to rest and disagreed that faith-based hospitals provided rewards for healthy behaviours. Correlation analysis results showed that there existed a significant moderate positive correlation between service delivery and occupational wellness programmes. Hypothesis testing results showed that employee occupational wellness programmes significantly influenced service delivery in faith-based hospitals in Nairobi metropolitan area. The fourth objective of the study was to establish the influence of employee’s physical wellness programmes on service delivery in faith-based hospitals in Nairobi metropolitan area. The study established that there was agreement among the respondents on the existence of employees’ physical wellness programmes in the faith-based hospitals. Specifically, descriptive results showed that faith-based hospitals encouraged physical exercise among the employees to remain fit, fitness challenges helped in ensuring that employees are physically fit, faith-based hospitals organize fitness challenges to help employee compete for a prize, hospitals encouraged staff to walk and use of stairs to ensure they are physically fit and hospitals provided sporting activities such as football and athletics. However, respondents were indifferent on the fact that physical exercise helps employees to refresh their minds so that they can perform their tasks better and that hospital had partnered with health clubs to help employees gain healthy living tips. Correlation analysis results showed that a significant moderate positive correlation existed between service delivery and physical wellness programmes. Moreover, hypothesis test results showed that employees’ physical wellness programmes significantly influenced service delivery in faith-based hospitals in Nairobi metropolitan area. The final objective of the study was to examine the moderating influence of credible leadership on the relationship between employee wellness programmes and service 172 delivery in faith-based hospitals in Nairobi metropolitan area. It was established that majority of the respondents believed that their leaders had moderate level of credibility. The study also established that leaders in faith-based hospitals encouraged team work and were problem solvers. However, they lowly inspired employees to offer best services, were forward-looking, competent, accountable and were role models. On service quality it was established that there was quality service delivery in faith-based hospitals in Nairobi metropolitan area. It was also noted that medical staff in faith-based hospitals demonstrated confidence at all times, there was increased customer satisfaction, there was consistency in service delivery, faith-based hospitals created a personal relationship with their customers and that medical staff were encouraged to convey hope to patients. However, faith-based hospitals in Nairobi metropolitan area did not have enough staff, customers were not always satisfied with services offered, there relative increase in accessibility of services and queues were long in faith-based hospitals. Correlation results showed that a significant moderate positive correlation existed between service delivery and credible leadership. Hypothesis testing results established that credible leadership had a significant moderating influence on the relationship between employee emotional wellness programmes, employee intellectual wellness programmes, employee occupational wellness programmes and employee physical wellness programmes and service delivery in faith-based hospitals in Nairobi metropolitan area. Therefore, it was determined that credible leadership had a significant moderating influence on the relationship between employee wellness programmes and service delivery in faith-based hospitals in Nairobi metropolitan area. 173 5.3 Conclusions The first objective of the study was to assess the influence of employee’s emotional wellness programmes on service delivery in faith-based hospitals in Nairobi metropolitan area. The study determined that there was moderate emphasis on employee’s emotional wellness programmes among the faith-based hospitals in Nairobi metropolitan area, a significant weak positive correlation existed between service delivery and employee’s emotional wellness programmes and that emotional wellness programmes had a significant influence on service delivery in faith-based hospitals in Nairobi metropolitan area. The study thus concluded that employee’s emotional wellness programmes had a significant influence on service delivery in faith-based hospitals in Nairobi metropolitan area. The second objective of the study was to investigate the influence of employee’s intellectual wellness programmes on service delivery in faith-based hospitals in Nairobi metropolitan area. It was determined that there were employee’s intellectual wellness programmes in their hospitals in Nairobi metropolitan area, a significant moderate positive correlation existed between service delivery and intellectual wellness programmes and that employees’ intellectual wellness programmes had a significant influence on service delivery in faith-based hospitals in Nairobi metropolitan area. Therefore, it was concluded that employees’ intellectual wellness programmes had