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Item Determinants of Hospital Emergency Preparedness in Machakos County Kenya: A Case of Machakos Level 5 and Kangundo Level 4 Hospitals(Kahare, M. M., Mwangi, E. & Njuguna, S. (2020). Determinants of Hospital Emergency Preparedness in Machakos County Kenya: A Case of Machakos Level 5 and Kangundo Level 4 HospitalsAcademic Journal of Health Systems and Reform (AJHSR), 2020-07-29) Kahare, Munanie Mercy; Mwangi, Eunice; Njuguna, SusanEmergency preparedness is emerging as a key security priority globally. Plans are needed, not only for responding to the impacts of events, but also to maintain business continuing while managing the crisis, and to guide recovery and reconstruction effectively. Machakos being along Nairobi-Mombasa highway recorded 27% increase of emergency cases in 2017, 39% 2018 in Machakos level 5. During these period deaths increased from 191 to 497 from 2016. 35% increase of referrals to other hospitals was recorded. In the face of these emergencies, the ability of affected facilities like Kangundo level 4 and Machakos Level 5 Hospital Kenya to provide care to the injured can quite literally make the difference between life and death. This study assessed the determinants of Hospital Emergency Preparedness in Kangundo level 4 and Machakos Level 5 Hospitals in Machakos County. The study adopted cross-sectional design and simple random sampling method. Whereby a sample size of 128 respondents was obtained using the Yamane 2008 formula; 49 respondents from Kangundo level 4 and 79 from Machakos level 5 hospital. Simple random sampling was applied to select respondents. Self-administered questionnaire as a data collection tool was applied. The questionnaire was developed based on the objectives and identified gaps from literature review. The finding reveals high understanding of the meaning of emergency preparedness (M = 4.29; SD = 0.67), with 94 (74%) of the respondent considering themselves prepared for emergency. The mean was 3.67; SD = 1.06. While 80 (64%) considered themselves key leadership figure in emergency preparedness. One hundred and eleven (88%) of the respondents agreed with the statement that training on emergency preparedness should be conducted quarterly with mean of M = 4.27; SD = 0.95. Respondent agreed that emergency tray is well equipped with various equipment for management of emergency with a mean of 3.51± 1.101 and that hospital has a drug supply system with drug suppliers with mean of 3.51± 1.108. Majority of the respondent agreed with the statements that financial allocation for emergencies preparedness should be increased (4.07± 1.195), and that the facility has transport and logistics support in case of any emergency (3.4 ± 1.231). The respondent further agreed with proposition that the hospital has policy in place for emergency preparedness 91 (72%) and the hospital has a clear chain of command system in case of any emergencies 83 (65%). There results showed strong and positiverelationship between commodity availability, financial resources, policies and emergency preparedness with coefficient of correlation of r=0.619, p<0.001, r=0.626, p<0.001, and r=0.702, p<0.001 respectively. The study found that policy formulation and implementation, commodities and finances significantly influenced emergency preparedness. The study variables under this study are important in determining emergency preparedness, and that emergency preparedness will work well if the variables in this study are taken into account. Therefore, hospital management need to build stable drug supply system with adequate drug suppliers. Resources should be allocated to purchase ultra-modern equipment. Additionally, clear mechanism of access of emergency commodities should be developed by hospital management and staff be made aware on it. There is need for staff participation in emergency policy formulation, guidelines, emergency plans, and lobbying for emergency preparedness. Addition institution needs to make emergency drills, safety inspections regular.