a significant influence on service delivery in faith-based hospitals in Nairobi metropolitan area. The third objective of the study was to examine the influence of employee’s occupational wellness programmes on service delivery in faith-based hospitals in Nairobi metropolitan area. The study found that there was agreement among the respondents on the adoption of employee’s occupational wellness programmes among faith-based hospitals in Nairobi metropolitan area, there existed a significant moderate positive correlation between service 174 delivery and occupational wellness programmes and that employee occupational wellness programmes significantly influenced service delivery in faith-based hospitals in Nairobi metropolitan area. The study thus concluded that employee occupational wellness programmes significantly influenced service delivery in faith-based hospitals in Nairobi metropolitan area. The fourth objective of the study was to establish the influence of employee’s physical wellness programmes on service delivery in faith-based hospitals in Nairobi metropolitan area. It was established that there was agreement among the respondents on the existence of employees’ physical wellness programmes in the faith-based hospitals, a significant moderate positive correlation existed between service delivery and physical wellness programmes and that there was a significant relationship between employees’ physical wellness programmes and service delivery. The study therefore concluded that employees’ physical wellness programmes significantly influenced service delivery in faith-based hospitals in Nairobi metropolitan area. The fifth objective of the study was to examine the moderating influence of credible leadership on the relationship between employee wellness programmes and service delivery in faith-based hospitals in Nairobi metropolitan area. It was determined that employee wellness programmes were moderately implemented in faith-based hospitals, leaders had moderate level of credibility and that there was quality service delivery in faith- based hospitals in Nairobi metropolitan area. A strong positive correlation between employee wellness programmes and service delivery existed. Also, a significant moderate positive correlation existed between service delivery and credible leadership. Hypothesis testing results established that introduction of credible leadership reduced the influence of emotional wellness programmes and service delivery in faith-based hospitals 175 in Nairobi metropolitan area as depicted by reduced standardised beta coefficient. However, the relationship between the variables remained constant. Since the interactive term was significant, it was concluded that credible leadership had a significant moderating influence on the relationship between emotional wellness programmes and service delivery in faith-based hospitals in Nairobi metropolitan area. Hypothesis testing results also showed that introduction of credible leadership in the model enhanced the influence of emotional wellness programmes on service delivery in faith- based hospitals in Nairobi metropolitan area as indicated by increased standardised beta coefficient. It was also observed that the interactive term was significant and thus it was concluded that credible leadership had a significant moderating influence on the relationship between intellectual wellness programmes and service delivery in faith-based hospitals in Nairobi metropolitan area. Additionally, hypothesis testing results established that credible leadership reduced the influence of occupational wellness programmes on service delivery in faith-based hospitals in Nairobi metropolitan area as illustrated by the reduced standardised beta coefficient. However, the relationship between occupational wellness programmes on service delivery remained constant. Further, since the interactive term was significant, it was concluded that credible leadership had a significant moderating influence on the relationship between occupational wellness programmes and service delivery in faith-based hospitals in Nairobi metropolitan area. Finally, hypothesis testing results showed that introduction credible leadership in the model reduced the influence of physical wellness programmes on service delivery in faith-based hospitals in Nairobi metropolitan area as demonstrated by reduced standardised beta coefficient. Since the coefficient of the interactive term between physical wellness 176 programmes and service delivery was significant, it was concluded that credible leadership had a significant moderating influence on the relationship between physical wellness programmes and service delivery in faith-based hospitals in Nairobi metropolitan area. Overall, the study determined that credible leadership significantly moderated the relationship between all the indicators of employee wellness programmes. Thus, the study concluded that credible leadership significantly moderated the relationship between employee wellness programmes and service delivery in faith-based hospitals in Nairobi metropolitan area. 5.4 Recommendation for Policy and Practice The study concluded that employee’s wellness programmes had a significant influence on service delivery in faith-based hospitals in Nairobi metropolitan area. To this effect the study recommends that the management of faith-based hospitals in Nairobi metropolitan area and beyond should ensure that there are stress management programmes and training in place that would ensure that the hospital employees are mentally healthy. Also, the management should ensure that they sponsor hospital employees to pursue higher education, offer on the job training and collaborate with training and research institutions to improve intellectual wellness of their staff. Moreso, the management should conduct regular health risk assessments and enforce regular breaks from work to improve occupation wellness of their staff. To ensure this, hospitals should employ adequate staff in all departments. Hospitals should also regularly organise physical activity competitions for employees, encourage walking and use of stairs and partner with health clubs for the benefit of physical fitness of their employees. The study also concluded that credible leadership significantly moderated the relationship between employee wellness programmes and service delivery in faith-based hospitals in 177 Nairobi metropolitan area. The study thus recommends that the management of faith-based hospitals and beyond should ensure that they portray honesty with their staff, inspire their employees to do the right thing, they should be accountable for their actions, forward- looking and demonstrate competence so as to instil confidence in their employees and motivate them to offer quality services. The study also recommends that the government and its agencies through the ministry of health and labour as well as and the County governments should ensure that there are strategies and policies that would ensure that employee wellness is well taken care of. Thus, the government should ensure that employees in hospital do not work for longer hours, there should be flexible work schedules, continuous training of medical staff to upscale their skills, mental health programmes such as guidance and counselling as well as physical exercise. Moreover, the study recommends that hospital employees through their unions should ensure that their work environment is conducive to discharge their duties effectively for quality service delivery. Employees should also take physical exercise seriously because it affects their performance. Staff unions should also encourage their members to seek emotional support services to ensure that they are mentally healthy to do their work. Finally, staff unions should encourage their members to pursue higher education to improve on their intellectual wellness. 5.5 Contributions of the Study to Knowledge The study contributed to the body of knowledge in several ways. First, the study presented empirical evidence that employee wellness programmes significantly influenced service delivery and therefore employee wellness programmes can be adopted by faith-based hospitals and indeed private and public hospitals to improve quality of service delivery to 178 their patients. The study established that employee wellness programmes significantly influenced service delivery in faith-based hospitals in Nairobi metropolitan area. Therefore, by focusing developing strategies that would improve employee’s emotional wellness, employee’s intellectual wellness, employee’s occupational wellness and employee’s physical wellness would help improve service delivery. Secondly, the study contributes to the body of knowledge by addressing some of the research gaps that had been earlier identified in literature. The study earlier identified contextual gaps where existing studies on employee wellness programmes were conducted in other contexts such as commercial banks and hospitality industry which are significantly different from the health sector. This study fills the gap by contextualising the study in the health sector. The study had also identified conceptual gaps where existing studies had conceptualised employee wellness programmes by leaving out key components such as intellectual wellness. Additionally, previous scholars had ignored the role of credible leadership in moderating the relationship between employee wellness programmes and service delivery. 5.6 Recommendations for Further Research The current study was conducted in the health sector and therefore the conclusions reached can only be perfectly inferred on the health facilities that have similar characteristics as those of faith-based hospitals in Nairobi metropolitan area. 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Box 1957—10101, Karatina, Kenya RE: REQUEST FOR PARTICIPATION IN RESEARCH STUDY Dear Sir/Madam I am a student at Karatina University currently undertaking a study titled “EMPLOYEE WELLNESS PROGRAMMES, CREDIBLE LEADERSHIP AND SERVICE DELIVERY IN FAITH BASED HOSPITALS IN NAIROBI METROPOLITAN ” This study is a partial requirement for the award of the degree. I identified you as a key informant to provide the requisite information for the study by virtue of the position you hold the organisation. Kindly participate in the study by responding to the attached questionnaire. This study is purely academic and as such, all the information you provide shall be used strictly for academic purposes related to this study and that the information shall be handled with utmost confidentiality. Your identity would be concealed and you should not provide any identifying information. For any clarification, you can reach me directly on 0722891236 or contact Karatina University on (+254) 202 176 713 or (+254) 729 721 200; Email Address: info@karu.ac.ke Yours sincerely, Beatrice Wairimu Karanja. 192 Appendix II: Research Questionnaire This questionnaire is designed to collect data to investigate the influence of employee wellness programmes and credible leadership on service delivery in faith-based hospitals in Nairobi metropolitan area. You were selected because of the critical role that you position plays in designing and implementing programmes to improve service delivery in your institution. Kindly give your most objective response by ticking appropriately in the provided spaces. Section A: Demographic Information 1. Indicate your gender Male [ ] Female [ ] 2. How long have you worked in your current organization? Less than 1 year [ ] Between 1-5 years [ ] Between 6-10 years [ ] Over 10 years [ ] 3. What is your highest level of education? Certificate [ ] Diploma [ ] Bachelor’s Degree [ ] Masters [ ] PhD [ ] Section B: Emotional Wellness 4. The study seeks to determine the influence of employee’s emotional wellness programmes on service delivery in faith-based hospitals in Nairobi metropolitan area. Kindly indicate your opinion on the following statements. Using the scale 1-strongly disagree, 2-disagree, 3-moderate, 4-agree, 5-strongly agree. Aspects of emotional wellness 1 2 3 4 5 Our organization provides stress management programmes for its employees Stress management programmes helps to promote positivity and a healthy workplace Our organization provides mental health programmes Mental health programmes ensure reduced stress among employees and allows them to focus on their tasks Our organization promote support services to help employees cope with stress and anxiety The support services in our organization help employees to cope with setbacks and challenges at work Our organization provides mindfulness training to enhance their skills 193 Mindfulness training help our employees to become more aware of their own emotions and reactions, as well as those of their colleagues 5. In your own opinion, does emotional wellness programmes influence service delivery in your hospital? Explain. ……………………………………………………………………………………………… ……………………………………………………………………………………………… ……………………………………………………………………………………………… Section C: Intellectual Wellness 6. The study seeks to investigate the influence of employee’s intellectual wellness programmes on service delivery in faith-based hospitals in Nairobi metropolitan area. Kindly indicate your opinion on the following statements. Using the scale 1-strongly disagree, 2-disagree, 3-moderate, 4-agree, 5-strongly agree. Aspects of intellectual wellness 1 2 3 4 5 Our organization offer its employees professional development classes Professional development classes allow our employees to perform better and prepares them for positions of greater responsibility Our organization provide employee with the on-the-job training programmes On-the-job training is important for our employees because it provides firsthand knowledge and experience in the workplace Our organization encourages brainstorming sessions to enhance service delivery Brainstorming sessions help our employees in problem solving as they undertake their tasks Our organization encourages collaboration opportunities among the employees Collaboration opportunities ensures that tasks in our organization are linked to achieve the set goals 7. In your own opinion, how does intellectual wellness programmes influence service delivery in your hospital? Explain. ……………………………………………………………………………………………… ……………………………………………………………………………………………… ……………………………………………………………………………………………… ……………………………………………………………………………………………… …………… Section D: Occupational Wellness 8. The study seeks to determine the influence of employee’s occupational wellness programmes on service delivery in faith-based hospitals in Nairobi metropolitan area. 194 Kindly indicate your opinion on the following statements. Using the scale 1-strongly disagree, 2-disagree, 3-moderate, 4-agree, 5-strongly agree. Aspects of Occupational Wellness 1 2 3 4 5 Our organization offer employees regular health risk assessments Health risk assessments engages employees' health and promotes the prevention of diseases. Our organization encourages regular breaks from work to reduce fatigue Regular breaks give employees a chance to rest, promote clearer thinking and greater productivity. In our organization rewards for healthy behaviours are provided Rewards for healthy behaviours encourages employees to practice good relations with their colleagues In our organization employees are involved in leadership decisions Employee involvement in leadership decisions help them feel that their contribution is valued in the organization Our organization has a set of family-friendly policies to enhance employee productivity Family friendly policies helps employees to maintain a successful work-life balance 9. In your own opinion, how does occupational wellness programmes influence service delivery in your hospital? Explain. ……………………………………………………………………………………………… ……………………………………………………………………………………………… ……………………………………………………………………………………………… ……………………………………………………………………………………………… ……………………………………………………………………………………………… ……………………………………………………………………………………………… Section E: Physical Wellness 10. This study seeks to determine the influence of employee’s physical wellness programmes on service delivery in faith-based hospitals in Nairobi metropolitan area. Kindly indicate your opinion on the following statements. Using the scale 1-strongly disagree, 2-disagree, 3-moderate, 4-agree, 5-strongly agree. Aspects of physical wellness 1 2 3 4 5 Our organization encourages physical exercise among the employees to remain fit Physical exercise helps the employees to refresh their minds so that they can perform their tasks netter Our organization has partnered with health clubs to help employees gain healthy living tips 195 Partnering with health clubs shows that our organization promotes healthy behaviours Our organization encourages staff walking and use of stairs Walking and use of stairs helps in ensuring that the employees are physically fit Our organization organize fitness challenges to help employee compete for a prize Fitness challenges helps in ensuring that employees are physically fit Our organization provides sporting activities like football matches and races 11. Do physical wellness programmes influence service delivery in your hospital? Explain. ……………………………………………………………………………………………… ……………………………………………………………………………………………… ……………………………………………………………………………………………… Section F: Credible Leadership 12. The study seeks to determine the moderating role of credible leadership on the relationship between employee wellness programmes and service delivery in faith- based hospitals in Nairobi metropolitan area. Kindly indicate your opinion on the following statements. Using the scale 1-strongly disagree, 2-disagree, 3-moderate, 4- agree, 5-strongly agree. Aspects of Credible Leadership 1 2 3 4 5 The leadership in our hospital considered honest Our leaders inspire employees to offer best services Our organizational leaders are accountable Our organizational leaders are required to be forward-looking Our organization has competent leaders Our leaders encourage team work Our organizational leaders are required to be role models Our organizational leaders are required to be problem solvers 13. In your opinion would say you have credible leadership in your hospital ……………………... 14. Does the leadership in your hospital influence service delivery? Explain. ……………………………………………………………………………………………… ……………………………………………………………………………………………… ……………………………………………………………………………………………… 196 Section G: Service Delivery 15. Kindly give your opinion on the following statements about service delivery in your organization. Using the scale 1-strongly disagree, 2-disagree, 3-moderate, 4-agree, 5- strongly agree. Aspects of Service Delivery 1 2 3 4 5 There has been increase in customer satisfaction Customers always come back because they are satisfied with our services We have enough staff so that customers get services quickly We always have short queues in our facilities There has been an increase in accessibility of services Our patients are able to consult our staff on phone for review Our medical staff are encouraged to convey hope to our patients Our medical staff demonstrate confidence at all times We create a personal relationship with our customers We always ensure that we are consistent in delivery of services 16. How else can your organization enhance service delivery? ……………………………………………………………………………………………… …………………………………………………………………………………………….. Thank you for your participation 197 Appendix III: List of Faith Based Hospitals in Nairobi Metropolitan Area No. COUNTY HOSPITAL NAME LEVEL 1. Muranga AIC Githumu hospital 4 2. Muranga Gaichanjiru catholic hospital (Muranga) 4 3. Muranga Kiriaini Consolata hospital (Muranga) 4 4. Kiambu Infant Jesus Kalimoni Mission Hospital 4 5. Kiambu ACK Emmanuel Mission Hospital 4 6. Kiambu Holy family catholic hospital Githunguri 4 7. Kiambu Cure (AIC) International Hospital 4 8. Kiambu Kikuyu (PCEA) Hospital 4 9. Kiambu Nazareth Hospital 4 10. Kiambu Immaculate Heart Hospital Kereita 4 11. Kiambu Kalimoni Mission Hospital (Juja) 4 12. Kiambu Immaculate Heart of Mary Hospital 4 13. Kiambu Kijabe (AIC) Hospital 5 14. Kiambu St Mulumba Mission Hospital 4 15. Kiambu Mary Help of The Sick Hospital 4 16. Kajiado ST. MARY'S MISSION HOSPITAL 4 17. Kajiado Fatima Maternity Hospital 4 18. Machakos Bishop Kioko Catholic Hospital 4 19. Nairobi City Royal Victory Hospital 4 20. Nairobi City Shree Swaminarayan Hospital (Langata) 4 21. Nairobi City Nairobi Adventist Hospital 4 22. Nairobi City Jesse Kay Hospital 4 23. Nairobi City Better Living Hospital 4 24. Nairobi City Ruaraka Uhai Neema Hospital 4 25. Nairobi City St Francis Community Hospital (Kasarani) 4 26. Nairobi City The Mater Hospital 5 27. Nairobi City St Francis Com Hospital 4 28. Nairobi City Jamaa Mission Hospital 4 29. Nairobi City St Mary's Mission Hospital 4 30. Nairobi City St.Scholastica Uzima Hospital 4 198 31. Nairobi City Coptic Hospital (Ngong Road) 4 32. Nairobi City Jumuia Hospital Huruma 4 Source: Ministry of Health (2023) 199 Appendix IV: Research Authorisation from Karatina University 200 Appendix V: Research Permit 201